What is cortisol? How to lower levels amid concerns over "cortisol face"

"Cortisol face" is a trending topic on TikTok — but what is cortisol, exactly? And can it really impact your face shape? 

Cortisol is a hormone that mainly helps regulate your body's response to stress.

TikTok users have recently garnered attention with videos blaming increased stress, which can stimulate the release of cortisol, for facial puffiness and swelling, which they refer to as "cortisol face."

Experts say that while the hormone can impact your face in some ways, it's not like some of the posts suggest.

Cortisol can affect your skin by increasing oil gland production, which can result in clogged pores and worsening acne.

"When you are stressed, your body releases stress hormones that have a tremendous impact on your entire body, including your skin," dermatologist Dr. Samer Jaber, of Washington Square Dermatology in New York, recently told CBS News. 

But everyday stress does not raise cortisol levels high enough or long enough to cause significant facial swelling and bloating, CBS Boston's Dr. Mallika Marshall explained. If you are feeling a little more puffy than usual, Marshall said to limit your salt intake, drink more water and get adequate sleep. 

People with Cushing syndrome, who have chronically high levels of cortisol, and people who take steroids for long periods of time, can develop what's known as "moon facies," or a "moon face." This refers to the buildup of fat on either side of the face, which gives it a rounder or puffier appearance. 

Earlier this year, Amy Schumer revealed her Cushing syndrome diagnosis after receiving comments about her appearance following several TV interviews. The actress and comedian said her condition was caused by getting steroid injections in high doses, which are sometimes prescribed to treat endometriosis, although Schumer did not specify why she received them.

Symptoms of high cortisol levels

It's normal to have natural fluctuations of cortisol throughout the day, Dr. Natalie Gentile previously told CBS Pittsburgh.

Blood, urine or saliva tests can be used to measure cortisol levels, but there are also signs that can point to someone with too much cortisol (like someone with Cushing syndrome) or too little cortisol, which is known as adrenal insufficiency.

Common signs and symptoms of higher-than-normal cortisol levels, according to the Cleveland Clinic, include:

• Weight gain, especially in your face and abdomen
• Fatty deposits between your shoulder blades
• Wide, purple stretch marks on your belly
• Muscle weakness in your upper arms and thighs
• High blood sugar
• High blood pressure 
• Excessive hair growth on the face, chest and back
• Weak bones and fractures

Symptoms can vary depending on how elevated cortisol levels are. If you notice persistent swelling of your face, abdomen or legs, see a health care professional to rule out any serious medical conditions, Marshall said.

How to lower cortisol

Keeping cortisol levels at an optimal ranges goes back to "lifestyle basics," Gentile said, which includes getting quality sleep and moving regularly.

"Sleeping is huge for cortisol," she said. "So getting proper, quality sleep — and if you're not, figuring out why."

Other things to keep in mind include hydration, nutrition and mental health, Gentile said. 

"If we can get in more colorful fruits, vegetables, our whole grains, our legumes... that can be very helpful," she said.

For Cushing syndrome or adrenal insufficiency, medical treatment is typically needed to regulate levels, so it's important to talk to a health care professional.