Why is the Internet Blaming Cortisol For Facial Puffiness?

The Internet has always introduced us to some OTT health and wellness trends. Previously health influencers on social media platforms had claimed that sipping on overnight-soaked Okra water was the one-stop solution to all your gut and digestion-related problems. Now, recently health fanatics have been blaming the stress hormone cortisol for a visibly bloated facial appearance.

The term cortisol face has recently gained momentum on the Internet, which blames the stress hormone for causing a visible change in a person's facial structure, identified by puffy cheeks and a visibly sluggish appearance. Experts believe that the stress hormone alone cannot be blamed for visible bloating of the face.

What is a cortisol face?

The term “cortisol face” is a term used to describe the visible puffiness of the cheeks which gives the face an inflated appearance. The inflated appearance gives the face a full and rounded appearance leading to what health and lifestyle educators on the web also call it 'Moon face'.

Although the internet continues to blame the stress hormone for causing significant changes in facial structure, doctors believe that a visibly puffed-out face does not always indicate high levels of cortisol.

Does cortisol make your face puffy?

“Facial puffiness can reflect many problems like hindered functioning of the heart, liver and kidney and can also be just a manifestation of lack of sleep, mild fluid retention that happens if you’re not taking enough water or taking too much salt. Sometimes in people with puffy faces, upon examination, we have found the cortisol levels are not that high”, says Dr Ambrish Mithal, Chairman of Endocrinology and Diabetes at Max Healthcare Hospitals, Delhi.

He further adds, “An increase in cortisol may sometimes reflect in the form of a puffy face, and may indicate what is defined in medical terms as Cushing's syndrome. Cushing's syndrome has many symptoms like the face getting red, the skin becoming friable, the arms becoming noodle-like and the legs resembling sticks. An easy way to check whether cortisol levels are high is to do a simple cortisol blood test under the guidance of an endocrinologist”.

Other reasons for high cortisol levels

While facial bloating may be an underlying indication for a condition called Cushing’s syndrome, there are many other physical indicators that may indicate an abnormal increase in cortisol levels in the body.

High blood sugar levels

According to astudy published by the Journal of psychoendocrinology, the stress hormone cortisol has a significant role in triggering glucose release into the bloodstream which makes it possible for the individual to face extremely stressful situations like an attack by a wild animal or when your house is on fire. The increased level of glucose in the bloodstream often leads to Type 2 Diabetes also known as Diabetes Mellitus.

“The abnormal increase in cortisol levels leads to an increase in the glucose levels being released into the bloodstream, which in turn triggers the body to release more insulin. Due to continuous exposure to insulin the body cells become resistant to the hormone and thus the blood sugar levels always remain high " says Dr Aastha Gupta, Endocrinologist at Sant Parmanand Hospital, Delhi.”.

Abnormal weight gain

“Cortisol does a lot of intangible things apart from causing facial puffiness”, says, Nutritionist Nipa Ashram, It also leads to excess fat deposition in the lower abdomen area which is also known as a cortisol belly, to be used to fuel actions and responses during intense situations which in turn leads to excess weight gain”.

Apart from releasing hormones like adrenaline, cortisol also acts as a catalyst to metabolise fat and glucose present in the body, which may at times lead to an increase in appetite and thus lead to abnormal weight gain.

Weak bones and muscles

People with high cortisol levels have often been found to have weak muscle and bone mass density. Although, lack of nutrients both macro and micro is also one of the reasons for decreased bone mass density and muscle mass, high levels of cortisol when left undiagnosed can also lead to gradual weakening of the body’s skeletal and muscular system.

“Under stressful situations the brain needs more glucose to function well and hence cortisol tries to draw glucose from stored places in the body, says Dr Nipun Rana, a Delhi-based orthopaedic surgeon. He further adds, “Due to an increase in the demand for glucose in the bloodstream, the glucose is pulled out from the bones and muscles and provided to the brain to function properly. The lack of glucose levels in the bones hinders calcium absorption and gradually hampers bone health and makes the person feel sedentary. Moreover, they are also at a higher risk of counteracting osteopenia and osteoporosis”.

Insomnia

Cortisol triggers the release of hormones like adrenaline which is released during extremely stressful situations and helps a person devise survival strategies. However, the excess release of cortisol interferes with the body’s natural circadian rhythm and leads to sleep disorders like insomnia.

“Elevated cortisol levels put the body on a high alert zone and interfere with the sleep-wake cycle causing Insomnia, says clinical psychologist Dr Shivani Misri Sadhoo, Hence, the mind always remains alert and active and is unable to relax as it senses threats almost everywhere. This when left untreated or undiagnosed can lead to impaired immune function, cognitive decline, anxiety, and depression”.

Will cosmetology procedures help reduce facial puffiness?

Although umpteen treatments and holistic procedures are available in the market that claim to reduce facial puffiness and inflated appearance, experts believe, the results are short-lived.“Although Corticosteroids are prescribed to people who suffer from visible facial bloating, for patients with Cushing's syndrome, or with excess cortisol levels, the after-effects of treatments like Blepharoplasty, and lymphatic drainage procedures are short-lived”, says dermatologist and esthetician Dr Indu Ballani. She adds, “To get rid of the visible bloating on the face, the root cause is regulating the release of cortisol into the bloodstream, and dermal procedures do not promise any long-term effects".

How does an increase in cortisol levels affect women?

The earliest symptoms of high cortisol or Cushing syndrome can be identified with excessive facial hair growth in women, while the reason for excessive hair growth in women can also mean PCOS(polycystic ovarian syndrome), high levels of cortisol can also lead to abnormal hair growth in women.

“The repeated release of insulin causes a condition known as hyperinsulinemia, a condition that leads to impairment of the insulin receptors of the cells. To counteract the excessive production of insulin, the body responds by releasing male hormones like testosterone which are medical terms also known as androgens leading to a condition known as Hirsutism”, says Delhi-based gynaecologist Dr Hriday Kapoor.

How to regulate cortisol levels in the body?

"Our body generally knows how to regulate cortisol, and it would need to secrete excess cortisol on a consistent, prolonged basis, which doesn't happen in normal stress conditions", says, Malavika Siddharth. She further adds, "Increased water consumption, reduced salt intake, improved sleep, cold face plunge/icing, lymphatic drainage massages, and improving gut health are some tips that can help

Plus, here are a few bonus tips in which you can regulate the levels of cortisol in your body and embrace a happier you.

Work in sync with your circadian rhythm

Circadian rhythm can be defined as the body’s internal clock. It includes the physical, mental and behavioural changes that a body undergoes in a 24-hour cycle. When you have high levels of cortisol the body remains alert and has difficulty falling asleep as it is constantly supplied with fight or flight hormones.

“In addition to releasing hormones like adrenaline to combat stressful situations, cortisol also helps in the metabolism of glucose”, says, Nutritionist, Nipa Ashram, “When you wake up in the morning the cortisol levels are high, and it helps to metabolise glucose to help us get going through the day, as evening approaches, the cortisol levels decrease and melatonin increases, which makes us sleepy. The mistake people make is that they don't prioritise sleep. For all those struggling with cortisol imbalance, one bonus tip, they should avoid working out after four o'clock because it spikes the levels of the stress combating hormone  in the bloodstream”.

Give yourself a break

Although this tip may be highly underrated, taking a break in between your schedule can significantly help lower cortisol levels as it helps to unwind from the stress thereby breaking the cycle of cortisol production by the body.

Nutritionist Nipa Ashram recommends using the 90-20 minute method to help regulate cortisol levels, she says, “The 90- 20 method usually refers to working for 90 minutes and then taking a break for 20 minutes as this process helps to work in sync with the body’s ultradian rhythm which is also defined as the body’s regular functioning like digestion, metabolism and hormonal release. This process works well for people who are too used to being wired with their regular functioning, as this gives your mind and body the much-needed break it deserves”.

Be consistent with your physical activity

Exercising helps generate feel-good hormones or endorphins which are also defined as the body’s natural mood elevators that help to boost blood circulation and improve cognitive functioning thereby reducing levels of cortisol.

Spend time with your loved ones

Spending time with loved ones instils a sense of belonging in the minds of people thereby reducing stress exerted due to excessive loneliness. Moreover, it also triggers the release of feel-good hormones thereby annihilating the after-effects exerted due to excessive release of cortisol.

“ Positive interactions trigger the release of oxytocin, serotonin,  a few feel-good hormones that calm the nervous system and enhance blood circulation throughout the body and also counteracts the production of cortisol being released in the bloodstream, says, Dr Shivani Misri Sadhoo, “This can also help reduce problems like eating disorders that in turn may reduce excessive weight gain due to cortisol”.

Is cortisol really that bad ?

Though cortisol has been demonised as the “stress hormone”, it has a vital role to play in suppressing inflammation, regulating blood sugar levels, and releasing fight-or-flight hormones during extremely stressful situations. Dr Ambrish says, “Too much of anything is bad and the same applies to cortisol, an excess secretion of the hormone can lead to symptoms like deposits of fat behind the neck, thin arms and limbs, profound muscle weakness, high blood pressure, high blood sugar, glaucoma in the eyes. Cortisol is important for survival without which we would all die, as it helps us fight our everyday battles”. Long story short, a little bit of cortisol is not all that bad.