In recent months, cortisol, one of the stress hormones, has been at the heart of many discussions on social networks. The “cortisol face” trend, originating from TikTok, links high cortisol levels to the appearance of a “puffy” and swollen face. Wellness influencers also attribute elevated stress hormones to other symptoms, including fatigue, poor sleep or weight gain. The latter therefore recommend reducing this rate, by adopting good habits: avoiding screens before sleeping, favoring a non-inflammatory diet, or even adopting a regular sleep schedule.
We asked an endocrinologist, an expert in the hormonal system, Professor Olivier Chabre, to explain the mechanisms of cortisol on our body and to give us his opinion on the reality of this trend.
What is cortisol and what is the role of this hormone?
The cortisola hormone secreted by the adrenal glands, has multiple roles: it helps regulate blood sugar and metabolismand it is responsible for the management of carbohydrates, lipids and proteins in the body. Cortisol is also called “stress hormone”, or arousal hormone, because it is a real tool for managing stress, in the medical sense of the term, that is to say any aggression perceived by the body (physical trauma , fever, infection, etc.), as well as psychological stress (mental distress). It is to adapt to these situations that this hormone regulates different parameters of our body.
Cortisol levels: what are we talking about?
Cortisol level fluctuates throughout the day : it is at its maximum in the morning when you wake up, and minimum at bedtime, and it varies depending on the situations to which the body is exposed. Although there are different tests to measure cortisol levels, these are reserved for people who are suspected of showing signs of illnesses that permanently raise cortisol levels. These (rare) signs are grouped under the name “Syndrome de Cushing”.
For the latter, the reference values take into account the time of sampling and the range of normal values is wide. Thus, the cortisol level is complex to interpret: “On a single sample, it is not possible to know if there are too many”.
Can high cortisol levels really impact our physical appearance?
As explained, certain endocrine diseases, linked to hormones, such as Cushing’s syndrome, involve an overproduction of cortisol, by a generally benign tumor, which is located either at the level of an adrenal gland or at the level of the pituitary gland, which controls the adrenal gland. In these cases, it is possible to notice certain signs such as weight gain in the upper body, particularly the face, which becomes rounder, but there also appears fragility of the skin, muscle wasting, osteoporosis, hypertension, diabetes, menstrual disorders.
All these signs also appear if you take certain treatments based on corticosteroids, because these drugs act on cortisol receptors: “It’s as if we took 15 to 20 times the dose of cortisol that we produce naturally, (…) the face will become rounder and the other signs of Cushing’s syndrome will also appear.”, specifies the professor. Finally, in most Cushing’s syndromes, the adrenal glands often also produce a little androgen: women can develop excessive hair growth (called hirsutism).
In the absence of this type of pathology, can cortisol be responsible for a swollen face, as the “cortisol face” trend suggests?
Professor Chabre explains that our daily stress does not impact our physical appearance. He specifies that our body does not produce enough cortisol due to everyday psychological stress to see the effects on our body or our face. And even when stress affects our cortisol levels, they will quickly return to normal. So, “it is not really possible to develop these signs with occasional psychological stress”.
Professor Chabre adds that it must, however, be recognized that people subjected to intense and prolonged psychological stress, as can be seen in certain chronic psychiatric pathologies, can see signs of Cushing’s syndrome appear at a minimum, even though they do not do not have a tumor of the adrenal gland or pituitary gland. “It is thought that these people produce too much cortisol on a long-term basis because they are subjected to prolonged stress, which leads to chronic stimulation of the part of the pituitary gland which controls the adrenal glands,” he specifies. Currently, it is considered that this situation, which we call “pseudo Cushing syndrome” is only encountered in a proven psychiatric context, but not in a person exposed to acute psychological stress.
What to remember from the trend from “cortisol does”
Even if it is true that increased stress raises cortisol levels, Professor Olivier Chabre explains that to his knowledge, there is no study to date that proves the link between weight gain, facial roundness and occasional elevation of cortisol levels during acute psychological stress.
He also specifies that a rounded or “swollen” face can have other causes:obesitythe metabolic syndromewhich may be associated with a syndrome of polycystic ovaries (PCOS)and also thesevere hypothyroidisml’heart failureor other causes of edema encountered in certain kidney diseases.
Professor Chabre adds that “if the face has always been rounded, it is likely that there is no disease. If, on the other hand, the face has recently become rounded, it is advisable to consult a doctor who will be able to sort through the different possibilities before knowing whether you should be concerned about your cortisol level.”.
Although he does not encourage everything to be linked to cortisol, Professor Olivier Chabre finally reminds us that stress is obviously not beneficial for health, and any measure aimed at reducing stress is therefore entirely welcome: “Even if the scientific message (linked to this trend, editor’s note) is not demonstrated, it is rather positive advice”, since being concerned about a “cortisol face” encourages you to adopt good habits in terms of sleep, diet and physical activity.
Thanks to Professor Olivier Chabre, Professor Emeritus at the University of Grenoble-Alpes and member of the French Society of Endocrinology (SFE).
