What Is Cortisol Face, And How Can You Fix It?

If you’ve scrolled social media at all over the past few years, you’ve probably come across content warning of the dangers of high cortisol levels in your body. Countless influencers claim that the hormone causes poor sleep, depression and even a range of beauty issues, from wrinkles to puffy faces and thinning hair.

While it would be useful to have a single culprit for all of our beauty woes, is cortisol really to blame? We asked some leading dermatologists and hair restoration experts to explain what cortisol is and why it has such a bad reputation when it comes to beauty woes.

According to Dr. Tanya Kormeili, a board-certified dermatologist with the Derm and Rejuvenation Institute in Santa Monica, California, “Cortisol is a hugely necessary steroid hormone without which we would all be dead.” Although too much cortisol can be harmful in rare cases, for most people, cortisol is not the enemy it’s made out to be, she explained.

Cortisol is a steroid hormone produced by the adrenal glands, explained Dr. Michelle Draznin, a board-certified dermatologist with Kaiser Permanente. It’s commonly known as “the stress hormone” because our bodies produce extra cortisol to trigger the body’s fight-or-flight response when we are under acute stress, explained Dr. Corrie Alford, a board-certified dermatologist with MetroDerm in Atlanta, Georgia. When that happens, “cortisol increases blood pressure, heart rate and muscle tension,” Alford said.

However, cortisol does a lot more than help us escape a pride of lions. It’s critical for maintaining appropriate organ function and regulating blood pressure, glucose levels, immune response and the sleep-wake cycle, according to Alford.

Because cortisol naturally rises and falls in sync with the rhythm of our days, for most people, periodic high cortisol levels are not harmful to their health or appearance. “It is highest early in the morning in order to get people up and going, and lowest late in the evening in order to facilitate sleep,” Draznin explained.

Additionally, “during short periods of high stress or trauma, cortisol levels increase rapidly,” Alford said. For example, cortisol increases when we are under mental stress, such as trying to meet a deadline at work, after a fight with a friend, or reading about geopolitical events. Cortisol also increases when we are under physical stress, such as strenuous exercise or exposure to extreme temperatures, she explained.

Chronically high cortisol levels are another story. “Very high constant stress” can cause excess cortisol over a prolonged period of time, although that is rare, Draznin explained. Other conditions that can cause long-term excess cortisol production include adrenal gland tumors, pituitary gland tumors and long-term steroid use for autoimmune diseases or cancer, she added. Chronically high cortisol can suppress your immune system function, increase inflammation and cause hypertension, elevated glucose and fatigue.

Excess cortisol reduces the production of the skin’s building blocks, collagen and elastin, Alford explained. “As their production slows, the skin becomes thinner and more prone to premature wrinkles and stretch marks,” she said.

Too much cortisol can also lead to altered oil production, resulting in acne, dry skin or both, Alford explained. “Because cortisol causes androgen production, sebum levels rise and acne is inevitable. Additionally, cortisol slows down epidermal cell turnover so skin can look dull and flaky,” Kormeili said.

High cortisol levels can also cause melasma, or dark patches on the skin, she added. Chronically elevated cortisol can also slow wound healing, leading to scarring, she said.

High cortisol can also lead to facial adiposity, a build-up of fat that can change the shape of your face, Draznin explained. This is sometimes called “moon face,” because it makes the front of the face so round that it can be difficult to see a person’s ears from the front. Excess cortisol can also cause fat accumulation behind the neck, known as buffalo hump, according to Kormeili.

Moreover, excess cortisol can increase sodium retention, leading to fluid buildup in tissues. Fluid buildup can cause a bloated-looking face and puffy eyes, Draznin explained. Additionally, at high levels, cortisol can alter digestion. This can cause abdominal bloating and distention, she said.

If you’re under a lot of stress, your cortisol levels might remain high throughout the day. “By nighttime, you are crashing into fatigue rather than the natural decline of cortisol levels to help in gentle sleep regulation,” Kormeili said. This can prevent you from getting a good night’s sleep, leaving you looking tired and haggard when you wake up.

In more general terms, “chronic stress and high cortisol levels are increasing the wear and tear on our body, which we call allostatic load,” Kormeili said. This can lead to premature aging, including how we look.

Chronically high levels of cortisol can also be a factor in hair loss, explained Dr. Yücel İskender, chief medical officer and board member at NOVE Group, a hair transplant center in Turkey. Excess levels of cortisol can disrupt the hair’s natural growth cycle by prematurely forcing hair follicles into the telogen, or resting, phase of hair growth, he explained. “This leads to the widespread shedding we call telogen effluvium,” İskender said.

High cortisol can also reduce the amount of oxygen that reaches the scalp and cause an imbalance in hormones that play a role in how our hair looks and how much we have, he said. “Over time, this combination of stress, inflammation and hormonal disruption can make hair more fragile and prone to shedding,” İskender explained.

Hair loss related to high cortisol levels “generally occurs roughly three months after an immense stressor and reverts to normal three months after the stressor has subsided,” Draznin explained. If hair does not return to its normal appearance on its own, lifestyle changes to reduce stress or medical or pharmacologic options such as topical minoxidil may help, İskender said. Hair transplants are usually only recommended for permanent hair loss and generally would not be appropriate for temporary thinning related to high cortisol levels related to stress, he explained.

Although social media is full of reels promising fail-proof ways to control cortisol to help you look your best, they probably won’t work. “We cannot really control cortisol secretion,” Draznin said. Moreover, absent a serious medical issue that causes chronically high cortisol levels, it’s unlikely that reducing cortisol will solve your beauty problems anyway.

If you’re concerned that you have chronically high cortisol, you should consult with a doctor, Draznin recommended. However, she stresses that just having one symptom of chronically high cortisol, such as dry skin or bloating, isn’t usually cause for alarm.

For those still committed to trying to lower their cortisol levels in hopes of gaining radiant skin, a full head of hair and a flat stomach, Kormeili has some suggestions. “You can stay on top of your cortisol levels by getting adequate sleep, creating relaxation through moderate exercise, laughter and connection to others while eating a balanced diet with proteins and staying away from excess sugars, alcohol and caffeine,” she advised. İskender noted that although moderate exercise may help lower cortisol, excessive exercise can increase cortisol because it puts the body under stress.

Nevertheless, unless your cortisol levels are abnormally high, trying to lower cortisol too much or eliminate it entirely isn’t wise. “Low cortisol is not consistent with survival,” Draznin said.