What Living With "Cortisol Face" Is Really Like, as Someone With a Chronic Illness

I lived with what my FYP calls "cortisol face" for about two years. In 2021, two ischemic strokes led to my first three-month round of high-dose corticosteroids — anti-inflammatory drugs that increase cortisol levels in the body. "You know you're going to blow up, right?" a doctor asked me after seeing my new prescription, referring to the puffy "moon face" (recently rebranded as cortisol face) that many patients experience on corticosteroids. I spent the rest of the night in my hospital bed deep in search results, sobbing to my friends, searching for meal plans, and trying to figure out how to remain in control. I had just survived two strokes, yet I was arguably more concerned about my impending cortisol face.

In the months to follow, my face changed and so did I. The medication made me agitated and restless. It affected my water retention and fat distribution, so that I looked as different as I felt. At its peak, the sides of my face were so swollen, you could hardly see my ears. Even worse, the drugs didn't seem to be making me better. I had just lost my health, my stability, my strength, and now I was losing my face too.

Caroline Messer, MD, is an endocrinologist at Fifth Avenue Endocrinology and Founder of Well by Messer.

Lucky Sekhon, MD, is a double board-certified reproductive endocrinology and infertility (REI) specialist and OBGYN at RMA of New York.

I tapered off the steroids in October, but my cortisol face stayed with me. People treated me differently than they did when my face was thinner — most days, I felt like I was invisible. I had no interest in a healthy relationship with food or exercise and started restricting my intake. When I should've been focused on recovering from my strokes, I was more determined to shake my cortisol face as quickly as possible. Then, in November of 2021, doctors found a mysterious mass of inflammation behind my eye, and I was placed on steroids for the second time that year.

I cried to the doctors making the decision, thinking about the brief progress I had made. "Have any of you been through this? Do any of you understand?" I asked them. They stared back at me blankly. Now in 2024, I scroll as influencers talk about cortisol face like it's a new health trend. The marketing is admittedly tempting. They tell you your face is round, puffy, and bloated as a result of high cortisol levels — and thankfully, there's a quick fix! (If only you head to the link in their bio.)

Although cortisol — the body's main stress hormone — can increase due to chronic stress or diet, it can also be caused by rare conditions like Cushing's syndrome, and it certainly isn't something you fix with a detox tea. In fact, as Caroline Messer, MD, previously told PS, "high stress does not result in sufficiently elevated levels of cortisol to present with cortisol face," and many suspected cases of cortisol face may actually be attributed to weight gain.

"Actual cortisol excess or Cushing's Syndrome is not common at all," Lucky Sekhon, MD, previously said to PS in the same article. "Cortisol face is not going to happen if you are tired or stressed – but you can retain fluid, have a puffy face, and not feel your best due to being tired, ingesting high sodium foods, and unhealthy lifestyle choices." If you do have high cortisol (which can be found with a blood, urine, or saliva test), treatment will address the underlying cause.

Since getting off of corticosteroids, I look more like myself, and my mental health is better for it. I can't say I ever expected cortisol face to become TikTok's latest obsession, but a part of me understands. It's hard to see yourself change, and while there's plenty of misinformation on social media, it's comforting to hear you might be able to "fix" it. As a person with chronic illness, I know I'm still working to heal my relationship with my body (former cortisol face included), but at the very least, it feels good to know it's mine again.

Chandler Plante is an assistant editor for PS Health & Fitness. Previously, she worked as an editorial assistant for People magazine and contributed to Ladygunn, Millie, and Bustle Digital Group. In her free time, she overshares on the internet, creating content about chronic illness, beauty, and disability.