Moon face, in any other case referred to as moon facies, is most frequently brought on by Cushing’s syndrome or extended steroid remedy and leads to an additional fats build-up on the edges of the face.
Moon face, in any other case referred to as moon facies, is a medical signal characterised by the face creating a rounded look as a consequence of fats deposits on the edges of the face.
The most typical explanation for moon face is alleged to be related to Cushing’s syndrome or extended steroid remedy (particularly corticosteroids). It will possibly additionally happen as a symptom of different well being situations, together with hypothyroidism. The individual’s face reveals vital swelling and seems a lot rounder than normal. The results of it are most noticeable across the cheeks and chin, making the face seem extra “apple-y” and full, therefore the time period moon face.
What’s the pathophysiology of moon facies?
An elevated launch of hormones, particularly cortisol, is a explanation for moon face. The adrenal glands, that are triangular-shaped glands situated on the highest of each kidneys, launch extra cortisol that causes elevated fats deposition and salt and water retention within the physique. The individual feels extra hungry, leading to binge consuming and fats redistribution.
Moon facies can steadily trigger the face to change into extra spherical, full or puffy. The edges of the face could change into so spherical from the buildup of fats that the ears cannot be seen from the entrance. Fats deposits over the edges of the cranium may also add to creating the face look rounder. Moon face may additionally consequence from cortisol-secreting tumors or as a consequence of extended consumption of steroid drugs.
Situations related to moon facies
Situations that result in elevated cortisol ranges (hypercortisolism) are the commonest explanation for moon face, which incorporates:
- Steroid remedy is likely one of the most typical causes of moon facies. Prednisone is prescribed for quite a lot of situations, similar to rheumatoid arthritis or different autoimmune situations as a result of it helps scale back swelling and irritation. Nonetheless, long-term use of this remedy could cause adversarial results, similar to redistribution of fats deposits in some individuals. This results in fats accumulation in particular components of the physique, together with the face, stomach and again of the neck.
- Cushing’s syndrome is a situation that happens when the physique produces an excessive amount of of the hormone cortisol. The elevated cortisol stage additionally will increase the deposition of fats across the face, giving it the form of the moon.
- Elevated launch of a hormone, adrenocorticotropic hormone (ACTH), from the pituitary gland additionally prompts the adrenal gland to supply cortisol.
- Nonpituitary tumors, similar to tumors of the lung, pancreas or thymus, may additionally trigger massive releases of ACTH.
- Benign tumors or cancers within the adrenal gland.
How is moon facies identified?
To verify moon facies on account of irregular cortisol ranges, the physician could counsel blood and urine assessments. Confirming the reason for excessive cortisol ranges could require different assessments, similar to magnetic resonance imaging (MRI) or computed tomography (CT) scan.
How is moon facies handled?
The remedy for moon face will depend on the trigger, however could embody:
- When the moon face is brought on by prednisone or one other steroid, the only remedy is usually to cut back the dosage. Over time, being on a decrease dose will scale back the looks of the moon face. By no means cease or lower the dosage of medicines with out consulting the physician.
- Managing hypothyroidism with thyroxine dietary supplements could assist deal with moon face.
- Keep away from meals excessive in salt as a result of they’ll worsen the moon face.
- Have a nutritious diet and ample bodily exercise to handle weight.
- Remedy of underlying situations (similar to cortisol-producing tumors) could also be wanted.
Medically Reviewed on 8/16/2021
Nguyen HCT. Iatrogenic Cushing Syndrome. Medscape. https://emedicine.medscape.com/article/117365-overview