Experts warn against influencer claims that stress causes ‘cortisol face’

‘I can medically explain through a constellation of factors – as opposed to just one,’ doctor says

Influencers are claiming facial swelling – called ‘cortisol face’ – is caused by high levels of cortisol (Getty Images/iStockphoto)

Influencers on TikTok have been blaming a bloated, puffy face on “cortisol face.”

In a recent TikTok video, wellness influencer Mandana Zhargami explained to viewers that they weren’t “ugly,” but that their faces were bloated from high levels of cortisol, a “stress hormone” known for regulating the body’s response to perceived threats, whether it’s actual danger or, in our modern era, pressures from the office. Cortisol typically regulates glucose, metabolism, and blood pressure.

Zhargami’s hormonal wellness journey began after a 2020 doctor’s visit, in which her doctor at the time told her that stress was to blame for her visibly bloated face and abdomen. She was then motivated to find tools to help her combat her stress. Through trial and error, she found that lifestyle changes including drinking diluted apple cider vinegar in the morning and green tea throughout the rest of her day. Physically, she stopped weight lifting and practiced more low-impact exercises like yoga.

The influencer credits these changes with reducing not only her cortisol levels but also the swelling in her face.

“I did a lot of research on how to fix this naturally,” she told viewers, claiming that “cortisol face” could be tackled holistically without drugs or expensive products. As she dispensed advice and peddled her “hormone-balance tea” – which she sells from her shop – to combat “cortisol face,” more influencers and content creators like her have pushed the narrative that stress causes a more rounded face. Some have claimed that after trying hormone-friendly diets or teas like the one Zhargami sells, they achieved slimmed-down jawlines and svelte faces.

However, Dr Cristina Psomadakis – a dermatologist based in London – noted that this attempt to “medicalize” a rounder face may be symptomatic of trying to exercise control when people have none.

“I think the ‘cortisol face’ trend is trying to explain a perceived cosmetic issue, like a round face, and trying to medicalize it, in order to be able to take control of fixing it,” Dr Psomadakis explained to the New York Times. “All the symptoms that people are describing, I can medically explain through a constellation of factors – as opposed to just one.”

Cortisol has been singled out online as the culprit for fatigue and stomach bloating. Cortisol may spike temporarily in response to not only stress but lack of sleep as well as consumption of alcohol or foods higher in salt and sugar. However, since cortisol levels fluctuate regularly, the body ordinarily keeps the levels in check.

Those posting their “cortisol face” transformations might be spreading misinformation on how they achieved their slimmer looks. Dr Psomadakis explained that the majority of the transformations shared may instead indicate weight loss or gain or the natural migration of facial fat pads.

Through a series of blood tests, doctors can also determine whether or not a patient has abnormally high levels of cortisol as opposed to slightly elevated cortisol levels. There is one serious condition with facial swelling symptoms called Cushing’s syndrome, in which the body produces too much cortisol. However, Cushing’s is rare and normally caused by taking steroid medication for another condition rather than simple everyday stress.