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Gen Zen: Is ‘cortisol face’ on TikTok really a thing? Relax, everyday stress won’t give you a ‘puffy, round face’

SINGAPORE — Something a woman said in a TikTok video made me sit up: “You’re not ugly. You just have cortisol face.”
Wait, what is a “cortisol face”? Isn’t cortisol a hormone? 
Once the algorithm on my mobile phone started recognising my “interest” in the topic, I was gradually fed videos of more women talking about “cortisol face”, showing pictures of them with bloated and puffy faces. 
Then, they talked about how they successfully “reduced their cortisol levels”, resulting in a magical glow-up such that they now have slender faces. 
A search on Google threw up some content on “cortisol face”, which supposedly refers to the look of someone who has a rounder, puffier face due to “elevated cortisol levels”.
Cortisol is a hormone released by the body’s adrenal glands in response to stress.
I was puzzled. I looked at my visage in the mirror and wondered if it could look so bloated when I am under stress. Is cortisol that bad?
As expected, these TikTok videos don’t elaborate much about this. Yet these women share what they did to combat “cortisol face” as if they were professionals, such as by drinking apple cider vinegar in the morning, avoiding caffeine right after waking up and stopping high-intensity workouts. 
I turned to a health specialist and a psychologist to get the truth.
Right off the bat, the experts told me that “cortisol face” is a social media trend that exaggerates the effects of cortisol instead of being an actual medical condition. 
Dr Stephanie Ho, a consultant dermatologist who runs her own private practice, explained that certain medical conditions involving prolonged and elevated cortisol levels can cause the face and body to become rounder.
Still, it is an exaggeration to suggest that everyday stress can raise cortisol levels enough or for a long enough period to change one’s appearance noticeably.
“It is an exaggerated claim with little medical evidence to support it,” she asserted. 
Ms Angelin Truscott, a counselling psychologist at Annabelle Psychology, said that some symptoms associated with “cortisol face” resemble those of Cushing’s syndrome, a rare hormonal disorder characterised by prolonged over-secretion of cortisol.
“However, unlike the ‘cortisol face’ (depicted in those TikTok videos), patients with Cushing’s syndrome may experience other symptoms such as pink or purple stretch marks on skin or the development of dark hair on the face and body other than a rounded face.” 
Cortisol, a steroid hormone produced by the adrenal glands, is important in the body’s response to stress.
Dr Ho said that during periods of stress, cortisol helps prepare the body for a “fight or flight” response by increasing heart rate, respiratory rate, blood pressure, blood glucose and muscle tension.
It also keeps the body awake, alert and focused.
“Most of us experience short periods of stress where the cortisol levels peak, then stabilise once the stressful event is over.
“This peak allows us to rise to the challenge, but the balance is restored once the challenge is over.” 
However, chronic stress presents a different challenge.
Ms Truscott explained that prolonged exposure to stressors disrupts various bodily processes, affecting the cardiovascular, respiratory, endocrine and gastrointestinal systems, among others.
Rather than just causing a puffy face, she said that chronic stress increases the risk of numerous health problems, including anxiety, depression, digestive problems, headaches, muscle tension and pain, heart disease, high blood pressure, stroke and sleep disorders.
More importantly, both experts advised online users to be more discerning when consuming health-related content. 
“Social trends that raise more awareness regarding stress can be beneficial in encouraging better self-care.
“However, medicalising differences in physical appearance runs the risk of misguiding the public with inaccurate medical information and spreading fad treatments,” Ms Truscott said. 
Dr Ho warned that such trends also oversimplify complex health concepts and send out incomplete, inaccurate and sometimes exaggerated messages.
“Some followers may self-diagnose inaccurately and develop health anxiety or unrealistic beauty standards, leading to increased anxiety and stress about their appearance.”
Even though the TikTok videos on “cortisol face” seemingly perpetuate the idea that cortisol is bad, both experts emphasised that cortisol is a crucial hormone for various bodily functions — and maintaining optimal levels is essential for overall health.
Additionally, Dr Ho said that having a high cortisol level during the fight-or-flight response can help us focus, solve problems and meet challenges. 
“As long as there are sufficient rest periods and the cortisol levels are allowed to subside and restore balance, having a high cortisol level is not always a bad thing.”
She also said that one can often feel relaxed and calm after the initial cortisol boost.
In that same vein, Ms Truscott said that stress often gets a bad name, but not all forms of stress are detrimental.
Eustress, which refers to stress that leads to a positive response, can be enjoyable, stimulating and inspiring.
These positive stressors may be associated with:
“Eustress may, in fact, foster mental acuity, motivation and even resilience in the face of challenges,” she added. 
When it comes to managing stress, Dr Ho said that some effective and practical methods include regular physical activity, a good sleep routine, a good diet that cuts down on sugar, saturated fats and processed foods, as well as breathing exercises and meditation. 
Psychologically, Ms Truscott said that we can consider adjusting our mindset in stressful situations.
“Ask yourself the following questions: Will this situation last forever? Does this situation affect all aspects of your life? Am I solely responsible?”
She also recommended practising positive self-talk, in which we speak to ourselves in a kind, encouraging and supportive manner like we would when we show care to someone.
“Focus on what you have control of, so that you can act on what you have the power to change, while accepting what is beyond your control.” 

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