The appearance of your face, this content often implies, directly correlates with your health and how well you care for it. Sometimes it goes even further. One creator I came across recently argued that a bloated “moon face” is a sign of a malfunctioning liver. “Your liver is your detoxing organ, so if you’re inflamed and you’re puffy, it’s likely that you’re not detoxing properly. Looking after your liver can get rid of so much of that puffiness and inflammation.” Another kicked off a video by saying, “You’re not ugly, you’re not puffy, you just have cortisol face. I was so inflamed from so much stress and anxiety; it caused my face to swell up all the time.” (Unsurprisingly, the video was made in partnership with a company selling “cortisol-reducing” supplements.) Some creators go even deeper down the rabbit hole, suggesting that a puffy face is a telltale sign of an autoimmune or hormonal disorder like adrenal dysfunction, polycystic ovary syndrome, or Hashimoto’s disease.
It’s true that how you feel is sometimes reflected in your face. But as board-certified dermatologist Mona Gohara, MD, explains, mild facial bloating is a normal and necessary function of the human body: “Facial puffiness is far more normal than the internet would have us believe.” She says it can be caused by a number of everyday factors including but not limited to sleep deprivation, stress, allergies, diet, travel, and even sleeping position. Genetics, of course, impacts your overall facial structure, too; some people just have naturally full undereyes. But in most people, facial bloating and undereye puffiness are usually just reactionary. “Inflammation doesn’t always signal disease; sometimes the face is simply responding to life,” Dr. Gohara says.
Framing perfectly normal facial swelling as evidence of an underlying health problem is, at best, disingenuous. Can we all admit that we’re not really looking to get healthier when we’re seeking out ways to depuff our own faces? I think, subconsciously or not, most of us just want to be hot; I can’t judge that in a society where hotness has the power to open doors and change lives. When I have too many martinis and wake up looking visibly worse for wear, the first thing I do is consult TikTok for an anti-bloating gua sha routine. I don’t do it to feel healthier; I do it to give the illusion that I have healthier habits than I do. By scraping my bloated face with my little rock, I’m hoping to erase the previous evening’s hedonism and look like someone who went to bed on time and woke up for a 5 a.m. run. If I were really looking to improve my health, I might have actually gone on that run instead of inspecting myself in the mirror for puffiness. Or, you know, consulted an actual doctor for advice.
It’s only natural to want to look more put together than you feel—or to feel pressured to meet today’s hyper-snatched beauty standard—but trying to find a medically significant reason to justify this desire can be harmful. Dr. Gohara can tell you exactly why: “The problem is that online culture has moralized these natural fluctuations, equating puffiness with poor health or lack of discipline,” she says. “We’ve confused wellness with worthiness, but the face is not a report card.”