My face had always been shaped a bit like a cherub: round cheeks, round shape, soft jawline. However, in my early twenties, my face changed; it swelled to the point of being almost a perfect circle and no longer looked normal or healthy. [I ordered a panel of blood tests to rule out Cushing's syndrome, hypothyroidism, and other diseases that could cause fat deposits in the face. Thankfully, the test results were negative, but the doctors noted that my cortisol (“stress hormone”) levels were high.

I did not need medication or extreme worry, but was told to “relax.” Nevertheless, I switched from high-intensity HIIT to low-impact Pilates, downloaded Calm, and added Ashwagandha tea to my meal plan to reduce stress.

Could higher-than-average cortisol levels have caused my face to change shape, PCOS (a hormonal disorder I suffer from that can cause weight gain), a less-than-optimal lifestyle (I sleep only 5 hours a night and eat French fries and iced coffee constantly ), and other factors may have been responsible as well.

Recently, TikTok has become enamored with the idea that cortisol-induced stress makes the face round and plump. They call this the “cortisol face,” and nearly 100,000 users with “abnormally puffy” faces believe they are and that stress is the sole cause. They also believe that natural remedies, natural meditation, special wellness drinks, scrape rituals, or magical supplements purchased from TikTok stores can solve the problem. [But the stress-induced “cortisol face” is not real. The “cortisol face” is a buzzword coined (misleadingly) by social media.

“High stress does not cause a cortisol face, also known as a moon face, if cortisol levels are sufficiently elevated,” explains Caroline Messer, M.D., a board-certified endocrinologist. True cortisol face is caused by conditions that significantly increase cortisol in the body, such as high doses of steroids or tumors that stimulate cortisol overproduction.”

Cortisol face or moon face is a medical diagnostic name, not a synonym for facial swelling, water retention, or weight gain. Using such terms can create a dangerous dialogue. The harm of the social media “cortisol face” lies in unnecessary worry and self-diagnosis.” People mistakenly believe they have a hormonal imbalance, which can lead to stress and unhealthy behaviors and treatments,” says Gowri Reddy Rocco, M.D., an expert in regenerative medicine and hormones.

Here I spoke with Dr. Rocco, Dr. Messer, functional medicine expert Jana Delka, M.D., and board-certified dermatologist Paul Jarrod Frank, M.D., to debunk the hype surrounding the so-called “cortisol face.”

Cortisol is the body's primary stress hormone. Dr. Deluca explained, “Cortisol is responsible for much of the body's fight-or-flight response.” For example, when a person is in danger, cortisol spikes, signaling other systems, such as the digestive and immune systems, to put it off until the danger has passed.

When cortisol is functioning properly, cortisol is a good thing (despite the bad press it gets on TikTok). Says Dr. Frank, “Cortisol has several positive functions, including reducing inflammation and regulating blood pressure.” When cortisol levels are elevated for a long period of time, the body goes haywire.”

What TikTokers call a “cortisol face” is actually a “moonface” or “moonfaces,” to use the medical term. Excess cortisol causes the face to gradually become rounder and rounder, Dr. Messer explains. Fat deposits in the temples, under the cheekbones, and on the skull make the face appear puffy, “obscuring the ears and making the face closer to a perfect circle.”

However, it is important to understand that a “moon face” is not the same as a common puffy or round face shape. A slightly puffy appearance can be caused by a variety of factors, Dr. Frank explains, including weight gain, salt intake, alcohol, etc. Medical conditions such as PCOS can also cause facial puffiness.

A true “moon face” may be the result of many factors, including:

Let's be clear: A true “moon face” caused by a disease such as Cushing's syndrome is real. However, since Cushing's Syndrome only affects 10-15 people per million per year, it is clearly not possible that all of the hundreds of thousands of people on TikTok suffer from Cushing's Syndrome.

“The vast majority of suspected cases of ‘cortisol face’ are actually due to weight gain and can be treated with diet, exercise, and weight loss medications,” says Dr. Messer.

“Often a rounded face resembles a cortisol face, but it is not due to excess cortisol.

If you are concerned that you may have moonface, make an appointment with a certified primary care physician or endocrinologist. They can check your blood, saliva, and urine to see if your cortisol levels are high.

The bottom line is this: “You can't look at a person and tell if they have a cortisol face,” Dr. Frank explains. 'Everyone's face looks different. If you notice a change in their face, cortisol may be affecting it, but you usually can't tell from across the room.”

Consult your doctor before doing anything. Do not self-medicate or take a break from medication. Know that this is not something that happens quickly.” It takes time to identify the cause of high cortisol, but it also takes time to lower cortisol levels and return the body to a level of homeostasis,” Dr. Deluca says.

Even if you don't have a true “moon face,” there are things you can do to reduce facial swelling without medical intervention. Here's what our experts recommend:

In addition to facial swelling, Dr. Messer says you should contact your doctor if you have other symptoms that are indicative of Cushing's syndrome. These include high blood pressure, broken bones, easy bruising, slow wound healing, thinning arms and legs, thickening of the trunk, stretch marks on the belly, buttocks, thighs, breasts, and underarms, acne, excessive sweating, fatigue, muscle weakness, and menstrual changes.