'Cortisol face': Medical and fitness experts dissect the new social media trend

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Another day, another social media trend. This time, the trend has less to do with viral dances and more with a phenomenon that creators believe has seemingly innocuous symptoms. We're referring to the ‘cortisol face' or the ‘moon face', typified by swelling or puffiness on the face.

"In this phenomenon, your cheeks appear fuller, rounder or puffier than usual. Over time, your face may take on a more swollen or bloated look," explains Dr Salaah Qureshi, MD at Qure Clinic.

A content creator talks about cortisol face in an Instagram reel. Pic Courtesy/Instagram

Integrative lifestyle expert, Luke Coutinho adds, "High cortisol levels can lead to fluid retention, causing facial puffiness. While not everyone with elevated cortisol will develop these changes, it's common among those experiencing chronic stress, prolonged anxiety, or conditions like Cushing's syndrome."

No cause for alarm

The hormone's bad reputation comes down to a growing concern about the adverse effects of stress among people. Since the body releases the hormone when it experiences stress, it is easy to make the oversimplified correlation of cortisol being bad for you. Dr Pranav A Ghody, endocrinologist at Wockhardt Hospital in Mumbai Central warns against casting the blame on the hormone. He explains, "Some social media influencers have termed all facial puffiness as ‘cortisol face'. Cortisol is a steroid hormone produced by adrenal glands [small triangular glands situated above each kidney]. It does much more than just respond to stress - our body requires it for vital functions such as maintaining blood pressure, blood sugar and regulating a response to inflammation, among others. A temporary rise in cortisol levels does not cause facial changes," Dr Ghody further clarifies that such changes only occur when the body produces excessive cortisols over a period of several months or years. However, this is much rarer than social media would have you believe.

Dr Pranav Ghody; Luke Coutinho and Dr Salaah Qureshi

Coutinho points out that the hormone also essays crucial roles in the body's day-to-day functions. "Have you ever noticed how your energy levels dip in the afternoon, but you still manage to push through? This is where the hormone comes in. It also regulates how we process the nutrients we consume. And let's not forget, cortisol also plays a key role in forming memories, and helps to prioritise emotional memories," he says.

Sudden and unexplained exhaustion can be a red flag

Too much, too often

High cortisol levels can be caused by chronic stress, poor sleep, or lifestyle factors. "This can produce adverse effects such as a craving for sugary or fatty foods. In fact, cortisol is helpful in a short-term crisis but leads to fat gain, inflammation, and metabolic issues when it becomes chronic. It can dampen your immune response and mess up your sleeping patterns," Coutinho shares.

Experts suggest including foods rich in omega-3 fatty acids and antioxidants in your diet to regulate cortisol levels

Elevated cortisol levels also lead to anxiety, depression and memory problems. With the brain constantly in ‘stress mode', it can be difficult to relax. This can have a cascading effect on several other functions. Notable among these are slowed digestion, reduced production of thyroxine and a fall in testosterone levels and fertility.

Practising yoga and breathing exercises like pranayama can be beneficial

"Such extreme symptoms are most common in individuals with prolonged exposure to external steroids in the form of steroid tablets, inhalers, injections in their joints and/or steroid creams, for a few months or years, or sometimes due to a rare tumour in the pituitary gland or adrenal gland [Cushing's Syndrome]. Stress affects everyone differently, and short-term stress usually doesn't cause lasting changes to your appearance. Managing overall health is more important than worrying about ‘cortisol face'," observes Dr Ghody.

Pace your life

Coutinho suggests a few lifestyle ‘pillars' to restore balance and support overall well-being.

. Nutrition: Providing your body with nutrient-dense, whole foods that support cellular function and reduce inflammation is important. Foods rich in omega-3 fatty acids fight inflammation, while antioxidant-rich fruits and vegetables support detoxification processes. Include magnesium-rich foods to help regulate cortisol levels and destress the body.
. Exercise: Regular and moderate exercise is one of the most effective ways to manage stress and lower cortisol levels. Physical activity promotes the release of endorphins - natural mood lifters - and helps burn off excess cortisol.
. Good quality sleep: Ensure sufficient and good quality sleep each night to keep the hormone in balance. Stick to a consistent bedtime schedule.
. Emotional wellness: Incorporate practices that enhance emotional wellness such as mindfulness meditation,
journaling, and spending time in nature.
. Breath work: Deep diaphragmatic breathing shifts the body from a stressed state to a calm, healing mode by activating the parasympathetic nervous system. Practices like yoga and pranayama can be effective tools in stress management.

Spot the signs

Dr Ghody lays down a basic checklist to determine if and when you should seek out help about elevated cortisol levels.
. Unexplained and sudden weight gain
. Sudden onset of or worsening facial hair (in women), or acne
. Fatigue
. Muscle weakness
. Mood swings or irritability
. New red-purple stretch marks
. Easy bruising
. Irregular periods (in women)
. Impotence