TikTok is flooded with hot takes on beauty and wellness, and sometimes the two collide. Enter: cortisol face. A wave of creators on social media are linking a round, puffy face to elevated levels of the stress hormone cortisol—calling it “cortisol face” or “moon face.”
Cortisol is a steroid hormone produced and released by the adrenal glands, according to the Cleveland Clinic. It influences nearly every organ and tissue in the body, playing a role in regulating the stress response, metabolism, inflammation, and the sleep-wake cycle.
In one viral clip, TikToker Mandana Zarghami says, “You’re not ugly. You just have cortisol face.”
But is there truth behind the trend? Can high stress really change how your face looks? Doctors break it down.
What is cortisol face?
There’s no clinical definition of “cortisol face”—it’s not a recognised medical condition. That said, the general belief is that cortisol face refers to changes in the appearance of the face when cortisol levels are consistently high.
“Cortisol face is not a real medical condition,” says Dr Cindy Wassef.
Cortisol is released during periods of stress, both acute and chronic, adds dermatoloists Dr Ife J. Rodney.
What’s being discussed online is the idea that ongoing stress and raised cortisol levels may lead to puffiness or swelling in the face.
What causes cortisol face?
Plenty of people on social media claim that higher cortisol levels caused by stress will lead to a round or puffy face—but that’s not entirely accurate.
Cushing’s syndrome
There is a rare medical condition known as Cushing’s syndrome, which is linked to excessive circulating cortisol, explains endocrinologist Dr Luma Ghalib. In people with Cushing’s syndrome, “too much cortisol leads to a more rounded face, pinkish-red cheeks, thinning of the skin with easy bruising, a puffy neck and a more prominent upper back hump,” she says.
However, endocrinologist Dr Christoph Buettner says Cushing’s syndrome is rare—and unlikely to cause just a round face on its own. “To claim that an isolated round face without these other symptoms is caused by Cushing’s is misleading,” he adds.
“Stress doesn’t only result in high cortisol,” Dr Buettner explains. “It also elevates other hormones throughout the body.”
So, what could actually be behind changes in facial appearance?
Certain medications
Stress alone is unlikely to reshape your face, says Dr Rodney. However, long-term use of corticosteroid medications (such as prednisone) can lead to a condition called “moon face,” where the face becomes noticeably rounder, adds board-certified dermatologist Dr Gary Goldenberg.
“You’ll only see this with extremely high corticosteroid use for specific medical conditions,” Dr Rodney notes. “That’s different from the elevated cortisol you might get from stress.”
Dr Wassef agrees: “While emotional or life-related stress can increase cortisol levels, the spike wouldn’t be high enough to visibly change your face.”
Diet changes
Stress eating is common—and that could be what’s actually behind a fuller face, says Dr Buettner. “If you’re stressed and eating more, any weight gain can affect the shape of your face,” he says. “That’s not directly caused by cortisol—it’s caused by behaviour.”
Sodium and water retention
This varies from person to person, but research has found that some people retain more sodium when they’re under pressure, while others lose more through urine. If you’re feeling frazzled and consuming a high-sodium diet, you may notice a bit of puffiness, Dr Rodney says. Still, it not a given.
Signs of cortisol face
TikTok users often describe cortisol face as having a puffy, rounded face. While it’s not a recognised medical term, experts say chronic stress may affect facial appearance in more subtle ways.
“Stress hormones have been shown to age the skin and reduce collagen and elastin, which are crucial for a more youthful look,” says Dr Goldenberg.
Prolonged stress may also influence behaviour that impacts facial appearance. For example, disrupted sleep—common during stressful periods—can increase the risk of under-eye circles and puffiness, says Dr Wassef.
Cortisol face treatments
Because cortisol face isn’t a medical diagnosis, there are no specific treatments. However, if facial puffiness is new, noticeable and persistent, it’s worth investigating.
“If you’re experiencing new or ongoing facial swelling, speak with your GP,” says Dr Buettner. “It might be something simple, like excess salt intake or it could be linked to something more serious—such as Cushing’s syndrome, although that’s rare and usually accompanied by other symptoms.”
If your GP suspects Cushing’s syndrome, they may order tests such as a 24-hour urine cortisol test, salivary cortisol test or blood work. These help assess cortisol levels and check for hormonal imbalances.
Still, experts caution against jumping to conclusions. “There are many factors that can cause skin puffiness,” says Dr Rodney. “I wouldn’t immediately blame stress alone.”