Cortisol Face: What Is It and Do I Have It?

What is cortisol and what is its function in the body?

Sudha Penumala, MD: Cortisol is a hormone that is produced by the adrenal glands. People often refer to it as the stress hormone. Its function is vast and complex. It plays a role in stress response, blood pressure control, metabolism, electrolyte balance, inflammation, blood sugars and much more.

What are some common signs of both high and low cortisol?

Sudha Penumala, MD: Signs of low cortisol can include low blood pressure due to volume depletion, fatigue, abdominal pain, darkening of the skin, fever, decreased appetite, confusion etc.

Excessive cortisol levels can lead to weight gain, especially in the face and belly. Other effects include facial redness, acne, muscle weakness, irregular periods and extra hair growth.

What factors can contribute to elevated cortisol levels?

Sudha Penumala, MD: Stress, illness, alcoholism, obesity, pregnancy, malnutrition, anorexia, intense chronic exercise, adrenal disorders, pituitary disorders, certain cancers etc.

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How do I know if my levels are high? How do I test my levels?

Sudha Penumala, MD: If a person has some of the symptoms suggesting a high cortisol level, the first thing they should do is to discuss it with their doctor. Providers can order different tests when they suspect that levels are too high. Tests can include looking at cortisol in blood, in saliva and in urine.

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Can changes in cortisol levels impact facial appearance, such as causing puffiness? Where on my body should I look for bloating or swelling?

Sudha Penumala, MD: Yes, inappropriately elevated cortisol for a long period of time can change the face shape. It causes more rounding of the face.

Typically, there is weight gain in the face and in the abdomen. It can also cause fat accumulation at the back of the neck.

People sometimes refer to the term “cortisol face” as “moon face.” From a medical perspective, what do these terms mean?

Sudha Penumala, MD: From a medical point of view, we use the term "moon face" to describe a rounder face in patients. This term can also be used to describe the face shape of a patient with high cortisol levels. “Cortisol face” appears to be a term used more in social media. This term can be misleading, as it’s suggesting a relation to cortisol, however, it may or may not be related.

Some social media users say they have reduced "cortisol face." They did this by lowering cortisol levels, using stress management, facial exercises or dietary changes. Is there any truth to this?

Sudha Penumala, MD: Increased stress can raise cortisol levels. However, it often does not rise high enough or last long enough to change their face. Managing stress has many benefits. It can also help reduce swelling or puffiness.

If the facial swelling is from water retention or fat buildup, dietary changes or facial exercises can help.

If a medical issue causes facial puffiness due to too much cortisol, lifestyle changes may not help. Stress management, exercise and diet changes might not make a difference.

In general, should a healthy person be concerned about "cortisol face"? Or is it just a social media trend?

Sudha Penumala, MD: An average healthy person should not worry about "cortisol face." Some mild changes to our face will happen as we age. If you notice a big change in your face's structure, talk to your doctor. This is especially important if your family and friends notice it too.

If you’ve noticed unexplained facial puffiness or other symptoms of hormone imbalance, it could be more than just stress. Don’t rely on social media for answers—talk to your doctor.

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