Moon Face Caused by Corticosteroids

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"Moon face" is a term that refers to a round, full, and puffy face. The swelling often occurs when taking high doses of prednisone or other corticosteroids, and can be a medication side effect. Some research also links moon face to diseases and disorders such as Cushing's syndrome.

Moon face symptoms aren't painful, but they can be stressful and affect your sense of self-esteem. When you stop taking steroids, the swelling should go away. If you can’t discontinue the medication, there are things you can do to reduce the puffiness while living with moon face.

This article will explain how steroid medications cause facial swelling. It will look at the emotional and physical affects, as well as the options for moon face treatment.

prednisone and facial swelling.

Verywell / Lara Antel

What Causes a Moon Face?

Moon face describes how the shape of your face changes, becoming rounder like a full moon, when you are taking prednisone and other corticosteroids. This happens because fat deposits shift, causing your cheeks to get puffy and your jawline to fill out.

If you take corticosteroids for a long time, your body is also more likely to retain water. This also causes swelling and puffy facial features.

Corticosteroid-related moon face results from trying to treat a serious medical condition. Some of the conditions treated with steroids include:

The corticosteroids act like cortisol, a stress hormone that the body produces naturally. Cortisol is key to fighting infections, regulating insulin levels, balancing fluid and salt, regulating circadian rhythms, controlling blood pressure, and easing inflammation.

Too much cortisol, though, is a problem. Too much of the corticosteroids that act like cortisol are also a problem. They flood the system and cause a condition called Cushing’s syndrome.

What Is Cushing's Syndrome?

Cushing's syndrome is a rare disorder in which the body has too much cortisol. When cortisol is out of balance in Cushing syndrome, it affects a number of body systems. Cushing syndrome symptoms can include:

  • Weight gain
  • Increased body hair
  • Thinning skin
  • Acne
  • Bruising
  • Swollen legs
  • Stretch marks
  • Rosy cheeks

How Moon Face Affects You

Moon face is often just thought of as an annoying side effect of prednisone, but it can significantly affect your quality of life.

Emotional Health

In some instances, people’s faces seem to be dramatically altered by extra fat and water retention. You may feel like you don’t even recognize yourself in the mirror. This can cause low self-esteem and depression.

The emotional stress caused by moon face can be made worse by depression or mood swings, which sometimes occur when you take corticosteroids.  

If you think prednisone or similar medications are affecting your emotional or mental state, talk to your healthcare provider about changing your dosage.

Physical Health

Corticosteroids change how your body stores fat. Moon face is one way this affects you. You may also develop a “buffalo hump,” extra fat on the back of the neck. Many people also gain weight around the abdomen and middle of the body.  

This extra body fat puts you at risk for metabolic syndrome. Metabolic syndrome is a group of conditions that increases your chances of developing heart disease, stroke, and type 2 diabetes.

Prednisone side effects

Verywell / Brianna Gilmartin

Moon Face Treatment

Moon face symptoms typically resolve when you stop taking prednisone or other corticosteroids. Your face should eventually return to normal. However, it's extremely important that you do not suddenly stop taking the medication.

You need to taper, or gradually reduce, your dosage of corticosteroids. If you stop all at once, your body may not have enough cortisol. This can lead to problems such as:

  • Extreme tiredness
  • Weakness
  • Upset stomach
  • Weight loss
  • Changes in skin color
  • Mouth sores
  • Craving for salt

Work with your provider to plan your tapering schedule. How quickly the dosage is lowered depends on how long you've been taking the drug and what dosage. If you've been taking corticosteroids for a long time at a high dose, you may need to lower the dose very slowly every week or every few weeks.

How Long Does Moon Face Last?

Once you stop taking corticosteroids, extra weight, water retention, and the puffiness of moon face will begin to go away. It can take about a year, though, for your body and face to return to their pre-corticosteroid states.

Managing Facial Swelling

If you can’t stop taking prednisone or similar medications, you can reduce how much your face swells by taking some precautions:

  • Control what you eat and limit calories to avoid additional gain. 
  • Reduce salt intake to prevent fluid retention.
  • Drink more water and sleep more to reduce swelling throughout your body.

Summary

Prednisone and other corticosteroid drugs are frequently prescribed because they are effective at treating inflammation, autoimmune diseases, and other illnesses. They help people with serious illnesses such as IBD, asthma, and arthritis to take control of their health.

The benefits come with some possible downsides. though, and a puffy-looking moon face is just one of the possible impacts. The transformation to your looks is a sign that your body is undergoing many changes, some of which could lead to health problems.

If you notice other symptoms of Cushing's syndrome, talk to your healthcare provider about lowering your dosage or slowly tapering your body off corticosteroids.

A Word From Verywell

Feelings of sadness or depression often come with corticosteroid use, and dealing with moon face and your appearance may add to them. Being informed and discussing issues with your healthcare providers can help you to improve your health and your quality of life.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.