‘Cortisol Face’ is Real, But It’s Not as Common as You Might Think

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On social media platforms, the hashtag “#cortisolface” has gained popularity, with many users claiming that facial puffiness and bags are a result of elevated cortisol levels. Influencers often begin their videos with statements like “You’re not ugly, you just have a cortisol face” and promote various remedies and lifestyle changes as solutions. However, experts warn that while high cortisol levels can contribute to these symptoms, it is not the only cause of facial puffiness.

Before blindly believing social media trends, it is crucial to investigate the underlying causes, which may include medications, health conditions, or lifestyle factors. Addressing high cortisol levels requires a different approach than what many of these social media influencers are suggesting.

Dr. Maria Olenick, associate professor at the Texas A&M University School of Nursing, offers valuable insights into the concept of the “cortisol face,” its effects on the body, and methods to lower cortisol levels.

What is ‘cortisol face’?

While high cortisol levels are a factor in some cases of facial puffiness and bags, the symptom is not as common as social media claims. In some cases, it’s not cortisol, but the food you eat. For example, eating a meal or snack that is high in sodium can make you feel bloated, as the salt can cause you to retain water and look more puffy than usual.

“Some of the more serious symptoms, like moon face and other symptoms, you could consider a serious problem, and someone really needs to go to their health care provider because that requires a medical diagnosis,” Olenick said.

Moon face—or lunar facies, in medical terminology—describes increased facial swelling due to high cortisol levels. This is a more serious condition that does not appear or disappear overnight.

How does cortisol affect the body?

Cortisol has been called the body’s “built-in alarm system” because it plays a crucial role in the body’s response to stress, metabolism, immune activity, and maintaining homeostasis. The amount of cortisol produced varies from day to day due to various mental and physical stressors.

“In healthy individuals, cortisol follows a diurnal pattern where levels are highest upon waking, then increase significantly for about 30 minutes, and then decline steadily from the peak for the remainder of the day, reaching a nadir in the middle of the night,” said Olenick, whose research focuses on effective stress management techniques and therapies for veterans dealing with post-traumatic stress disorder (PTSD).

Hormones act as chemical messengers that travel through your bloodstream to regulate various bodily functions. Cortisol, often referred to as the stress hormone, uses receptors that receive and use the hormone in various ways by communicating with your brain to control your mood, motivation, and anxiety.

Different ways cortisol responds and adapts To cope with stress, among other things:

  • Regulate blood pressure
  • Regulating metabolism
  • Regulating blood sugar levels
  • Controlling how your body uses carbohydrates, fats and proteins
  • Suppress inflammation
  • Helps control your sleep/wake cycle
  • Help form memories

Cortisol secretion is regulated by a hormonal axis through a feedback loop involving your hypothalamus, pituitary gland, adrenal glands, and certain hormones known as the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus and pituitary glands in your brain monitor cortisol levels in your blood before sending signals to the adrenal glands, which sit on top of each kidney. When a change in cortisol levels is detected, your adrenal glands respond to these signals by adjusting the amount of cortisol to be released.

The feedback system starts when the hypothalamus senses stress and releases corticotropin-releasing hormone (CRH). This hormone travels to the pituitary gland and signals it to release adrenocorticotropic hormone (ACTH). ACTH will then make its way to the adrenal glands and stimulate them to produce cortisol.

Once produced, cortisol is released into the bloodstream, where it helps regulate several functions, including stress response, metabolism, and immune activity. The HPA axis feedback loop is completed when cortisol levels rise and signal the hypothalamus to decrease CRH production, maintaining an effective secretory loop.

What causes high cortisol levels?

Cortisol is elevated during times of stress for your body, but our bodies are not designed to handle prolonged stress. When too much cortisol or an excessive amount of cortisol is produced, it can cause major changes in your body’s daily functions.

Chronic emotional or physical stress can lead to persistently high cortisol levels as part of the body’s stress response system. Stress triggers signals that prompt the adrenal glands to release hormones such as adrenaline and cortisol, leading to an increased heart rate and increased energy for the fight-or-flight response.

Cortisol temporarily suppresses non-essential functions such as digestion, reproduction, and inflammation in the short term to prepare for danger. However, if stress is constant, this response can remain active, negatively impacting many bodily functions including sleep, weight management, memory, focus, and mental health. Chronic stress can also increase the risk of anxiety, depression, digestive problems, headaches, muscle tension, pain, and high blood pressure.

Stress isn’t the only culprit for high cortisol levels, however. It can indicate serious underlying health problems.

“You want to make sure that if you’re having issues with cortisol levels, you don’t actually have a tumor or something more serious. If you feel like you have symptoms and they’re not being resolved by making lifestyle changes, make sure you see a health care provider because that could be something completely different and it could require significant medical attention,” Olenick said.

Cushing’s syndrome

Cushing’s syndromealso known as hypercortisolism, is characterized by excessive cortisol levels in the body. Long-term use of corticosteroid medications can lead to exogenous Cushing syndrome, in which the excess cortisol comes from external sources rather than the body’s own production. A common cause of high cortisol levels is the use of glucocorticoid medications, such as prednisone, which are prescribed for inflammatory conditions such as asthma, rheumatoid arthritis, and lupus.

“Sometimes people use steroids like prednisone for another condition. If you are taking steroids and you start showing signs of serious cortisol problems, talk to your health care provider,” Olenick said.

Another major cause of Cushing’s syndrome is pituitary tumors that secrete excessive amounts of ACTH, which overstimulates the adrenal glands to produce more cortisol. This form of Cushing’s syndrome, also known as Cushing’s disease, is attributed to benign pituitary adenomas and accounts for a large percentage of cases in both adults and children. Effective management of Cushing’s syndrome involves addressing the underlying cause, which may include surgical removal of tumors or adjusting medication regimens to lower cortisol levels and reduce associated health problems.

Adrenal gland tumors can also contribute to high cortisol levels. These tumors can be benign or malignant, leading to similar symptoms as those caused by pituitary tumors. Tumors that affect the pituitary or adrenal glands can lead to elevated cortisol levels, but most of these tumors are noncancerous and can be treated with proper medical care.

Understanding the underlying causes of high cortisol levels is critical to proper diagnosis and treatment, as the medical implications of these conditions extend beyond what is portrayed in the popular media.

What are common symptoms of high cortisol?

The right cortisol balance is essential for your health, and too much or too little cortisol can be the cause of your health problems. cause health problemsincluded:

  • Bags or weight gain in the face
  • Weight gain in the midsection or abdomen
  • Excess fat behind the neck, above the back
  • Memory and concentration problems, or brain fog
  • Sleep problems or insomnia
  • Severe fatigue
  • High blood pressure
  • Psychiatric disorders

Symptoms can vary, so the only real way to confirm whether your cortisol levels are higher than normal is to have them checked, either with blood, urine, or saliva tests. When Olenick evaluates cortisol levels in veterans for PTSD research, her preferred method is to collect saliva samples. A saliva test can be done at home, but is most effective when taken at various times throughout the day.

How can someone lower their cortisol levels?

Maintaining a healthy diet, maintaining a regular sleep schedule, and getting regular, moderate exercise can all help lower cortisol. It’s also important to manage stress effectively; this may mean finding healthy ways to cope, such as talking to someone you trust or giving yourself time to relax and unwind. Self-care is key; taking breaks and participating in rejuvenating activities isn’t a waste of time, but a necessary part of maintaining your balance.

Avoid extreme measures like severe calorie restriction or intense workouts, which can increase cortisol levels due to the stress they place on the body. Instead, opt for low-intensity exercises like walking. Additionally, Olenick says that natural remedies and supplements like apple cider vinegar and vitamins can help with cortisol management, but it’s wise to monitor their effects and consult a healthcare provider as needed. Ultimately, finding a balance between self-care, stress management, and maintaining a healthy lifestyle is key to effectively managing cortisol levels.

“There are a lot of things you can do to regulate your cortisol, like eating well, sleeping well, reducing stress. Basically, things to take care of ourselves,” Olenick said.

Olenick says social media platforms are great attention-grabbers, but it’s important to take health trends with a grain of salt and pay attention to your body’s needs. If you identify with any of the symptoms and are concerned about your cortisol levels, alert your healthcare provider and seek medical attention.

Provided by Texas A&M University


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