Recently, during my standard late-night TikTok scroll, a video popped up on my feed. In it, a woman seemed to speak directly to me, saying: “You’re not ugly, you just have cortisol face.”
Bold messaging, but okay.
Since then, “cortisol face’ has continued to cross my feeds. The term is all over social media. If we’re being honest, it smacks of Internet wellness talk, which often…well, isn’t necessarily rooted in science or fact.
The term “cortisol face” feels new, but online chatter about cortisol is definitely not. People on social media often talk about doing things to “lower their cortisol” or claim certain habits (like checking their phone first thing in the morning, for example) “spikes their cortisol levels”.
So is “cortisol face” a real thing, or another example of unchecked medical misinformation? Obviously, the latter runs rampant on social media, so let’s get to the bottom of this particular social media talking point.
Cortisol *is* a real thing
According to the Mayo Clinic, cortisol is the primary stress hormone our bodies create, and it affects our bodies in some real (and very unpleasant) ways. When cortisol is released, it can put our bodies into “fight or flight” mode. The good news? Typically, our bodies regulate themselves, and after our stress response passes, those hormones return to baseline. However, too much exposure to cortisol can lead to issues ranging from anxiety and muscle tension, to even heart disease.
So yeah, reducing stress — and thereby reducing cortisol — is good for our overall health. But is it actually making you “ugly”, as social media suggests?
First of all, let’s unpack what these social media users are actually saying here
They’re telling people that excess cortisol can make their faces appear puffier. For the record, contrary to what the beauty standards tell us, rounder faces are not “ugly”, and every single one of us will experience changes in the way we look, sometimes year-to-year and sometimes day-to-day (ever looked in the mirror and noticed your face looks different after a night of bad sleep or a super salty meal? Because same).
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So yes, cortisol is a real thing, and it affects your body in real ways.
And yes, various factors can affect the way your face looks. But the relationship between these two things? It may not be as prevalent as social media leads us to believe.
Let’s talk cortisol and face shape
There are certain conditions that can cause “moon face”, or facial swelling that produces that rounded, puffy look. For the purpose of the “cortisol face” conversation, Cushing’s Syndrome is the most relevant.
Cushing’s syndrome is a condition that results when your body produces too much cortisol. It can be caused by long-term steroid use, your pituitary gland producing too many hormones, high stress levels, and certain tumors. According to the OHSU Brain Institute, Cushing’s Disease is a type of Cushing’s Syndrome, and occurs when a pituitary tumor causes the body to make too much cortisol. This accounts for about 70 percent of Cushing’s Syndrome cases.
People who notice a little swelling on their faces — coupled with the assertions on social media that “you have cortisol face” if you’re seeing that swelling — may jump to conclusions that they’re dealing with Cushing’s Syndrome.
But before you go there, let’s check in with what the experts have to say.
One family and obesity medicine doctor, Dr. Jennah Siwak, shared a TikTok adding her commentary to the “cortisol face” discourse — and it's the science-backed take we need.
“While it is true that cortisol is our body’s stress hormone, and when we are stressed we may release more of it, this doesn’t mean you have a pathological disease. It doesn’t mean there’s an underlying hormonal disorder,” she says.
“Cortisol elevation from stress alone — not in the setting of a true hormonal issue like Cushing’s disease and Cushing’s syndrome — is not going to be enough to change somebody’s visible appearance, or at least that would be very, very, very unlikely,” Dr. Siwak adds. “A puffy face could be someone’s normal appearance, or it could indicate one of many potential things: It could be seen with aging, it could be seen with allergy, with infection, with thyroid issues, fluid retention such as from eating a higher salt diet.”
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Don’t let “cortisol face” content get under your skin
You probably don’t have to put much stock into those viral social media videos that suggest you need to take up multiple “self-care” practices like lymphatic drainage massages or shelling out a bunch of supplements or taking up daily meditation or whatever. You obviously can do those things — but let’s be real: Social media misinformation can be a *source* of stress, and adding a bunch of these wellness practices can make anyone feel even more overwhelmed. Which is ironic, because this particular social media fad is all about stress reduction, when it comes right down to it. It’s also all about making us feel insecure about the way we look, which…come on, people. Can’t we leave that behind already?
One TikTok video nails the deeper effect of all this “cortisol face” (beyond the medical misinformation of it all)
“Every other freaking video on my ‘for you’ page is assaulting me about my cortisol levels. It’s like, does anybody even know what that means? Because up until a year ago nobody was talking about this,” a TikToker with the handle @astoldbyvee says. “It comes from stress…well girl, you’re stressing me out. Now I’ve got to figure out cortisol levels”
Luckily, we have experts on the apps as well, who can help us break down why worrying about “cortisol face” is…probably not worth your energy (unless of course you feel like something larger may be going on in your body, in which case it’s always a good idea to check in with your doctor).
“Does everyone who has a little bit of roundness in their face have Cushing’s Syndrome or high cortisol? Not even close. The actual rate of high cortisol levels, or Cushing’s Syndrome, is 40-70 out of every million people,” says Karen Tang, MD in a TikTok clip commenting on the “cortisol face” fad.
So there you have it. Obviously, if you have worrisome symptoms, check with a medical provider. But if you’re finding yourself stressing out about this content, remember: True cortisol issues are far more rare than this type of wellness-y content suggests.
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.