‘Moon Face’ Is Trending on TikTok—Here’s What a Doctor Wants You to Know

If you keep seeing TikToks about “moon face” or “cortisol face” and are wondering what the heck that means, well, welcome to the club. I was confused myself until I recently went down a social media rabbit hole, where I discovered videos (with thousands of views, BTW) of people showing their swollen, puffy faces and blaming too-high levels of the stress hormone cortisol. After sharing tales of woe, and a few “before” and “after” pics, many posters end their videos with not-so-discreet callouts to buy their ebook, use their products, or “learn more at the link in bio,” so viewers can get rid of their moon face, too.

But what exactly is moon face, and why does everyone seemingly have it now? Is it possible that we all have too-high cortisol levels that can be remedied at home with the shiniest new product?

To clarify, cortisol is more than just a buzzword: It’s a vital hormone that helps our bodies regulate blood pressure, balance blood sugar, and turn food into energy, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). And despite the vilifying online, we actually do need some cortisol in our systems to stay healthy.

Here, a hormone expert breaks down what moon face actually means, whether the TikTok claims around it are true, and whether it’s possible to lower cortisol levels at home—or if we even need to.

So, what is moon face?

Moon face (also known as “moon facies”) is swelling that builds up on the sides of your face, making it look puffy and round like a full moon, per the Cleveland Clinic. “It’s a buildup of fat deposits throughout the face and it’s usually due to excessive cortisol production, whether from your own body or from medications that you’re taking,” says Gowri Reddy Rocco, MD, a double board-certified family medicine physician who specializes in regenerative health and hormones.

It’s not a condition, but rather a side effect of underlying health issues that affect levels of hormones like cortisol in the body, says Dr. Rocco. She sees it most often in people being treated with corticosteroids, such as prednisone, for conditions like arthritis, asthma, autoimmune diseases like lupus and multiple sclerosis, skin conditions like eczema and rashes, or certain kinds of cancer.

Some other common causes behind moon face include insulin resistance, steroid use, Cushing’s syndrome, and hypothyroidism, Dr. Rocco says, but you’d also notice other side effects from these conditions. In the case of Cushing’s syndrome: a rounder gut and midsection, thinner arms and legs, easy bruising, and a fatty hump between the shoulders, per the NIDDK. (But keep in mind Cushing’s is fairly rare: Only about 40 to 70 people out of a million get it every year in the U.S.)

Other medical reasons for moon face may be more common, like insulin resistance, diabetes, or hypothyroidism, but you’d likely experience other side effects too, like fatigue, sleep problems, and depression or anxiety, among other things, says Dr. Rocco.

Are all the TikTok claims about moon face true?

It’s not likely that all the TikTok girlies claiming they have moon face actually do. If anything, Dr. Rocco says they are using the term “moon face,” which is usually a side effect of a health condition, to describe general puffiness you can experience from other things like “water retention, weight gain, drinking too much alcohol, dehydration, and a poor diet high in fats, sugars, and ultra-processed foods.” All can contribute to a rounder-looking face.

Plus, let’s not forget: Everyone’s face shape is different. It’s natural for some people to have a rounder face, but thanks to our recent obsession with prominent cheekbones, sharp jawlines (read: TikTok’s obsession with chin straps and “quick-fix” culture), and even “Ozempic face”—a rapidly thinning face due to the effects of taking the popular weight-loss drug—we’ve been led to believe a thinner face means you’re healthier. But not every round face signals a medical issue, and Dr. Rocco warns against anyone promoting a “quick fix” for moon face online.

Can moon face be triggered by stress?

Many TikTok videos say stress is the biggest cause of moon face, but is it actually? According to Dr. Rocco, stress can contribute to facial puffiness but doesn’t directly cause it.

“When you’re stressed, you’re more likely to turn to unhealthy coping mechanisms, like eating sugary or fatty foods, drinking alcohol, getting little sleep, and avoiding exercise, which can contribute to water and fat retention, and consequently a puffier body and face,” says Dr. Rocco.

While a stressful event here or there is not likely to mess much with your hormones, chronic stress can increase the chances of turning to these poor lifestyle habits, which may contribute to elevated cortisol levels over time and side effects like sleep problems, anxiety, and weight gain, per the Mayo Clinic.

Bottom line: Not everyone with facial puffiness actually has moon face or cortisol face. Unless you have a true medical diagnosis that affects your cortisol levels, facial puffiness may simply be a result of certain lifestyle factors like poor diet, dehydration, and lack of sleep.

Should we all, then, be concerned about lowering cortisol levels?

As we’ve learned, our bodies need at least some cortisol in order to function properly. In fact, healthy blood levels of cortisol typically peak in the early morning and decline throughout the day. For most adults, that’s around 10 to 20 micrograms per deciliter from 6 a.m. to 8 a.m. and 3 to 10 micrograms per deciliter around 4 p.m., per the Cleveland Clinic. So the goal should never be to completely eliminate cortisol in the body.

That said, too-high levels of cortisol (from certain medical conditions or chronic stress) can lead to effects like weight gain, depression, inflammation, and more, says Dr. Rocco. If elevated cortisol is due to a medical condition, you’ll need to go to the doctor for treatment or medicine. But in general, healthy lifestyle habits you may already engage in can help lower cortisol levels overall—no fancy supplements, ebooks, or products needed.

Here are Dr. Rocco’s recommendations:

• Get plenty of sleep. Chronic sleep issues are associated with higher levels of cortisol, per the Cleveland Clinic.
• Exercise daily. Walking, Pilates, or any other exercise you love can help release feel-good hormones like endorphins and reduce cortisol over time, per Harvard Health Publishing.
• Eat a balanced diet. Adding more fruits, veggies, protein, and healthy fats is great for overall health, while limiting refined sugar and sodium, Dr. Rocco says.
• Reduce alcohol intake: Moderate and binge drinking is associated with elevated cortisol levels, per a July 2023 study in Neurobiology of Stress¹.
• Spend time doing things you enjoy (with people you enjoy). This can help promote feel-good hormones like oxytocin and endorphins, per Dr. Rocco. Find things you love to do that help reduce stress, like reading a book, being in nature, journaling, etc. Also, spending time around toxic people or those who exacerbate stress can increase cortisol levels, per the Cleveland Clinic, so try to spend more time with those you love.
• Laugh! Laughter also helps release endorphins, so getting a good belly laugh each day might be just what the doctor ordered, per the Cleveland Clinic.
• Seek therapy. If you’re having a hard time regulating your stress, Dr. Rocco recommends reaching out to a mental health professional to help better understand yourself and work through any unwanted feelings.

“Stress management and mental health is so important,” says Dr. Rocco. She emphasizes prioritizing joy, saying, “the opposite of cortisol is oxytocin and endorphins, which help you feel healthier overall.”

When to see a doctor about moon face

Ultimately, not everyone claiming they have moon face on TikTok actually does. They may be describing general facial puffiness that comes with poor lifestyle habits, weight gain, or prolonged stress, or even just their natural face shape. Moon face, in particular, is usually a side effect of an underlying medical condition like Cushing’s syndrome or insulin resistance, which can be treated by your doctor.

“If you start noticing you’re gaining weight even with exercise, eating better, and sleeping, I would 100 percent recommend going to the doctor and getting your blood checked,” says Dr. Rocco. Blood work can often detect insulin resistance, thyroid function, and cortisol levels.

Additionally, if you have other symptoms like fatigue, sleep issues, loss of your period, or mental health concerns, reach out to your doctor. This could point to an underlying hormone condition.

—reviewed by Jennifer Logan, MD, MPH