Unpacking ‘cortisol face’: When should you worry about facial puffiness?

“Cortisol face is a made-up term.”

If you’ve scrolled through TikTok in the last couple of months, you’ve almost certainly heard of ‘cortisol face‘. If not, let me fill you in. Cortisol is a stress hormone triggered by – you guessed it – stress. Wellness and beauty influencers are now claiming that high cortisol levels, rather than your natural bone structure, are the real culprits behind your puffy face. 

To demonstrate their point, these influencers invariably share photos of themselves before and after trying a ‘miracle’ cortisol-lowering product (linked in their Amazon storefront, of course). The idea insinuates that if your face is round, you must be stressed. If you can lower your stress levels (by using the product they’re promoting), your face will de-puff – a simple solution to what they see as a common insecurity.

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I’m aware that I’m probably not the target audience for these TikToks. Thanks to having my wisdom teeth removed in 2016, I have been left with well-defined cheekbones. Still, after watching all the before-and-after videos, I found myself wondering if my face did look a bit puffier. Could I have a cortisol face? Or is this just another way for influencers to capitalise on our insecurities?

Is ‘cortisol face’ even real?

I set out to learn whether or not cortisol can actually change our facial appearance. According to Dr Ada Cheung, an endocrinologist and professor at the University of Melbourne, it’s unlikely – high stress levels alone won’t change how our faces look. 

Cortisol levels naturally vary throughout the day and increase when our bodies are under stress. These are normal physiological mechanisms that don’t result in a rounder face shape. “People who are describing facial swelling due to stress – there is no objective data that this is because of cortisol. ‘Cortisol face’ is a made-up term. There are many reasons that people may feel their face is puffier, [such as] sleep deprivation, water retention, weight gain, or allergies,” Dr Cheung says.

Despite the lack of evidence, many hacks claiming to reduce cortisol levels and improve facial puffiness have gone viral on social media. Avoiding your phone when you wake up, making ‘adrenal mocktails’ with a cortisol-reducing powder, and taking hormone-balancing supplements are just some of the alleged cures for cortisol face. We’ve all heard that certain beauty tools, like jade rollers, can help momentarily decrease facial puffiness, so these tips don’t seem outside the realm of possibility. 

But should we count on influencers for a cortisol-lowering cure? “There is zero scientific evidence for any of these,” Dr Cheung says. While some of these tips can still be a nice act of self-care, be wary of any products claiming cortisol-reducing powers – it’s probably just a cash grab. 

When should you worry?

Although TikTok’s ‘cortisol face’ isn’t something to worry about, it’s important to note that in some rare cases, sustained high levels of cortisol over weeks or months could potentially change our facial appearance. According to Dr Cheung, such high levels are indicative of a condition called Cushing’s Syndrome or result from prolonged usage of a corticosteroid medication. 

If you’ve been experiencing a puffier face than usual, don’t let hypochondriac tendencies get the best of you. Dr Cheung says that many other symptoms accompany Cushing’s Syndrome besides a rounded face, including muscle weakness, a fatty hump between the shoulders, bruising, thin arms and legs and wide purple stretch marks on the skin. The condition can also lead to high blood pressure, bone loss, infections and type 2 diabetes. To address these concerns, you should turn to your doctor rather than the TikTok For You Page.

While stress may not affect our facial appearance, it can still play a huge role in making all of us feel a little bit worse, mentally and physically. If stress is affecting your quality of life, your sleep or your appetite, reach out to your healthcare provider. 

You can learn more about reducing stress here.