If you recently experienced rapid weight gain in your face, especially on the sides of your face, you may have developed a rounded appearance called ‘moon face’. To understand the causes and treatment, The Pioneer’s Tejal Sinha interacts with experts to gain insights on the same.
Tejal Sinha
Haven’t we heard the phrase ‘chaand sa roshan chehra’ many times? But what if your face turns out to be like a moon! Well, well, well, we don’t mean your face turning into something like that of a moon. If your face gradually gets swollen and turns into a rounded shape, you may have moon facies, aka moon face.
Moon face is a term used to describe a round, puffy face that can be caused by the buildup of fat. This is commonly linked to the use of corticosteroids like prednisone for a long time or can be a sign of other diseases like Cushing’s syndrome. The swelling and rounding of the face make it resemble the moon, hence the name Moon Face.
This condition is commonly seen as a symptom of Cushing’s syndrome, which involves an excessive amount of cortisol in the body. Cushing’s syndrome is a rare hormonal disorder, affecting an estimated 0.7 to 2.4 individuals per million people per year. Despite its rarity, this disorder significantly impacts those who develop it in a negative way.
Causes
Moonface, often a symptom rather than a disease itself, is caused by factors leading to elevated levels of cortisol. “The primary causes include Cushing’s syndrome, where the body produces excessive cortisol due to pituitary adenomas (benign tumours on the pituitary gland releasing too much ACTH), adrenal tumours (directly increasing cortisol production), and ectopic ACTH syndrome (non-pituitary tumours producing ACTH). Long-term use of corticosteroid medications, prescribed for conditions such as asthma, rheumatoid arthritis, and lupus, can lead to elevated cortisol levels, resulting in moonface. Additionally, adrenal hyperplasia, an overgrowth of the adrenal glands, contributes to increased cortisol production,” explains Dr. Mukesh Batra.
Meanwhile, Dr. Sowmya Dogiparthi, MBBS, MD (DERMATOLOGY), FAM (COSMETOLOGY), shares a few of the most common factors leading to the cause of the moon face:
l Cushing’s Syndrome: Cushing’s syndrome is one of the leading causes of moon face, a condition that is brought about by the overproduction of cortisol. This hormone imbalance arises from excessive cortisol secretion by the adrenal glands or the use of corticosteroid medications.
l Corticosteroid medications: Prednisone, which is used in treating conditions that cause inflammation such as asthma, rheumatoid arthritis, and lupus, is among the drugs that cause the development of Moon Face as a side effect. These drugs resemble cortisol in their mode of action and therefore cause fat redistribution in the body.
l Polycystic Ovary Syndrome (PCOS): Sometimes, women with PCOS may even develop hormonal irregularities that may cause them to develop moon face, but this is relatively rare as compared to those who have Cushing’s syndrome or those who are on corticosteroids.
l Hypothyroidism: This may cause facial swelling and fullness due to fluid retention and the accumulation of fat that gives a person a moon face.
Meanwhile, Dr. Ajay Deshpande, senior dermatologist, Sahyadri Super Speciality Hospital, Deccan Gymkhana, shares, “Moon face generally occurs when extra fat builds up around the sides of the face. It is most commonly associated with the body’s response to high levels of corticosteroids, either due to steroid medication (like prednisone) or diseases that increase the production of these hormones, such as Cushing’s syndrome. The increase in corticosteroids in the body leads to more fat deposits in facial tissues, causing a rounded appearance.”
Symptoms
l Swelling and puffiness on the cheek and jaw regions of the face, where the skin may become red or look flushed.
l Individuals experience weight gain in the facial and upper parts of the body.
l Fatigue and weakness are seen in patients with Cushing’s disease or in individuals who have been on corticosteroid therapy for a long time.
l High blood pressure and blood sugar levels are other symptoms that may be linked to conditions such as Cushing’s syndrome and the use of steroids.
How does moon face affect you?
“Moon faces can have physical and psychological effects on you. In terms of physical appearance, it can lead to the development of round and puffy cheeks, which may not be very appealing to the eyes. This change in appearance can affect your self-image and self-confidence, making you feel embarrassed or distressed. Support groups and counselling can be beneficial for individuals dealing with body image concerns and the psychological impact of the condition. One should try to control the root cause of moon face and seek help if the condition is impacting the quality of life,” explains Dr. Sowmya Dogiparthi.
Can you get rid of moon face?
Getting rid of the moon face depends on its underlying cause. Dr. Batra further highlights, “If it’s due to a temporary condition like prolonged corticosteroid use, discontinuing the medication under medical supervision may help reverse the symptoms over time. When the condition stems from a chronic illness like Cushing’s syndrome, the main goal of treatment is to target and resolve the root cause.”
Homeopathy, he says, as an alternative medical system, takes a holistic approach to medicine. “Its remedies strive to target the underlying cause by triggering the body’s innate self-healing capabilities. Corticotropinum 30 and Cortisonum 30 are recommended; 2-3 tablets can be taken twice a day with a constitutional approach. It is essential to consult a qualified homeopath for the treatment of Cushing’s syndrome.”
Medical treatment for moon face involves treating the underlying causes, such as Cushing’s syndrome, through surgery to remove the tumours, radiation therapy, or drugs that help in controlling the cortisol hormone. “If the cause is due to long-term use of corticosteroids, the doctor may lower the dose or change to a different medication. Adjusting the diet can also be influential in managing the condition. Avoiding the use of salt and adopting a proper diet reduces fluid retention, which can also cause weight loss. Exercise is important for maintaining a healthy lifestyle and helps prevent the accumulation of fat in the body. If a patient requires an immediate solution to the problem, then they can opt for some cosmetic surgery or even makeup to have the face reshaped temporarily,” further adds Dr. Sowmya.
Dr. Ajay also highlights that, in many cases, the moon face is reversible. “If the underlying cause (e.g., Cushing’s syndrome or corticosteroid medication) is addressed and treated effectively, the excess cortisol levels should decrease, and the moon face may gradually resolve. If the condition is drug-induced, such as from taking corticosteroids, discussing with a healthcare provider about adjusting the medication can help. The puffiness may decrease when the medication is reduced or stopped, though one should never adjust medication without professional guidance. In cases due to natural hormone issues, treating the primary condition usually resolves the moon face.”
How long does the moon face last?
The duration of the moon face varies depending on its underlying cause. If it’s a side effect of corticosteroid medication, improvement often occurs gradually after discontinuing the medication, usually within a few weeks to months. In cases of moon face linked to Cushing’s syndrome, the timeline for improvement can vary widely among individuals, with symptoms potentially diminishing over time with proper treatment.
People who are more prone to
developing moon faces
People who are likely to develop this condition are those who receive a long-term course of corticosteroids for other diseases like autoimmune diseases, asthma, or organ transplantation. Also, patients with diseases such as Cushing’s syndrome, which is associated with an increased level of cortisol, can be at risk.
“Moon face is not just a cosmetic problem; it is a symptom of other complications that need medical attention. The causes can be understood and treated appropriately, along with some lifestyle changes. It is therefore important to seek medical advice if you are suffering from symptoms of moon face so that the right diagnosis can be made, ensuring better overall health and quality of life,” shares Dr. Sowmya.
Meanwhile, Dr. Batra also highlights, “Some individuals are more at risk of developing a moon face. These include patients reliant on corticosteroid medications for conditions like asthma or rheumatoid arthritis, which can elevate the risk. Women, particularly those experiencing hormonal imbalances, may have increased vulnerability. Other risk factors include hormonal disorders like adrenal tumours, a family history of related conditions, chronic stress, and lifestyle choices such as an unhealthy diet and sedentary behaviour. These factors can compound the risk by promoting conditions like obesity and metabolic syndrome.”
