Stress and ‘moon face’: What experts say about this TikTok trend

By Sandee LaMotte, CNN

(CNN) — Social media users just won’t stop talking about how the stress hormone cortisol can cause cheeks and eyelids to swell out of recognition, a condition dubbed “moon face.”

“Your face is like a moon, it can be very circular,” one woman claims on TikTok. “It can look swollen and inflamed.”

“It’s from high cortisol, aka high stress,” a woman says in another post. “When I was going through the pandemic I was like (she puffs out her cheeks) ballon face.”

As people scurry to fit more and more into each day, constant stress can be a reality in today’s busy society. But can such stress actually expand your face?

“While chronic stress can lead to increased levels of cortisol in the body, those levels don’t usually rise high enough to create a 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 lead to fluid retention,” Katta said in an email.

True “moon face” is a byproduct of having Cushing’s syndrome, a condition in which the body has extremely high levels of cortisol, Katta said, typically from the protracted use of prescription medications such as the steroid prednisone or, more rarely, cases in which a person’s adrenal glands are overactive.

In addition to a rounded face, Cushing’s syndrome can cause increased fat around the neck or a fatty hump between the shoulders and upper body obesity, according to the Johns Hopkins Medicine website.

“For medical causes of fluid retention, treating the underlying cause will help. Your physician may also prescribe a diuretic to help your body rid itself of extra fluid,” Katta said.

How stress can affect the face

While cortisol levels from elevated everyday stress may not be the reason behind so-called moon face, the hormone can take a toll on the skin in other ways.

Stress hormones such as cortisol can trigger breakouts and dull skin, accelerate aging, and exasperate skin conditions such as eczema and psoriasis, according to dermatologist Dr. Whitney Bowe, an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.

“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 scaffolding of the skin that prevents fine lines and wrinkles,” Bowe said. “Hyaluronic acid keeps the skin plump, and ceramides are healthy fats that create a barrier to prevent skin permeability, thus locking moisture into the skin.”

Bad habits can stress the skin

People often turn to salty snacks when stressed, which might 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 “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 — eating too much sugar and ultraprocessed carbohydrates, which “unfortunately can damage the skin’s collagen over time through a process called glycation,” Katta said.

Glycation occurs when sugar molecules attach onto fats and proteins and create advanced glycation end products, or AGEs, which can make collagen and elastin proteins less supple — and the skin more likely to wrinkle, she said.

“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 less stress

There are ways to reduce stress that can benefit the skin as well, experts say. Exercise increases blood circulation to the face and helps with the release of endorphins, the body’s feel-good hormones.

Exercise also pushes oxygenated blood to all your body parts, 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 decrease cortisol production and stress levels.

Good-quality sleep is another way to improve skin and reduce stress, according to sleep specialist Dr. Raj Dasgupta, an associate professor of clinical and sleep medicine and pulmonary critical care at Huntington Health in California.

“It’s called beauty sleep because sleep does regenerate your skin at night,” Dasgupta told CNN earlier. “There’s a hormone called growth hormone that gets secreted during the deeper stages of sleep that stimulates fresh skin cell growth.”

Adults older than 18 need at least seven hours of solid sleep at night to be healthy, according to the US Centers for Disease Control and Prevention. Sleep debt, along with irregular sleep duration, has 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.

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