Tension and rounded facial features: Insights from specialists on this popular TikTok phenomenon
People just can't stop talking about how the stress hormone cortisol can make your cheeks and eyelids balloon out of proportion, commonly referred to as "moon face".
"Your face has a very round shape," one person claims on TikTok. "It can look swollen and inflamed."
"It's from high cortisol, aka high stress," another user explains in another post. "During the pandemic, I looked like this (puffs out cheeks)."
As we all strive to fit more and more into each day, constant stress can become a reality in today's fast-paced society. But can stress actually expand your face?
While chronic stress can lead to increased levels of cortisol in the body, those levels usually don't increase enough to cause "moon face", said dermatologist Dr. Rajani Katta, a clinical assistant professor at the Baylor College of Medicine in Houston.
"Fluid retention can be due to many causes, from your diet to medical conditions such as kidney disease. Some prescription medications can also cause fluid retention," Katta said in an email.
True "moon face" is a symptom of having Cushing's syndrome, a condition in which the body has extremely high levels of cortisol, Katta explained. This can be caused by the prolonged use of prescription medications like the steroid prednisone, or, less commonly, by an overactive adrenal gland.
In addition to a round face, Cushing's syndrome can cause weight gain around the midsection and neck, according to the Johns Hopkins Medicine website.
"For medical causes of fluid retention, treating the underlying cause will help," said Katta. "Your doctor may also prescribe a diuretic to help your body get rid of extra fluid."
How stress affects the face
While cortisol levels from everyday stress may not cause "moon face", the hormone can still have negative effects on the skin.
Stress hormones like cortisol can trigger breakouts and dull skin, speed up the aging process, and exacerbate skin conditions like eczema and psoriasis, said dermatologist Dr. Whitney Bowe.
"Consistently elevated cortisol levels have been shown to inhibit your skin's production of collagen, hyaluronic acid, and healthy lipids like ceramide," Bowe told CNN in an earlier interview.
Collagen is like the framework of the skin that prevents fine lines and wrinkles, said Bowe. Hyaluronic acid keeps the skin moisturized, and ceramide creates a barrier to prevent moisture from escaping the skin.
Bad habits that stress the skin
People often turn to salty snacks when they're stressed, which can explain swollen eyes and face, as well as swollen legs and feet, experts say.
"If your face is puffy, one of the first questions I would ask would be about your sodium intake. A high intake of sodium can lead to fluid retention throughout the body," said Katta, author of the book "Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet."
"If it's just a matter of too much sodium last weekend, then going back to your normal diet should help within a few days," she added.
Another culprit is consuming too much sugar and processed carbohydrates, which can damage the skin's collagen over time through a process called glycation, Katta said.
Glycation occurs when sugar molecules attach to fats and proteins and create advanced glycation end products (AGEs), which can make collagen and elastin proteins less elastic and more prone to breaking down.
"Foods rich in antioxidants and anti-inflammatory properties can help provide an extra layer of protection to your skin and can help promote your skin's defense and repair systems," Katta suggested.
Tips for reducing stress
There are ways to reduce stress that can also benefit the skin, experts say. Exercise increases blood circulation to the face and releases endorphins, the body's natural painkillers.
Exercise also delivers oxygenated blood to all parts of the body, including the skin, which can boost the skin barrier's recovery process, experts say. In addition, yoga, meditation, and deep breathing are all known to reduce cortisol production and stress levels.
Good sleep is another way to improve skin and reduce stress, said sleep specialist Dr. Raj Dasgupta.
"It's called beauty sleep because sleep does regenerate your skin at night," Dasgupta told CNN. "There's a hormone called growth hormone that gets secreted during the deeper stages of sleep that stimulates fresh skin cell growth."
Adults over the age of 18 need at least seven hours of sleep each night to be healthy, according to the US Centers for Disease Control and Prevention. Sleep debt and irregular sleep patterns have been linked not only to stressed skin but also to an increased risk of obesity, heart disease, dementia, and mood disorders such as anxiety and depression.
Despite high cortisol levels from everyday stress not causing "moon face", prolonged exposure to the hormone can still negatively impact the skin. Stress hormones like cortisol can trigger breakouts, dull skin, and exacerbate skin conditions such as eczema and psoriasis. This is because consistently elevated cortisol levels have been shown to inhibit the skin's production of collagen, hyaluronic acid, and healthy lipids like ceramide.
