Cortisol Face: Separating Fact from Fiction

Social media influencers have popularized the term “cortisol face,” but experts warn that the real causes are far more serious

Are your clients experiencing puffy faces and swollen cheeks? Are they worried that it might be their stress levels affecting their body? Social media wants them to think they may have come down with a case of “cortisol face.” According to experts, this is a total reach and a misinformed one.

TikTok and Instagram are home to hundreds of videos discussing the issue of “ cortisol face ,” sometimes referring to it as “moon facies”: a trend bent on solving the mystery of swollen and puffy faces.

Influencers have racked up millions of views showing off their “before and after” pictures, claiming they turned to certain products and lifestyle changes to alter their appearance and slim their face. They insist that their symptoms were due to high levels of cortisol, a hormone nicknamed the “stress hormone” as it is known for, amongst its other uses, regulating the body’s stress response.

However, these influencers are not talking about the actual “cortisol face” at all. They are dangerously misusing a term that’s attributed to serious health conditions.

What is “cortisol face”?

Real “cortisol face” or “moon facies” is a medical issue, typically caused by a rare medical condition, like Cushing’s Syndrome, hypothyroidism, or a pituitary gland tumor, or from taking prescription corticosteroids. According to author and women’s health expert Dr. Mindy Pelz , typical stress levels will not affect the average person and give their face that “puffy” look.

“Social media has warped the concept of cortisol face,” Dr. Pelz told Athletech News. “It’s a symptom of a rare and serious medical condition, not the result of everyday stress.”

While cortisol can create inflammation, Dr. Pelz maintains that it will not lead to noticeable facial swelling in the average person.

In real scenarios of “cortisol face,” an individual has extremely high levels of cortisol and experiences inflammation and increased fat deposits in the cheeks. This can also be paired with anxiety, memory problems, poor sleep, and hypervigilance, which is when an individual feels unable to relax, says Dr. Pelz.

“Normal stress won’t cause nearly enough cortisol release to produce cortisol face,

Dr. Pelz said. “The truth is cortisol face is not a realistic concern for most people—and if you do have cortisol face you should visit a doctor.”

If an individual is experiencing facial swelling, chances are it is rooted in something much more treatable, like an allergic reaction or infection.

Allergic reactions to substances such as dust, pollen, or other allergens can cause swelling symptoms. Sinusitis is another possible explanation for a puffy face, often causing swelling to the cheeks, eyes, or forehead. Some individuals wake up with a puffy face simply because they slept in a position where their face was pressed against their pillow.

Exercise & Cortisol

Fitness professionals should also be aware of the exercise/cortisol connection and how it might legitimately affect clients. While “cortisol face” may not be a realistic concern for most people, certain exercises, particularly High-Intensity Interval Training (HIIT), can affect cortisol levels in the body.

HIIT has gained popularity as an efficient exercise method that can improve various aspects of physical fitness , including metabolism, body composition, and insulin sensitivity. However, excessive HIIT without proper recovery can lead to elevated cortisol levels, potentially resulting in overtraining syndrome.

To maximize the benefits of HIIT while avoiding its potential negative effects, experts recommend limiting HIIT sessions to 2-3 times per week and prioritizing recovery between workouts. Recovery practices may include adequate sleep, proper nutrition, meditation, and other stress-reduction techniques.

While HIIT can be an excellent addition to program design, it’s important to approach it mindfully and monitor a client’s progress. If they experience persistent fatigue, mood changes, or other symptoms of overtraining, it may be time to reassess the program and refer the client to a healthcare provider.

What should a client do if they think they have a “cortisol face”?

According to Dr. Pelz, it is always wise to ask a doctor if you have concerns about facial swelling.

“If you’re experiencing significant facial swelling or sudden fat deposits in your cheeks, go to a doctor for a hormone test,” Dr. Pelz said. “You may have an autoimmune or thyroid disorder, or be experiencing side effects from taking prescription medication.”

While most people probably do not have an actual “cortisol face,” there are always ways to manage stress levels to maintain a healthy level of cortisol in the body.

To do so, Dr. Pelz always recommends maintaining a balanced diet to increase your resilience to stress.

“Taking magnesium and vitamin B12 can make a big difference, as stress depletes both nutrients,” Pelz said. “Long-term stress can cause more serious problems, like insomnia, depression, weight gain, and  increased heart disease and cancer risk.”

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