How Stress Shows in the Face, the Muscular Side
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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Stress shows in the face two ways: fluid, which is the puffiness everyone talks about, and muscular tension, which is the half that gets ignored.
This article covers what actually decides the answer, such as:
- The masseter, the one that changes shape
- The expression muscles
- The neck and shoulders
- What actually helps the tension half
- Where a device fits, and where it does not
and many more!
The tension half also has a counterintuitive answer, because the obvious move is to work the muscle and the correct move is to release it.
Key Points:
A clenched masseter enlarges over time, which squares and widens the lower face.
An enlarged chewing muscle needs releasing, not stimulating.
Repeated frowning folds skin in the same place thousands of times, which is how expression lines set.
Most clenching happens at night and while concentrating, which is why people do not notice it.
If you wake with a sore jaw or headaches, a dentist has more to offer than any facial routine.
The masseter, the one that changes shape
The masseter is the chewing muscle at the angle of the jaw, and like any muscle it enlarges when it is worked constantly.
Clench through a difficult day and grind at night and it is being worked for hours. Over months and years that produces a squarer, wider lower face, and people often read the result as weight gain or as a jawline problem.
Clench your teeth and put your fingers just in front of your ear; the muscle that hardens is the one. If it feels large and permanently tight, that is the story.
Here is the part that catches people out: an overworked muscle does not need more work. Stimulating it electrically asks a muscle already doing too much to do more, and the appearance gets worse rather than better.
The expression muscles
Frowning folds the skin between the eyebrows, and doing it thousands of times is how a line goes from appearing on demand to being present at rest.
Concentrating at a screen produces a held expression for hours at a time, and most people have no idea they are doing it until they catch themselves.
The upper face is where this matters most, which is also why neuromodulators are used predominantly there; relaxing a muscle that creases skin is a different goal from toning a muscle that supports tissue.
The neck and shoulders
Tension rarely stops at the jaw. Shoulders rise, the neck stiffens, and the platysma, the broad sheet of muscle running from the collarbone up over the jaw, holds tension with everything else.
Since the platysma is continuous with the layer in the lower face, a tight neck and a tight jaw are one problem rather than two.
It also restricts the drainage route, since lymph exits the face down the sides of the neck.
What actually helps the tension half
Release rather than stimulate. Firm slow pressure on the masseter itself, held rather than rubbed, a minute each side.
Catch the daytime clenching. A note on the monitor, or simply checking every so often whether your teeth are touching; they should not be at rest.
A mouthguard if you grind at night, which is a dentist's job and the single most effective intervention for night clenching.
Work the neck and shoulders too, since treating the jaw alone leaves half the pattern in place.
If you wake with a sore jaw, headaches, or clicking when you open your mouth, that belongs with a dentist rather than with any facial routine.
Where a device fits, and where it does not
It fits on the areas that are undertoned rather than overworked. EMS loads muscle, and Kavanagh and colleagues measured an 18.6 percent increase in cheek muscle thickness over 12 weeks of motor-level stimulation (10.1111/jocd.12007).
It does not fit on a clenched masseter. Deal with the clenching first, and then whatever else you plan for your lower face will work better and be considerably more comfortable.
A drainage pass at a low level addresses the fluid half, which is the other way stress shows. On PureLift, levels 1 and 2 are nanocurrent and microcurrent and contract nothing.
Three minutes per side is the maximum on any PureLift model, and the ten minute session ends on its own.
The obvious thing worth saying
The face is downstream of the stress, and a routine treats the symptom rather than the cause.
Sleep, movement and whatever reduces the load are doing more for how your face looks during a hard period than anything applied to it, and we would rather say that than imply a device is the answer to a stressful year.
For the fluid half, see cortisol face is not a real diagnosis, and for the jawline diagnostic, how to reduce the look of a puffy jawline.
Two related questions come up often alongside this one, and we have answered both in full: the five questions to ask before buying anything, and what the twelve weeks actually look like.