What can the ‘cortisol face’ phenomenon teach us about chronic inflammation
It’s not a clinical term but rather another example of social media making a problem out of something that in many cases is likely quite innocent.
Is your face looking a little puffy? According to social media wellness influencers this could be a sign you’ve been afflicted with the dreaded “cortisol face”.
So what exactly is cortisol face? It’s not a clinical term and one I hadn’t heard of until recently, but rather, it’s another example of social media making a pathological problem out of something that in many cases is likely quite innocent.
With the social media declarations that your facial puffiness, or even that slight double chin, means you need to reduce your cortisol levels comes a wealth of advice on how you can deal with this perceived issue.
Have you tried cutting gluten, dairy and seed oils from your diet? Maybe these facial exercises will help, or how about these supplements that I just so happen to be selling?
While cortisol face may be another overblown social media trend, there is a hint of truth hidden among the misinformation. And it’s name is inflammation.
What is cortisol and how is it linked to inflammation?
You may know cortisol as the “stress hormone”. In the short term, cortisol can help us deal with stressful situations, regulate blood sugar levels and blood pressure, and manage our sleep-wake cycles.
But another important role of cortisol is managing inflammation. Though we often consider inflammation a bad thing, acute inflammation actually plays an important role in the healing process. That pain, redness and swelling you get when you cut yourself is a natural process that we need to go through for the body to heal itself.
The issue comes about when inflammation becomes chronic – aka this natural process either won’t turn off, or it keeps recurring. This can cause damage to body tissues and has been linked to increased risk of chronic disease – including cardiovascular diseases such as atherosclerosis, the main driver for heart attack.
What are the signs of chronic inflammation?
Chronic inflammation can manifest in many ways – including persistent pain and/or aches, fatigue, skin issues, mood disorders, changes in weight, gastrointestinal issues or allergic reactions. Annoyingly, chronic inflammation can also be occurring without any noticeable symptoms.
So could that “cortisol face” really be a sign your body is chronically inflamed? Likely not, but moon face or in fact “moon facies” which is the clinical term – can be a symptom of diseases such as Cushing’s disease, where a tumour in the pituitary gland causes excess levels of cortisol.
This however is much less common than social media would have you believe. Facial roundness or puffiness on its own can have many causes – from being a natural face shape, to weight gain due to metabolic syndrome, potential allergies, or simply not getting enough sleep.
So what can increase your risk of chronic inflammation?
Aside from chronic inflammation being a sign of a chronic infection or an auto-immune disease, it is also strongly linked to lifestyle factors.
While they might not be as potent at raising inflammation as a chronic infection or an auto-immune disease, other drivers of inflammation include poor diet, poor sleep, excess alcohol, lack of physical activity, exposure to environmental pollution, stress, obesity and smoking. All of these factors can contribute to chronic inflammation – which is one of the reasons why health professionals so strongly recommend lifestyle change as a key factor in reducing the risk of chronic disease.
How do I know if I have chronic inflammation?
Rather than taking advice from social media, it’s best to discuss with your doctor if you’re experiencing any of the symptoms mentioned above. But note it’s unlikely you will have a condition like Cushing’s disease. There are several blood tests to check for inflammation, that include general tests like a C-reactive protein (CRP) test or erythrocyte sedimentation rate (ESR) test. There are also very specific tests for diagnosing a condition like Cushing’s disease. Medical imaging such as CT scans may also be used to diagnose or rule out specific conditions.
Those who are struggling with diet, sleep, getting enough physical activity may also benefit from discussing these concerns with your doctor to get ahead of any potential chronic inflammation issues in the future.
How can I manage or reduce my risk of chronic inflammation?
If not supplement X and a strict gluten-free diet, what does help to reduce the risk of inflammation and chronic diseases such as heart disease?
As with many health conditions, diet is a crucial factor. A well-balanced diet like the heart-healthy Mediterranean diet, has been shown to help reduce chronic inflammation. This includes eating plenty of antioxidant-rich fruits and vegetables and aiming to eat a variety of colours, which represent different phytochemicals.
Eating a good amount of cardioprotective omega 3 fats from foods such as fish is also beneficial, as is limiting saturated and trans-fat intake from foods such as red and processed meats.
Seed oils don’t need to be avoided and have been found to be beneficial to the heart when replacing high-saturated fat foods like butter.
Also aim to minimise your intake of ultra-processed foods and limit your alcohol intake.
Engaging in regular physical activity, managing stress, and getting good quality sleep are also important to help lower cortisol levels and reduce the risk of chronic inflammation.
If you suspect a chronic condition is the cause of your symptoms, it’s important to discuss this with your GP. Treatment options are available if the cause is an autoimmune condition. Newer medications such as semaglutide (sold as Ozempic and Wegovy) or tirzepatide (sold as Mounjaro) also potentially reduce inflammation, which may account for some of their beneficial effects.
There are also medications on the market, particularly canakinumab (an antibody that blocks a key inflammatory pathway), that while not approved for use in reducing inflammation related to cardiovascular events, have proven that this concept is viable. So the hunt is now on to find more targeted drugs to help manage inflammation that contributes to atherosclerosis, a major driver of heart attack.
In the meantime, if your face looks a bit puffy, or if you have any health concerns, don’t turn to TikTok or social media for answers. It could easily pull you down a rabbit hole and cause you a lot of unnecessary stress – which is in fact a real driver of inflammation.
Professor Jason Kovacic is a cardiologist and director of the Victor Chang Cardiac Research Institute.
This column is published for information purposes only. It is not intended to be used as medical advice and should not be relied on as a substitute for independent professional advice about your personal health or a medical condition from your doctor or other qualified health professional.
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