A Moon face is a

medical sign Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

in which the face develops a rounded appearance (reminiscent of the "

Man in the Moon In many cultures, several pareidolic images of a human face, head or body are recognized in the disc of the full moon; they are generally known as the Man in the Moon. The images are based on the appearance of the dark areas (known as lunar m ...

") due to fat deposits on the sides of the face.

Symptoms and causes

Moon face is often associated with

Cushing's syndrome Cushing's syndrome is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, ...

steroid A steroid is an organic compound with four fused compound, fused rings (designated A, B, C, and D) arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes t ...

treatment (especially

corticosteroids Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invol ...

), which has led to it being known as Cushingoid facies. Moon face is a type of

corticosteroid-induced lipodystrophy Corticosteroid-induced lipodystrophy (CIL) is a condition of lipodystrophy, abnormal fat deposition caused by corticosteroid medications. Fat accumulates in the facial area ("moon face"), dorsocervical region ("buffalo hump"), and abdominal area ( ...

along with "buffalo hump", which in one study occurred in 47% of the 820 patients. Moon face is among the most frequently reported adverse events of systemic

glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebra ...

s, along with

insomnia Insomnia, also known as sleeplessness, is a sleep disorder where people have difficulty sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low ene ...

(58%), mood disturbances (50%), and

hyperphagia Polyphagia, or hyperphagia, is an abnormally strong, incessant sensation of hunger or desire to eat often leading to overeating. In contrast to an increase in appetite following exercise, polyphagia does not subside after eating and often leads ...

(49%). Another long-term study of 88 patients on prednisone showed that lipodystrophy, such as moon face, was the most frequent adverse event, experienced by 63% of patients.

Incidence

The risk for moon face increases with higher doses and longer time on

treatment. One study showed an increased risk in women, those younger than 50 years of age, and those with a high initial BMI.

Complications

This change in facial appearance can be very distressing to patients taking steroids. Later studies of the 88 patients showed that those who had lipodystrophy had a greater risk for

metabolic syndrome Metabolic syndrome is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Metabolic syndro ...

characteristics such as increased

blood pressure Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...

, higher plasma concentrations of fasting glucose, triglycerides, and

total cholesterol Cholesterol is the principal sterol of all higher animals, distributed in body Tissue (biology), tissues, especially the brain and spinal cord, and in Animal fat, animal fats and oils. Cholesterol is biosynthesis, biosynthesized by all anima ...

, along with lower HDL-cholesterol.

Treatment

Cessation of steroid therapy or treatment of the cause of Cushing's syndrome causes moon face to slowly decrease and eventually vanish. One study proposed that limiting calories could decrease the risk of corticosteroid-induced lipodystrophy.

References

External links

{{Medical resources , DiseasesDB = 30817 , ICD10 = , ICD9 = , ICDO = , OMIM = , MedlinePlus = 003105 , eMedicineSubj = , eMedicineTopic = , MeshID = Medical signs