Is Stress Ruining Your Face? A Health Coach Breaks Down "Cortisol Face" (Exclusive)

During a time that Forbes deemed "The Digital Revolution," short-form content platforms like TikTok have us scrolling like zombies as new trends, products, challenges, and buzzwords are routinely fabricated. It's admittedly frustrating when trending phrases create a sense of paranoia about health and insecurity about physical appearance. Oftentimes, it seems as though the internet wants us to be in a perpetual state of wondering, "What's wrong with me?"

One phrase that falls under this category is "cortisol face," sometimes called "moon face." I could've gone my whole life not thinking about whether or not my face looks abnormally puffy and bloated, but perhaps more health knowledge is better (minus the fearmongering).

Hoping to understand what cortisol face actually is, and how to treat it, I spoke via email with Harvard-trained nutrition health coach Sam Cutler. Having completed the Ivy League medical school's certificate program "Designing a Sustainable Nutrition Plan," Cutler launched her health coaching and meal planning app MINDFULL in April 2024.

With holistic health strategies and "lifestyle medicine" at the forefront, Cutler exclusively relayed simple lifestyle changes that may help with facial puffiness.

As always, this article is not meant to be used as medical advice. Talk with your physician before making any significant lifestyle changes.

According to Mayo Clinic, cortisol is a steroid hormone produced and released by the adrenal glands. The glucocorticoid hormone is responsible for regulating the body's stress responses. Furthermore, glucocorticoids subdue inflammation, control your metabolism, and affect the body's sleep-wake cycles.

Mayo Clinic notes that a key sign of cortisol levels being too high is weight gain, especially in the abdomen or face, the latter being deemed "cortisol face."

Unfortunately, TikTok ran with this information, and has the average person who is experiencing facial puffiness assuming it's solely due to high cortisol levels.

Board-certified dermatologist and skincare education content creator Dr. Shereene Idriss, M.D., put out an April 2024 TikTok debunking ideas about cortisol face.

"It is when you have chronic swelling and puffiness in your face due to chronic stress, which may lead to increased cortisol levels affecting your face," she says of cortisol face. "Facial swelling and puffiness cannot be attributed to a single cause alone, like cortisol."

Dr. Idriss goes on to list lack of sleep, anxiety, stress, inability to process processed foods, sugar, salt, alcohol, medications, and underlying conditions as the various causes of facial puffiness.

Sam Cutler — who's made lifestyle changes to heal her own chronic inflammation and severe adult acne — mentions several of these factors.

"This puffiness or roundness in the face is a visible sign of how stress can manifest physically. That stress comes from a variety of lifestyle factors, like work and home situations, but is also tied to environment, nutrition, and other lifestyle habits," she tells Green Matters, noting that eating ultra-processed ingredients can harm the gut lining and further contribute to inflammation.

Concerning lifestyle changes that can help target the appearance associated with cortisol face and general puffiness, Cutler mentions an anti-inflammatory diet, the incorporation of stress-reduction techniques like meditation and yoga, exercise, hydration, and adequate sleep.

"Switching to a diet rich in whole, anti-inflammatory foods like fruits, vegetables, and healthy fats helped reduce facial puffiness and promote overall skin health," she says of her own experience with face inflammation.

Additionally, Cutler points to facial massage — an ancient technique with roots in countries like China, Mexico, France, and Sweden, as per British Vogue — as a method for minimizing facial puffiness.

"Facial massage and lymphatic drainage can help reduce face puffiness by stimulating circulation and promoting the removal of excess fluids," she shares.

Because the "cortisol face" video trend is arguably part of a larger problem — some people falsely self-diagnosing themselves with Cushing syndrome — I asked Cutler about her thoughts on self-diagnosing based on TikTok trends.

Though she says it's "understandable that people want to find quick solutions to their health concerns," she notes that self-diagnosis based on "misleading" TikTok trends is a problem.

"We should use these videos to inspire us to make 'better for us' choices ... we can never see the full picture in a short clip," she explains. "The changes in my face weren’t just about reducing cortisol; they were about addressing the root causes of inflammation and stress in a holistic way, which is something that trending topics on TikTok often overlook."