If you've spent any time on social media recently, you've likely encountered countless posts warning about the dangers of high cortisol levels. Influencers frequently blame this hormone for everything from poor sleep and depression to various beauty concerns including wrinkles, puffy faces, and thinning hair. But how much of this is scientifically accurate?
We consulted several board-certified dermatologists and hair restoration specialists to separate fact from fiction regarding cortisol's role in our appearance and overall health.
What Exactly Is Cortisol?
Dr. Tanya Kormeili, a board-certified dermatologist with the Derm and Rejuvenation Institute in Santa Monica, California, emphasizes that cortisol is essential for survival. "Cortisol is a hugely necessary steroid hormone without which we would all be dead," she stated. While excessive cortisol can be problematic in rare cases, she explained that for most people, cortisol isn't the villain it's often portrayed to be.
According to Dr. Michelle Draznin, a board-certified dermatologist with Kaiser Permanente, cortisol is a steroid hormone produced by the adrenal glands. Dr. Corrie Alford from MetroDerm in Atlanta, Georgia, added that it's commonly called "the stress hormone" because our bodies produce extra cortisol to trigger the fight-or-flight response during acute stress.
"When that happens, cortisol increases blood pressure, heart rate and muscle tension," Alford explained. However, cortisol's functions extend far beyond stress response. It plays critical roles in maintaining organ function, regulating blood pressure, glucose levels, immune response, and the sleep-wake cycle.
Short-Term Spikes Versus Chronic Elevation
Cortisol naturally fluctuates throughout the day, and for most people, periodic increases don't harm health or appearance. "It is highest early in the morning to get people up and going, and lowest late in the evening to facilitate sleep," Draznin noted.
Alford explained that cortisol levels rise during short periods of high stress or trauma, whether from mental stressors like work deadlines or arguments, or physical stressors like strenuous exercise or extreme temperatures.
Chronically high cortisol levels present a different scenario. "Very high constant stress" can cause excess cortisol over prolonged periods, though this is rare, according to Draznin. Other causes include adrenal gland tumors, pituitary gland tumors, and long-term steroid use for autoimmune diseases or cancer.
Chronic elevation can suppress immune function, increase inflammation, and cause hypertension, elevated glucose, and fatigue.
How Cortisol Actually Affects Your Appearance
High cortisol levels can significantly impact skin health. Alford explained that excess cortisol reduces production of collagen and elastin, the skin's building blocks. "As their production slows, the skin becomes thinner and more prone to premature wrinkles and stretch marks," she said.
Too much cortisol can also disrupt oil production, leading to acne, dry skin, or both. "Because cortisol causes androgen production, sebum levels rise and acne is inevitable," Kormeili added. "Additionally, cortisol slows down epidermal cell turnover so skin can look dull and flaky."
High cortisol can cause melasma (dark skin patches) and slow wound healing, potentially leading to scarring.
Long-term elevated cortisol can alter facial and body appearance. Draznin explained it can lead to facial adiposity, sometimes called "moon face," where fat buildup makes the face appear rounder. Kormeili noted excess cortisol can cause fat accumulation behind the neck ("buffalo hump") and fluid retention that creates facial bloating and puffy eyes.
High cortisol levels can also disrupt digestion, causing abdominal bloating and distention.
Cortisol's Impact on Hair Health
Chronically high cortisol levels contribute to hair loss, explained Dr. Yücel İskender, chief medical officer at NOVE Group in Turkey. Excess cortisol disrupts the hair growth cycle by prematurely forcing follicles into the resting (telogen) phase.
"This leads to the widespread shedding we call telogen effluvium," İskender said. High cortisol can also reduce oxygen reaching the scalp and create hormonal imbalances affecting hair appearance and quantity.
"Over time, this combination of stress, inflammation and hormonal disruption can make hair more fragile and prone to shedding," he explained.
Draznin noted that hair loss related to high cortisol "generally occurs roughly three months after an immense stressor and reverts to normal three months after the stressor has subsided."
For persistent hair loss, lifestyle changes to reduce stress or medical treatments like topical minoxidil may help. Hair transplants are typically only recommended for permanent hair loss, not temporary thinning related to stress-induced cortisol spikes.
Can We Control Cortisol Levels?
Despite social media promises of fail-proof cortisol control methods, Draznin stated, "We cannot really control cortisol secretion." Unless you have a medical condition causing chronically high cortisol, reducing levels likely won't solve beauty concerns.
If you suspect chronically high cortisol, consult a doctor, but having one symptom like dry skin or bloating usually isn't cause for alarm.
For those determined to try lowering cortisol, Kormeili recommends: "You can stay on top of your cortisol levels by getting adequate sleep, creating relaxation through moderate exercise, laughter and connection to others while eating a balanced diet with proteins and staying away from excess sugars, alcohol and caffeine."
İskender cautioned that while moderate exercise may help lower cortisol, excessive exercise can increase it by stressing the body.
Most importantly, trying to eliminate cortisol entirely is dangerous. "Low cortisol is not consistent with survival," Draznin emphasized.
