Another day, another TikTok mass diagnosis trend is sounding the alarm on our health. Thousands of videos on the app have users talking about “cortisol face” or “moon face,” characterized by a round, puffy appearance due to excess levels of cortisol, commonly known as the stress hormone. The condition often brings with it inflammation, facial swelling, and bloating.
It’s not so much the condition itself that’s causing concern among medical professionals and skeptical users; rather, it’s the perception the trend is creating of it being extremely common and self-treatable that’s unsettling. While many users are claiming stress is causing their puffy facial appearance — after all, who isn’t stressed these days? — the question remains: Is cortisol face really something we have to worry about? PS got to the bottom of this concerning trend.
Experts Featured in This Article
Caroline Messer, MD, is an endocrinologist at Fifth Avenue Endocrinology and Founder of Well by Messer.
Lucky Sekhon, MD, is a double board-certified reproductive endocrinology and infertility (REI) specialist and OBGYN at RMA of New York.
What Is Cortisol Face or Moon Face?
“Cortisol face is a description of the face as it gradually becomes rounder and fuller due to excess cortisol,” endocrinologist Caroline Messer, MD, tells PS. “It’s [often] referred to as ‘moon face’ because the face appears so puffy that the ears are unable to be visualized, and the face becomes a near-perfect circle. The roundness can be exacerbated by fat deposits on the site of the skull.”
The main culprit behind cortisol face is long-term exposure to high cortisol levels, explains Lucky Sekhon, MD, reproductive endocrinology and infertility (REI) specialist and OBGYN. “It’s a term you’ll hear in medical circles, especially when talking about conditions like Cushing’s Syndrome, which involves excess cortisol.”
Essentially, cortisol face can be caused by any condition that significantly increases cortisol in the body. Dr. Sekhon says that these elevated levels can cause the body to retain water and redistribute fat, which explains the puffy appearance that users associate with the condition. Cortisol face can be triggered by taking high doses of steroids for medical conditions, pituitary tumors that stimulate the adrenal gland to produce cortisol, and adrenal tumors that overproduce cortisol.
Unlike many TikTok claims, “high stress does not result in sufficiently elevated levels of cortisol to present with cortisol face,” says Dr. Messer. However, “stress eating may lead to weight gain in the face that mimics cortisol face.”
Though moon face isn’t a rare condition per se, “it’s typically a temporary condition that improves once your cortisol levels normalize. However, if the cause of the elevated cortisol sticks around or comes back, so can the puffiness,” says Dr. Sekhon.
What Are the Signs of Cortisol Face?
If you notice your face looking noticeably rounder and fuller around your cheeks and neck, Dr. Sekhon says it’s possible that higher cortisol levels may be to blame, but the cause is likely something deeper than just an uptick in stress. “Other signs include weight gain around the belly, fatigue, and high blood pressure,” which she notes are similar symptoms to Cushing’s Disease, characterized by excessive cortisol due to tumors and other issues affecting hormone regulation. “The vast majority of suspected cortisol faces are actually just due to weight gain,” says Dr. Messer. She goes on to explain that changing your eating habits, exercising, and weight loss medications (as needed and approved by a doctor) can help if it’s something you’d like to address.
How to Combat Cortisol Face
To tackle cortisol face, that is, if you truly have it, you need to address the underlying cause of your elevated cortisol levels. “This could mean medication for conditions like Cushing’s Syndrome, adjusting or reducing corticosteroid use with your doctor’s guidance, or making lifestyle changes to lower stress. Diet and exercise can also help. Surgery is usually a last resort, used in severe cases with tumors causing the excess cortisol,” Dr. Sekhon says.
Is Cortisol Face Really Something to Worry About?
The short answer here is no. “Actual cortisol excess or Cushing’s Syndrome is not common at all. Cortisol face is not going to happen if you are tired or stressed – but you can retain fluid, have a puffy face, and not feel your best due to being tired, ingesting high sodium foods, and unhealthy lifestyle choices,” says Dr. Sekhon, which includes drinking heavy alcohol, not getting enough sleep, and more. “While cortisol face can be worrying, it’s often not a reason to panic unless you have other serious symptoms suggestive of an actual hormone imbalance,” she adds. The best way to determine this is by consulting with your healthcare provider.
Dr. Messer notes that if you’re interested in testing your cortisol levels, do not do so if you’re on birth control pills. “[The cortisol levels in your blood] will be falsely elevated due the birth control pills and will cause unnecessary stress and additional testing.”
Just remember: take everything you read (or watch) online with a grain of salt. “Social media trends can sometimes blow things out of proportion, so it’s best to seek professional advice,” says Dr. Sekhon
Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well+Good.
