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Moon Face - Causes, Treatment, and Prevention

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Moon face occurs due to excess fat accumulation in the face. The below article unfolds the causes and treatment of the moon face.

Medically reviewed by

Dr. Basuki Nath Bhagat

Published At November 16, 2022
Reviewed AtNovember 16, 2022

Introduction:

Moon facies, more commonly called moon face, is not a disease but occurs due to other medical conditions. The face becomes full, puffed up, and rounded due to fat accumulation on the sides of the face. It occurs mainly in people who take steroid therapy for long periods. Though it does not cause any severe complications, the moon face can be disturbing to the person, thereby affecting their self-esteem. However, the condition is easily treatable when the underlying cause is identified and resolved.

What Are the Causes of Moon Face?

Multiple factors, conditions, and medications can lead to the development of a moon face. The below listed is the relationship between the moon face and various factors.

  • Steroids and Moon Face: Prednisone is a steroid medication that is prescribed to help relieve pain and inflammation. The most common cause of moon face is the long-term use of Prednisone. Long-term use of the drug affects the levels of hormones released by the adrenal gland, thereby causing side effects. The patient experiences puffing up and fullness of the face due to fat accumulation on the sides of the skull, to such an extent that ears cannot be seen from the front.

The drug Prednisone is prescribed under the following conditions:

  • Organ transplant.

  • Asthma, narrowing of airways causing cough, wheezing, and difficulty breathing.

  • Arthritis, in which there is swelling and inflammation of the joints.

  • Lupus erythematosus is an autoimmune condition that causes skin rashes, joint erosions, and kidney failure.

  • Anemia, or deficiency of red blood cells (RBCs).

  • Addison's disease is a deficiency of hormones released by the adrenal glands.

  • Chronic inflammatory conditions.

The side effects that occur due to long-term use of Prednisone include:

  1. Weight gain.

  2. Mood changes.

  3. Moon face.

Apart from Prednisone, other drugs from the corticosteroid group can also cause moon face. The drugs include:

  • Cortisone.

  • Methylprednisolone.

  • Dexamethasone.

Certain conditions that affect the adrenal and thyroid glands can also cause moon face as a side-effect. For example, hypercortisolism or hyperadrenocorticism is a condition in which excess cortisol is released by the adrenal glands, which are a pair of triangular glands.

The conditions related to moon facies include:

  • Increased ACTH (adrenocorticotropic hormone) released by the pituitary gland causes an increase in cortisol released by the adrenal glands.

  • Benign or malignant (harmful) tumors of the adrenal gland.

  • Tumors of the lungs, pancreas, or thymus gland can also trigger the release of large amounts of ACTH.

  • Chronic use of Prednisone for the treatment of autoimmune conditions.

Doctors advise blood and urine tests to determine if the moon face is caused due to elevated cortisol levels. In addition, an MRI (magnetic resonance imaging) or a CT (computed tomography) scan is suggested to know the exact cause of the moon face.

  • Cushing’s Syndrome and Moon Face: Cushing's syndrome is a condition in which the body produces too much of the hormone cortisol. The causes of Cushing's syndrome include receiving high levels of medicines like Prednisone, stress, tumors, or overproduction of pituitary hormones. Cushing's syndrome can cause fat accumulation on the trunk, abdomen, and neck, making the arms and legs look thin. If moon face and other characteristics worsen with time, then the cause of moon face due to Cushing's syndrome is confirmed. Treatment depends on identifying the cause and treating it.

  • Hypothyroidism and Moon Face: Hypothyroidism is one condition that can cause a moon face. Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones due to autoimmune disorders, irradiation of the neck, or removal of the thyroid gland.

  • Diabetes and Moon Face: People with diabetes have high blood sugar. These blood sugars get converted into fats and are stored by the body. This can cause weight gain with time, leading to a moon face. People with sudden weight gain must consult a doctor, as it is not a healthy sign and could be due to an underlying condition.

  • Weight Gain and Moon Face: Weight gain and obesity can make a face look puffier and rounder. A sudden loss of weight is not possible nor advisable. A gradual weight loss under the guidance of a doctor or a dietitian can make a face normal over time.

What Are the Risk Factors for Developing Moon Face?

The most common risk factor for developing moon face is the chronic use of Prednisone. The condition is more common in women compared to men and in older individuals compared to the younger age group. Also, conditions such as hypothyroidism and Cushing's syndrome affect females more than males, which is also a coinciding factor for developing a moon face.

Can Moon Face Be Prevented?

It is not possible to prevent moon faces. Stopping certain medicines to reduce the severity of moon face can cause severe symptoms to return. A change of drugs, if needed, has to be suggested only by doctors. However, there are a few ways that can help in reducing the puffiness, that include:

  • Managing the body weight.

  • Drinking enough water.

  • Reducing the intake of sodium.

  • Opting for a healthy diet.

  • Enquiring the doctor about treatments that are less likely to cause moon face.

How Is Moon Face Managed?

Moon face is not a disease; it is only a condition occurring due to another condition. There is no treatment for moon faces; however, identifying the underlying cause and managing it accordingly can help moon faces decrease in severity or disappear gradually. Doctors may advise a change of steroid medication or reducing its dose if moon face is due to the intake of Prednisone. In contrast, conditions like Cushing's syndrome or hypothyroidism are treated accordingly, which helps in reducing the symptoms caused by those conditions. Moon face is one of the symptoms, also tends to disappear with proper treatment.

What Are the Tips for Living With a Moon Face?

Some people with moon faces can be low on confidence, affecting their self-esteem and social interaction. A few tips that can help in boosting the morale of such persons include:

  1. Emphasizing Body Neutrality: Body neutrality focuses on making a person feel neutral towards their body rather than pressuring them to look a certain way.

  2. Encouraging Body Appreciation: Body appreciation means conscious thinking about the impressive things a body can do rather than focusing on how it looks. Also, if the weight gain is due to treatment, the mind must focus on the treatment's positive outcome.

  3. Reducing Water Retention: Reducing the intake of salt and processed foods can help decrease water retention in the body and improve the moon face.

Conclusion:

Moon face is a condition that causes a rounder, puffy-looking face due to fat accumulation on the sides of the skull. As it is not a disease, managing the underlying cause helps. Though it cannot disappear in a day or two, lifestyle changes like weight management and less salt intake can help ease the condition. In addition, joining support groups with people facing similar issues can help boost the lost self-confidence.

Frequently Asked Questions

1.

What Are the Conditions Associated With Moon Face?

Excessive fat accumulation in the face causes moon face. It is frequently associated with obesity, but can also result from Cushing's syndrome. This is why it is sometimes referred to as a Cushingoid appearance. Cushing's syndrome develops when the body is repeatedly exposed to high levels of a hormone called cortisol. Moon face can also be a side effect of certain conditions that affect the adrenal and thyroid glands.

2.

How Is Moon Face Treated?

Moon face is not a disease; it is simply a complication of another condition. It does not have a treatment; however, identifying the underlying cause and managing it appropriately can help moon faces lessen in severity or disappear gradually. If the moon face is caused by Prednisone, doctors may recommend changing or reducing the steroid medication dose. On the other hand, conditions such as Cushing's syndrome or hypothyroidism are treated appropriately, which aids in the reduction of symptoms caused by those conditions.

3.

How Long Does It Take for a Moon Face to Subside?

 
The extra weight, water retention, and moon face puffiness will begin to fade once they stop taking corticosteroids. However, it may take up to six months to a year for the body and face to return to their pre-corticosteroid states. Moon face is one of the symptoms; it usually goes away with proper treatment.

4.

Can Stress Cause Moon Face?

The body produces excess cortisol, a stress hormone, in people with Cushing's syndrome. Cortisol influences blood pressure and glucose levels, as well as causes inflammation. Because of the inflammation, people with this condition may have a moon face.

5.

What Causes Excess Accumulation of Fat in the Face?

 
Weight gain is usually the cause of increased facial fat. Excess face fat is often caused by lack of exercise, aging, poor diet, or genetic conditions. It could also be due to water retention, which can cause the face to appear puffy or swollen. Making changes to one's diet and lifestyle can aid in weight management and the prevention of excess facial fat.

6.

Can Water Retention Cause Moon Face?

 
Yes, too much salt can cause the body to retain water, leading to swelling. Salty foods may cause the face to appear puffier and rounder or the moon face appearance. Eating less processed foods, such as canned or frozen foods, is an excellent way to reduce salt intake.

7.

What Are the Causes of Moon Face?

A moon face can be caused by a variety of factors, conditions, and medications. The most common cause of moon face is long-term Prednisone use. Other causes include Cushing's syndrome, hypothyroidism, diabetes, and weight gain

8.

What Foods Can Cause Facial Fat?

Weight gain is usually the cause of increased facial fat. Therefore, cut down these foods from the diet as they cause excess fat accumulation in the face.
- Soy Sauce.
- Alcohol.
- Junk Food. 
- Bread.
- Refined Products like sugar or refined oil.
- Red Meat
- Added Salt.
Dr. Basuki Nath Bhagat
Dr. Basuki Nath Bhagat

Family Physician

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