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Cortisol, often called the "stress hormone," is a hormone the adrenal glands produce that influences nearly every organ and tissue in your body. According to the Cleveland Clinic, cortisol plays a role in the following:
Cortisol levels typically fluctuate throughout the day, peaking in the morning and declining by evening. Chronic high levels of cortisol can lead to various health issues.
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The term "cortisol face" refers to changes in facial appearance attributed to elevated cortisol levels, such as puffy or swollen face, particularly around the cheeks and jawline. However, are people getting this confused with moon face?
You may have heard "moon face" frequently used interchangeably with cortisol face. While both terms describe the same physical characteristic of a puffy face, cortisol face has questionable roots.
"Cortisol face is a made-up term from the media. What is real is moon facies, a condition in which the face appears round, puffy and moon-like," Bala told CNET. "This can be secondary to disorders like Cushing's disease, long-term steroid usage, specific hormonal issues or tumors, which can cause similar problems with cortisol production. Prolonged levels of high cortisol is what causes this appearance in the face."
One sign of moon facies is that if you look at the patient directly, face to face, you can't see their ears. Other symptoms associated with excess cortisol include a buffalo hump (dorsal fat pad), obesity, rash and fatigue.
Cushing's is rare, with only 10 to 15 people affected per million every year, as reported by the Endocrine Society. That being the case, another medical issue or unrelated cause may be more likely for many people reporting cortisol face.
Not everyone with facial puffiness has an underlying condition, but it is possible, so serious signs and symptoms shouldn't be ignored.
"Although nutrition, sleep, stress, inflammatory levels, etc., can also cause puffiness in the face, they will not cause moon facies," said Bala.
We'll take a look at specific causes of moon face and general puffy face.
Moon face tends to be long-term and remains present until whatever caused it subsides.
Causes of moon face include:
Unlike moon facies, a general puffy face tends to be temporary. It can also be more noticeable in the morning and go away by midday.
Causes of general puffy face or facial swelling may be linked to:
To effectively address and reduce cortisol face or puffy face, consider implementing these tips:
To get rid of moon face/cortisol face:
To get rid of general puffy face:
"I think many of us think that having high stress levels and waking up with a puffy face is equivalent to cortisol face aka moon facies. And I want to make it clear that they are not the same thing," explained Bala. "Many of us have chronic levels of oxidative stress in our bodies that cause us to feel congested and wake up with a puffy face that subsides throughout the day."
However, a puffy face that is constant and doesn't go away could potentially signal hypothyroidism, Cushing's, pituitary tumors or other underlying issues, so seeking medical help ensures proper treatment and prevents further complications.
"These need to be diagnosed by a trained healthcare professional who can order labs. These can include blood work, 24-hour urine testing, dexamethasone suppression testing, MRI or other imaging. If you suspect chronic health issues, fatigue, issues with your period, hormones, sleep, etc., it's always best to consult with a healthcare professional for further workup, diagnosis and treatment," Bala recommended.
Incorporating a few simple practices can make a significant difference in addressing and preventing facial puffiness.
Managing your mental health can help maintain normal cortisol levels, especially when engaging in regular stress management practices such as yoga and exercise.
Eating a diet rich in nutrients and low in salt can reduce fluid retention and prevent puffiness.
"Eating a balanced diet with protein and fiber in each meal to regulate blood sugar and insulin levels can help regulate cortisol rhythms as well," said Bala.
Ensure you get enough restful sleep to prevent facial puffiness. According to the Sleep Foundation, adults need at least seven hours of sleep every night.
Bala also suggested, "Waking at the same time every day to help regulate your circadian rhythm and cortisol awakening response." In addition, "going to bed around the same time daily, limiting screen time before bed and limiting overhead light exposure after dark" can help with sleep.
Hydration is key to helping the body release retained fluid and reduce puffiness.
"Staying adequately hydrated with at least 80-100 oz of water and getting plenty of electrolytes and minerals, especially if you spend a lot of time in the sun or sweating," Bala said.
The constant discourse surrounding cortisol face can be overwhelming, but before getting worried or seeing a doctor, consider possible reasons for your puffy face or facial swelling. That's not to say that Cushing's syndrome or another medical condition isn't the cause, but understanding the many potential causes, differences and management strategies can help address these issues effectively.
Of course, for ongoing or severe problems, consult a healthcare professional to ensure appropriate diagnosis and treatment.
Source: cnet.com