Does high cortisol cause moon face?

Do you have a puffy face or eyes? And have you come across a reel identifying its potential cause? Then you’ve probably heard a health influencer claim it's a sign of high cortisol - the “stress hormone” that has the potential to change the way your face looks.

“High cortisol can silently change the way your face looks,” claims a TikTok video with 1.5 million views and 20,000 likes. Another video with 11.6 million views claims that lowering cortisol levels may lead to “unbelievable transformation.” Videos also recommend reducing cortisol levels with the help of certain food items. 

The health influencer industry is booming, but as they offer hacks and break down health issues, chances are they may be providing misleading or harmful information. Amid this phenomenon, we found multiple videos with millions of views claiming that high levels of cortisol can lead to a moon-like face or puffy face and puffy eyes. Many videos and posts also claim that cortisol levels are responsible for a lack of sleep and other conditions like general lethargy,  brain fog, or dull skin. 

But the science behind the hormone is not straightforward and social media handles are exaggerating its potential adverse effects, experts told Logically Facts. So can you treat it with over-the-internet-available techniques? 

Social media posts explain the signs of high cortisol levels and suggest hacks to reduce them. (Source: Tik-Tok and Instagram)

Understanding the science behind cortisol

Cortisol is a hormone that the adrenal glands produce and release. High or low levels of cortisol may lead to two common problems: Cushing syndrome (suggesting high levels) and Addison disease (suggesting low levels). Cushing syndrome affects 10 to 15 people per million every year, and Addison disease is also very rare. 

Despite many influencers claiming certain signs indicate worrying levels of cortisol, having elevated cortisol for extended periods can only be assessed by a doctor through testing. Additionally, high corticosteroid levels due to general stress levels cannot cause the moon-face. Simple stress alone is unlikely to cause changes in face or skin texture. 

“Determining cortisol levels based solely on the appearance of an individual's swollen face may not be straightforward. While facial puffiness can be a symptom associated with elevated cortisol, it is essential to consider that various factors, including diet, hydration, and other health conditions, can also contribute to such physical changes,” endocrinologist Mahesh D M told Logically Facts. “Therefore, a comprehensive assessment that includes medical history and laboratory tests would provide a more accurate understanding of cortisol levels rather than relying on visual cues alone.”

Furthermore, cortisol levels vary throughout the day and are a natural phenomenon with it being highest early in the morning and lowest at about midnight, according to University of Rochester’s encyclopedia. It also explains how abnormal cortisol levels are often caused by long-term use of steroids used to treat certain medical conditions like asthma.  

This explains how there are general spikes or dips in cortisol levels during the day. We referred to Harvard Health blog posts on cortisol levels and adrenal glands which unpacks how our bodies release short bursts of cortisol under stress. Additionally, if the brain continues to perceive something as dangerous, it may prompt adrenal glands to release cortisol, but they fall once the threat passes. 

“Social media content frequently highlights the potential adverse effects associated with its usage, often exaggerating or overly simplifying the subject,” Mahesh said. “The relationship between cortisol levels and various physical manifestations, such as facial roundness and puffiness around the eyes, is a topic of considerable interest in both scientific and popular discourse. The notion that social media attributes a wide array of health and aesthetic issues to elevated cortisol levels may stem from a simplified understanding of the hormone's effects.”

It's more complex than just dietary changes

A continuous rise in levels may also lead to health conditions that require medical intervention. However, TikTokers routinely provide simple steps to reduce cortisol levels. Posts also recommend food, diets and lifestyle changes like exercise and meditation. For instance, an influencer in this video says, “Breathwork before bed, turn off overhead light 60 minutes before bed, and get outside in the sun within 60 minutes of waking.” Another recent video with 1.5 million views explains how to make a “cortisol mocktail recipe.”  

Speaking to Logically Facts, London-based nutritionist Ursula Arens said, “I am not aware of any data that dietary modification has been able to clearly and consistently lower levels of cortisol in the body.” 

These videos have one thing in common: they implore that cortisol is bad and why one should reduce or control it. However, cortisol has many functions, such as mediating the stress response, regulating metabolism and the inflammatory response, and regulating blood pressure and blood sugar. 

“Your body has an elaborate system to regulate your cortisol levels, " according to the Cleveland Clinic. Arens also highlighted that it is essential for glucose metabolism since it  “increases glucose release from the liver (where it is stored as glycogen) and also supports the production of glucose (gluconeogenesis) from amino acids (breakdown products from protein).”

Mahesh also stresses the fact that “while cortisol can indeed be a contributing factor to certain health issues, attributing a broad spectrum of conditions solely to this hormone oversimplifies the complex interplay of biological and environmental influences on human health.”