8 Important Signs of High Cortisol

Devi ShivaShanmi
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How do I know if my cortisol level is high or low?


Cortisol is an important hormone produced by the adrenal glands that affects several functions in the body, including metabolism, blood sugar and pressure regulation, inflammation reduction, and sleep-wake cycle regulation. However, an imbalance of cortisol levels, whether too high or too low, can have serious consequences on health. In this article, we will delve into the eight signs of high cortisol and how it can affect the body.


1. Weight Gain

High cortisol levels can cause significant weight gain, particularly in the face and midsection. The following are signs and symptoms of cortisol excess:


  • Moon face or plethora: Fatty deposits in the mid-face, particularly the cheeks, can create a rounded, moon-like appearance.
  • Buffalo hump: Excess cortisol can cause fat deposits to accumulate in the upper back, giving the appearance of a hump.
  • Thickened and shortened neck: Fat deposits can accumulate above the clavicle, creating a thickened and shortened neck appearance.
  • Truncal obesity: Cortisol can cause a significant amount of weight gain in the midsection, while the arms and legs remain unaffected.
  • Fatty deposits behind the eyes: In rare cases, roughly 8% of patients may develop fatty deposits behind the eyes.


It is essential to note that cortisol levels should always be balanced, and excess cortisol can have serious health consequences. 


Identify High Cortisol Levels with these 8 warning signs

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2. Skin Thinning

High cortisol levels in the body can cause a variety of health problems, including skin thinning. This condition is characterized by a reduction in the thickness of the epidermis and dermis, which makes the skin more fragile and prone to tearing.


  • Skin Thinning on Elbows and Knees: One of the most common areas where skin thinning occurs is on the elbows and knees. The affected skin takes on the appearance of wet cigarette paper and becomes very fragile, making it prone to tears.

  • Skin Thinning on Hands: Patients with high cortisol levels may also experience skin tearing and bruising on the backs of their hands. The atrophy of both the epidermis and dermis due to high cortisol levels leads to skin fragility, making underlying blood vessels beneath the skin more apparent. This can be seen in the form of dilated blood vessels or telangiectasias.

  • Peeling off Tape and Skin Tearing:  Another sign of skin fragility due to high cortisol levels is the peeling off of tape from the skin surface, such as an adhesive bandage, which can easily cause skin tearing.

3. Stretch Marks


Stretch marks, also known as stria, occur when the skin's dermis layer thins out, often due to sudden weight gain or growth spurts. However, there is a type of stretch mark that occurs as a result of high cortisol levels. These marks are wider, approximately a centimeter, and have a striking purple or bright red hue. In contrast, stretch marks from weight gain or pregnancy typically appear pink to silverish.

High cortisol stretch marks are often seen around the abdomen, inner thighs, arms, buttocks, thighs, lower back, and breasts. They can occur due to a variety of reasons, including Cushing's syndrome, a condition that causes high levels of cortisol in the body.

In addition to the physical appearance of these marks, individuals with high cortisol levels may also experience other symptoms, such as weight gain, mood changes, and increased susceptibility to infections.

Treatment options for high cortisol stretch marks may include topical creams, laser therapy, or cosmetic surgery. However, it is important to address the underlying cause of high cortisol levels to prevent further stretch mark development and other health issues associated with the condition.


4. Acanthosis Nigricans


Acanthosis nigricans is a skin condition characterized by thick, velvety, dark greyish-brown patches that often appear on the neck, underarms, and hands. It is a type of change to the epidermis and is commonly seen in people with insulin resistance, such as those with diabetes.

High cortisol levels play a vital role in regulating blood glucose levels, and acanthosis nigricans is the skin's way of indicating that something is wrong with insulin regulation in the body. The skin cells become responsive to insulin when its levels are high, and when there is insulin resistance, it directly shows up on the skin as a clue.

Acanthosis nigricans serves as a visual sign of an underlying endocrinological or metabolic problem, which must be addressed to improve the condition. Understanding the association between high cortisol levels and acanthosis nigricans can aid in identifying potential health issues, and timely intervention can prevent the condition from progressing further.


5.Steroid Acne


Steroid acne is a unique type of acne that can develop when cortisol levels are too high. It is different from the typical acne that one may develop at any point in life. Steroid acne appears suddenly and all lesions appear more or less the same, referred to as monomorphic steroid acne. It can erupt on the face, neck, upper chest, back, and upper arms.

Patients in the hospital who develop high cortisol levels due to medication may also develop steroid acne. The condition may be related to a little yeast called malassezia or piderosperum that naturally lives on everyone's skin. When cortisol levels are too high and inflammation is suppressed, the body starts responding to things that it otherwise ignored in the past. Steroid acne can be a manifestation of that response.

High cortisol levels suppress the immune system, which can lead to the development of steroid acne. It is crucial to address the underlying cause of high cortisol levels to prevent the condition from worsening. Understanding the link between high cortisol and steroid acne can help identify potential health issues and ensure timely intervention to prevent the condition from progressing.


6. Hair Thinning and Hair Loss 


High cortisol levels can lead to significant changes in hair growth. Androgens, hormones produced by the adrenal gland along with cortisol, can influence hair growth and contribute to hair thinning known as androgenetic alopecia. When androgen hormone levels are too high, it can lead to hair loss. Women may experience a widening of the central part, while men may have a receding hairline. Androgenetic alopecia can occur due to genetic tendency or as a result of elevated cortisol levels, which can lead to drastic changes in hair density and onset.

Women may also develop hirsutism, which is the growth of terminal hairs in a male pattern, including hair growth on the upper lip, face, upper chest, abdomen, and upper thighs. In addition, individuals may experience an increase in downy hair growth known as lenugo hair, which is almost peach fuzz and can happen on the face and body. These changes occur due to the influence of androgen hormones, which are responsible for hair growth and density.



7. Delayed Wound Healing


Cortisol, also known as the "stress hormone," plays a crucial role in the body's response to stress. However, high levels of cortisol can have negative effects on the body, including delayed wound healing. Cortisol reduces inflammation, which might seem beneficial, but inflammation is a necessary part of the wound healing process. When inflammation is suppressed too much, as a result of high cortisol levels, wound healing is slow.
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For individuals with high cortisol, a simple cut can take a long time to heal and is more likely to result in scarring and skin infections. Even brushing against something can cause tears that take a long time to heal due to the thinning of the skin. Therefore, it is essential to keep cortisol levels in check to ensure that the body's natural healing process is not hindered.


8. Skin Infections


High cortisol levels can cause an increased susceptibility to skin infections with fungi or yeast, such as steroid acne and tinea versicolor. High cortisol levels can also weaken the immune system, making the body more vulnerable to dermatophytes, which cause foot and nail fungus. Candidal yeast infections are also more likely to occur in the mouth, skin folds, and mucous membranes when cortisol levels are high, as the immune system is less able to respond optimally.
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