Moon Facies: Causes And Treatment - WebMD

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Written by Annie StuartMedically Reviewed by Zilpah Sheikh, MD on February 23, 2026

• What Are the Symptoms and Causes of Moon Facies?
• What Conditions are Related to Moon Facies?
• Is Moon Facies a Sign of Cushing's Syndrome?
• Does Hypothyroidism Cause Moon Facies?
• Can Steroid Treatments Cause Moon Facies?
• How Is Moon Facies Diagnosed?
• How Do You Get Rid of Moon Facies?
• Takeaways
• Moon Facies FAQs

6 min read

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

"Moon face is the name for when the face appears abnormally very round, like a full moon," explains Melanie Cree, MD, PhD, professor of pediatric endocrinology at the University of Colorado Anschutz in Denver.

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 your body has high levels of a hormone called cortisol for a long time.

What Are the 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, but Cree stresses that it's not painful.

"Cortisol (or steroid medications) changes where your body stores fat and can make muscles smaller," Cree says. "In terms of moon face, you get fat buildup in the upper cheeks, the sides of the forehead outside your eyebrows, the sides of your face just below your ears, and on either side of the jawbone.” 

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

What Conditions are Related to Moon Facies?

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

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

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

Is Moon Facies a Sign of Cushing's Syndrome?

It can be difficult to diagnose Cushing's syndrome. That's because signs and symptoms such as facial swelling can also 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.

For example, fat may also gradually build up in the back of the neck, abdomen, or trunk, but legs and arms often stay thin. This type of central obesity is the most common feature of Cushing's syndrome. However, if you are someone who diets or exercises a lot, you may have little or no weight gain, or you may have very mild moon face.

Treatment for Cushing's syndrome depends on what is causing it. In some cases, a surgeon can remove a tumor. In other cases, medicine, radiation therapy, or physical therapy can help.

Does Hypothyroidism Cause Moon Facies?

Hypothyroidism is diagnosed when your thyroid, a small gland in the front of your neck, doesn't make enough thyroid hormones. It causes your body functions to slow down and causes swelling under the skin, according to Cree. The puffy face that occurs with hypothyroidism is different from moon face.

"It can look like moon face," Cree says. "But cheeks will not be red, blood pressure will be low, not high…[you] will need to sleep more, not less and develop dry skin, not acne."

Can Steroid Treatments Cause Moon Facies?

Long-term use of steroids such as prednisone can cause many of the same signs and symptoms of Cushing's syndrome. Although millions of Americans take these types of medications, many others may be affected by moon facies but do not know its cause.

In fact, weight gain with fat redistribution, such as moon facies, is one of the most common signs of steroid use. Your risk of developing these signs depends on the dose of medication and how long you take it. With steroid use, an increase in appetite and food intake may contribute to weight gain.

Symptoms usually occur as a result of long-term use of oral steroids. But less commonly, injected or inhaled steroids may cause Cushing's signs and symptoms, too.

Despite the side effects, Cree notes that it's important to continue taking steroid medications, explaining, "Providers are typically using steroids to treat a medical condition with inflammation. Not treating [conditions like] severe asthma, celiac disease, or rheumatoid arthritis is much worse for your long-term health.”

The best way to lower the effect of symptoms is to reduce the dose of medication or stop it altogether, but you should never do this on your own. If you need to continue using it, your doctor will have you try the lowest effective dose. For example, taking the medication every other day can sometimes lessen Cushingoid changes. If this does not resolve moon facies and other symptoms, your doctor may suggest trying other types of therapies.

How Is Moon Facies Diagnosed?

If you develop moon facies after starting steroid medications, diagnosis is pretty simple, Cree says. But other causes of high cortisol that cause a swollen, puffy face will require a more thorough medical workup. A physical exam will also check for telltale physical symptoms of high cortisol levels."Medical high cortisol [that is] not from high stress can have many other signs and symptoms like severe acne on the face, back, and chest…cheeks may have a redder tone, [and] there can also be rapid weight gain around the waist that can cause wide and dark purple stretch marks," says Cree. "People have a hard time sleeping and may develop high blood pressure, high blood sugars, and obstructive sleep apnea."

Your doctor may recommend blood or urine tests or imaging studies (such as X-rays) to understand the cause, Cree says.

How Do You Get Rid of Moon Facies?

Treatment for moon facies depends on what's causing the puffiness and swelling. 

Cree notes that if it's related to medication, stopping the medications or lowering the dose can make moon face go away. If it's related to Cushing's syndrome, there are medication and surgery options that can help, she says.

Takeaways

Moon facies is not painful or dangerous, but the swelling and puffiness may make you feel self-conscious and leave you searching for solutions. Your doctor can help you find the cause and develop a treatment plan.

"If your face changes from medication, you can talk to your prescriber to make sure you're on the lowest dose needed to treat the condition," says Cree. "If you are worried you have moon face and some of the other signs that go with Cushing's disease, you can have a visit with your primary care provider to discuss this and see if you need further testing."

Moon Facies FAQs

When should you see a doctor for moon facies? 

It's a good idea to make an appointment with your doctor if you have unexplained facial swelling. Your doctor can assess your symptoms and develop a treatment plan that might include stopping steroid medications, reducing the dose, or ordering a thorough checkup to find the medical cause of moon facies, says Cree. 

Does magnesium reduce moon facies? 

The idea that magnesium can reduce moon face comes from social media. There is no scientific proof, and Cree is not aware of any diet or supplements, including magnesium, that may help ease facial swelling.

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