What is “Moon Face”?: New TikTok tutorials offer dubious solutions

After convincing the world that mold exposure the orthostatic tachycardia syndrome (POTTERY) were to blame for their fatigue, brain fog, anxiety and headaches, TikTok's latest mass diagnosis is swelling and facial swelling known as “moon face”, caused by high levels of the hormone stress, cortisol. Along with popular awareness before and after videounqualified wellness agents also offer a range of supposed cortisol-lowering treatments that range from useless to common sense.

While “moon face” is an actual symptom of a real condition known as Cushing's syndrome — resulting from elevated cortisol levels — is a challenging diagnosis even for experienced endocrinologists. Plus, treating it involves more than taking supplements, cutting out caffeine, or doing some morning stretches, as many TikTokers seem to suggest. So how common is “moon face” and what does it actually take to get rid of it? Rolling rock she talked to an endocrinologist, a plastic surgeon, and an internist to find out.

What is a “moon face”?

The lunar sound symptom refers to “a round, swollen face that often has a ruddy complexion,” he says Brian Burtch, MDendocrinologist at University Hospitals in Cleveland.

Moon face can result from a combination of swelling, water retention and fat deposits, he says Joel Kopelman, MD, a facial plastic surgeon in New York. “In cases of high cortisol levels, such as with Cushing's syndrome, these changes are often due to fluid retention and fat redistribution,” he says. Rolling rock. “It's a multifaceted issue, and understanding the underlying cause is key to effective treatment.”

Kopelman says he's seen an increase in the number of patients seeking “moon face” treatment at his Park Avenue practice, noting that social media sites like TikTok and Instagram play a major role in that trend. “These platforms often highlight beauty standards and trends that can make people more self-conscious and concerned about their appearance,” she says. “Other contributing factors are the increased general awareness of cosmetic procedures and the wider acceptance of cosmetic treatments in society. It is a combination of these influences that appears to be driving the rise in “moon face” consultations.

When patients come to Kopelman concerned about their “moon face,” most are looking for some type of fat reduction, such as liposuction or liposuction. “However, I always recommend a thorough evaluation by a health care provider to determine the underlying cause,” he says.

What causes the “moon face”?

The Moon face is most closely associated with Cushing's syndrome, “which basically means you have too much cortisol,” says Burtch. “But the bigger question is 'why is that?'”

Cushing's syndrome can be caused by something inside the body that produces too much cortisol — such as a pituitary or adrenal tumor — or an outside source, such as a drug. In addition to the moon face, Cushing's syndrome can also cause what is called a “buffalo lump” in the back of the neck, “supraclavicular fat” in the collarbone area, a large belly that can look like someone is holding a basketball under his shirt. thin skin almost the texture of paper and bright purple streaks on their bellies, Burtch explains. Women may also have hirsutism, or dark, coarse hair that grows on parts of the body that are normally hairless. “These symptoms often present with muscle weakness, especially in the shoulders and arms or thighs,” he says.

When Burtch's patients have Cushing's syndrome and the associated moon face, he says it's often because they've been taking high-dose steroid treatments — such as prednisone, hydrocortisone, or dexamethasone — for several months, for conditions like asthma, rheumatoid arthritis, or inflammatory disease. of the intestine.

According to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than 10 million Americans take this type of steroid medication each year, but it is not known how many develop Cushing's syndrome. The NIDDK Estimates that between 40 and 70 people out of every million in the US end up with the condition because their bodies overproduce cortisol.

Although high cortisol levels are a factor in some cases, it's not the root cause of everyone's puffy face, Kopelman says. “As a facial plastic surgeon, I've noticed that the 'moon face' isn't as prevalent as TikTok might lead you to believe,” he explains. “Social media has a way of amplifying health concerns, sometimes leading people to believe they have certain conditions when they don't.”

In these cases, it can be something called “pseudo-Cushing's,” which Burtch says can result from things like depression, alcohol abuse, and severe obesity. “In these conditions, when our bodies are stressed, we're going to produce more cortisol, and that cortisol helps maintain our energy, our blood pressure, [and] our sugar,” he explains. But those short-term increases in cortisol from stress or pain aren't going to trigger the syndrome itself — that would require “prolonged high cortisol levels,” he says. “If a person suspects this, they should really consult their doctor.”

Cortisol levels can be checked by a doctor through blood, urine or saliva samples, he says Raj Dasgupta, MDphysician specializing in internal medicine, pulmonology, critical care and sleep medicine and the chief medical advisor for Luck is health. “It's best to talk to your doctor who can order the right tests and interpret the results for you,” she says. Rolling rock.

“If you have a moon face, the question you have to ask is why,” says Burtch. “Is it a medicine you take? Do you have any kind of illness? Are you depressed? Do you abuse alcohol? You must first understand what the cause is before you can understand what the right treatment is.”

What does TikTok suggest?

In a video with more than 1.1 million views, TikTok user cortisol. mom flashes dramatic before-and-after pictures of herself with and without “cortisol face” — a transformation she claims is the result of consuming a wellness product called “Happy Juice“, was sold through a company of which he is a representative. As it turns out, a significant number of these before and after TikTok videos offering ways to lower cortisol levels are actually ads for products like gua sha tools, water magnesium bicarbonateadaptogens and other supplements that do not treat the root cause of the moon.

Other influencers take a different approach: They offer generic, common wellness tips to get rid of moon face — like eating a high-protein, low-carb diet, getting mixed forms of exercise, and getting more sleep — and continuously offering services they offer, like appropriateness, nutrition, or “wellness” training. Some frame their videos around the fact that women's health concerns are often overlooked or dismissed by doctors, suggesting that the moon aspect, as well as other issues such as hair loss, weight gain and eye twitching are the result of high levels cortisol and issues that can be taken into your own hands.

“A lot of these people are very good presenters and very smooth, and they make these concepts look very easy when they're really very complicated,” says Burtch.

While some of the treatments the TikToker has suggested aren't unreasonable for a healthy lifestyle — like intermittent fasting and strength training — Burtch points to a lack of empirical evidence that other strategies like hot and cold therapy and breathing techniques actually help reduce cortisol levels.

While health influencer-recommended supplements such as L-theanine, Shilajit, magnesium glycinate, electrolytes, adaptogens, medicinal mushrooms and ashwagandha “may have some role” in lowering cortisol levels, “It's important to remember that they are not regulated by the FDA, so you really need to talk to your healthcare provider about their use, where to get them, and whether they might interact with medications you may be taking,” says Burtch.

Likewise, cutting out caffeine and taking a warm bath before bed “may help lower cortisol levels for some,” but they're not targeted treatments, Dasgupta says. And drinking water with magnesium bicarbonate “is unlikely to have a significant effect on cortisol levels or the moon face and does not have strong scientific support,” explains Kopelman.

TikTokers also suggest techniques like gua sha, lymphatic drainage, facial reflexology and vagal stimulation, which Kopelman says can improve circulation and provide temporary relief from puffiness and swelling, but “are not treatments for high cortisol levels.” Along the same lines, reducing salt intake “can help reduce fluid retention, which can improve facial swelling, but similar to other 'at-home' remedies, it doesn't address the underlying causes [of moon face],” adds Dasgupta.

That said, for many people, simply having a morning routine or becoming more active can benefit their mental health and, in turn, reduce their stress levels, she explains. “So, indirectly, some of the things can work, whether there's a big scientific basis or not,” says Burtch.

Ultimately, the most effective way to treat facial swelling or moon face is to talk to your healthcare provider so they can address the underlying cause, Dasgupta says. “This could include medication adjustments, hormone therapy or lifestyle changes, depending on the specific cause,” he adds.

While managing stress through healthy lifestyle changes can help lower cortisol levels, Kopelman says it's “not advisable to rely solely on TikTok strategies or self-diagnosis” because “self-medicating based on social media trends can be ineffective and even harmful, so professional guidance is always recommended.”

But TikTok videos aren't completely useless: Burtch says you can use them as a starting point for a conversation with your healthcare provider.

“Doctors don't get confused when someone says, 'Hey, I saw this on TikTok, or Facebook, or this article,'” he explains. “We're not going to be disappointed by that. I always tell patients, “I'm glad you feel comfortable coming to me with this, because I'd rather you ask me about it than do it yourself.”