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Moon Facies

If your face has gradually swollen into a rounded shape, you may have moon facies. Also called moon face, this is usually not serious. But it may make you feel self-conscious.

Moon facies occurs when extra fat builds up on the sides of the face. It is often related to obesity but can be from Cushing's syndrome. That's why people sometimes refer to it as a Cushingoid appearance. Cushing's syndrome occurs when the body is exposed for long periods to high levels of a hormone called cortisol.

Symptoms and Causes of Moon Facies

Moon facies may cause the face to gradually become round, full, or puffy. The sides of your face may become so round from the buildup of fat that the ears can't be seen from the front of your face. Fat deposits in the sides of the skull can also make the face look rounder.

A high release of hormones, especially cortisol, is a cause of moon face. This is called hyperadrenocorticalism or hypercortisolism. The adrenal glands, triangular-shaped glands that sit on top of the kidneys, release the cortisol.

Conditions Related to Moon Facies

The conditions that most commonly lead to hypercortisolism and the symptom of moon facies include:

  • Increased release of a hormone (ACTH) from the pituitary gland; ACTH prompts the adrenal gland to produce cortisol.
  • Nonpituitary tumors -- such as tumors of the lung, pancreas, or thymus -- which may also cause big releases of ACTH
  • Benign tumors or cancers in the adrenal gland
  • Long-term use of steroid medications like prednisone for conditions such as rheumatoid arthritis or other autoimmune conditions

To confirm that moon facies is the result of abnormal cortisol levels, your doctor may do blood and urine tests. To confirm the cause of high cortisol levels, you may need other tests, such as an MRI or CT scan.

Moon Facies and Cushing Syndrome

It can be difficult to diagnose Cushing's syndrome. That's because signs and symptoms such as facial swelling can be caused by other conditions. But it is more likely to be Cushing's syndrome if moon facies gets worse gradually along with other characteristic symptoms.

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