Is ‘Cortisol Face’ a Real Thing?

“Cortisol face”: You may have seen it referenced on social media as the reason for a fuller visage. But is this just another TikTok trend designed to make us feel insecure, or could there be a medical reason for a suddenly puffy face? For answers, we turned to Sara Szal Gottfried, M.D., an integrative health physician and author of The Autoimmune Cure.   

First, let’s get to the bottom of what cortisol is. The hormone is essential to a number of bodily functions, produced in the body to help manage our metabolism, as well as fat, protein, and carbohydrates. “Its main job is to increase glucose to provide energy and modulate the immune system, the source of inflammation,” Dr. Gottfried says. 

In some cases, very high levels of cortisol in the body may be linked to a medical issue such as diabetes, taking high doses of corticosteroids, or poor sleep habits. This can make one’s face appear puffy or full. However, often there are other culprits responsible for the change in appearance, as factors such as diet, eczema flare-ups, allergies, and high salt intake can cause the face to look more puffy. 

Then there’s the stress component in raising your cortisol levels. “In the absence of a medical reason, such as PCOS or enzyme deficiencies, what I see as a cause [of facial inflammation] is high perceived stress,” she says. “People who have high perceived stress and chronically high cortisol levels tend to have more inflammation, which can show up as a puffy face and hands.”

If you notice your face or other body parts looking fuller, consult with a physician to determine whether medical issues are to blame. If a health care provider rules out conditions such as PCOS and diabetes, or prescribed medications as the cause of the inflammation, then consider adjustments to lifestyle. “Once medical reasons are excluded, I recommend addressing the root cause, such as learning how to address chronic stress in a new way,” Dr. Gottfried says. “Most people begin with yoga, meditation, or exercise.” The doctor also suggests using wearable tech (such as an Apple Watch) as a way to help track and measure stress, and working with your doctor to have healthy cortisol levels. And if you’ve ruled out any medical issues and just happen to have rounder features, don’t let anyone on social media make you feel ashamed about your face shape.