Moon Face: Causes, Steroids, How Long It Lasts and What Helps

Moon face is when your face becomes rounder and fuller, mainly at the cheeks and the sides. The medical name is moon facies. [1] It is a common side effect of steroid medicine, and it is also a sign of Cushing’s syndrome. [1] [4]

If you take steroids for lupus, Crohn’s disease, rheumatoid arthritis, asthma, MS or after a transplant, this guide is for you. It covers why steroids cause moon face, how long it takes to appear and to go, what helps, and what to make of “cortisol face” and PCOS posts online.

What is moon face?

Moon face is a build-up of fat on the sides of the face that makes it look round and puffy. In some people the face gets so round that you can’t see their ears from the front. [1]

It is not painful or dangerous on its own. [1] But it changes how you look, and that can be hard. In a study of 80 people starting long-term prednisone, changes in where fat sits on the body were the most common side effect, and the one people found most distressing. [9]

The main causes are:

• Steroid medicine, such as prednisone, prednisolone or dexamethasone. This is the most common cause. [1] [4] [6]
• Cushing’s syndrome, which means too much cortisol in the body. Most cases come from taking high doses of steroid medicine for a long time. Rarely, a growth in the pituitary or adrenal gland makes too much cortisol. [4]
• An underactive thyroid (hypothyroidism), which can also make the face puffy. [1] Our Hashimoto’s symptoms guide covers the other signs.

Why do steroids cause moon face?

Steroid medicines (corticosteroids) are man-made versions of hormones your body makes, such as cortisol. They calm inflammation and stop the immune system attacking the body. [3] That is why they are used for so many long-term conditions, including asthma, rheumatoid arthritis, lupus, inflammatory bowel disease and after organ transplants. [5] [6]

At high doses, or over a long time, they act like having too much cortisol. Doctors call this exogenous Cushing’s syndrome: it comes from medicine, not from your own glands. [6] [15] Too much cortisol leads to weight gain, especially in the tummy and face. [15]

Steroids also make you hungrier and make your body hold on to more water. [2] This adds to weight gain and puffiness.

Tablets are the usual cause, but steroids from injections, inhalers and creams can also cause Cushing’s syndrome. [15] Any of these routes can affect your own cortisol system. [12]

If you take steroids for a flare, see our guides to lupus flare-ups and Crohn’s disease symptoms. In Crohn’s, steroids are one of the medicines used to treat flare-ups. [19] In MS, steroids are used to reduce swelling and help the nerves work better. [20]

How long does it take for moon face to appear?

It depends mostly on the dose and how long you take it. Steroids often don’t cause side effects if taken for a short time or at a low dose. [3] Cleveland Clinic says anyone taking steroids for more than a few weeks has a high chance of moon face. [1]

In studies of people on higher doses, it usually showed up within the first few months. In 37 older people starting about 44 mg of prednisone a day, it took a median of 3 months to appear (range 1 to 4 months). [8]

In the 88-person study, moon face was more likely in women, people under 50, people with a higher starting weight (BMI), and people who ate more calories. [7] Women are also more likely to get Cushing’s syndrome in general. [4]

These numbers come from small studies, mostly in people with one condition, so your own chance may be different.

Does moon face go away, and how long does it take?

For most people it does go away, but slowly. It usually fades as the dose of steroid is reduced. [1] [8]

In the study that photographed 37 people every month, moon face faded in 71% while their dose was being lowered or within 6 months of stopping. [8] The median time from starting steroids to the moon face going was 19 months, and by then most people were on about 4 mg of prednisone a day. [8] Those people were older (average age 75), so younger people may be different.

Before and after, in words. Here is roughly what to expect, based on these studies:

• First weeks: you may feel hungrier and notice some weight gain and puffiness from holding water. [2]
• Around 1 to 4 months on a higher dose: the cheeks and sides of the face get fuller. Some people also get a fat pad at the back of the neck. [7] [8]
• While the dose comes down: the round look often stays for a while. A Cushing-like look is common early in a taper. [12]
• Months after a low dose or stopping: the face slowly goes back towards how it was. Appetite and water retention return to normal once you stop prednisolone. [2] [8]

If you need to stay on steroids long term, the face may not fully go back while you take them. Ask your doctor whether a lower dose or a different medicine is possible for you.

How do you get rid of moon face?

There is no quick fix. The thing that helps most is a lower dose of steroid, when that is safe for your condition.

• Talk to your doctor about the dose. They may lower the dose or try a different steroid. [1] Doctors aim for the lowest dose that controls your condition. [5]
• Ask about steroid-sparing medicines. Some conditions treated with steroids can be treated with a non-steroid medicine instead. [5]
• Lower the dose slowly, with your doctor. If you have taken steroids for more than 3 weeks or at a high dose, the dose usually has to come down gradually, often over several weeks. [3] [13]
• Eat well without making portions bigger, and keep active if you can. The NHS suggests this to help keep your weight stable on prednisolone. [2] In one study, eating more calories went with a higher chance of moon face. [7]
• Cut down on salt. Cleveland Clinic suggests less salt, drinking enough water and getting enough sleep to reduce swelling. [1] These are sensible habits, but we found no studies showing they shrink steroid moon face.

Moon face can affect how you feel about yourself. If it is getting you down, tell your doctor. Cleveland Clinic suggests a support group so you can talk to others going through the same thing. [1]

Not sure whether a change is from your medicine or your illness? Our guide to telling a flare from a medication side effect can help.

What doesn’t help moon face?

• Stopping your steroids on your own. This can be dangerous, especially after a high dose for a long time. Your condition can flare, and you can get withdrawal symptoms such as severe tiredness, weakness, body aches and joint pain. [13] Your own glands may not make enough cortisol for a while, which can lead to adrenal insufficiency. [12] [14]
• “Cortisol-lowering” diets, drinks or supplements. An endocrinologist at the University of Colorado says she knows of no diet that balances cortisol levels. [15]
• Face exercises, massage tools and draining tricks. We found no studies showing they shrink moon face from steroids. The extra volume is fat, not only fluid. [1]

If a puffy face goes away after a diet change or a supplement, it was probably not caused by high cortisol in the first place. [15]

Is moon face a sign of Cushing’s syndrome?

It can be. A red, round face is one of the signs of Cushing’s syndrome. [4] The redness may be harder to see on brown or black skin. [4]

Cushing’s syndrome that comes from your own body (not from medicine) is rare. Estimates range from about 40 to 70 people in every million. [5] Taking steroid medicine is by far the most common cause. [4] [6]

People with Cushing’s syndrome usually have several signs, not just a round face: [4] [5]

• more fat on the neck, upper back, chest and tummy, with thinner arms and legs
• a fatty hump between the shoulders
• skin that bruises easily, and wide purple stretch marks
• weak muscles, especially at the top of the arms and legs
• irregular or stopped periods, and extra hair growth
• mood changes, such as feeling irritable, anxious or depressed

If you have these signs and you don’t take steroids, see a GP. They can check the cortisol in your blood, pee or spit. [4] If you do take steroids, tell the doctor who prescribes them. The NHS lists moon face with weight gain in the upper back or tummy, very bad headaches and slow wound healing as signs of Cushing’s syndrome to call a doctor or 111 about. [2]

Is “cortisol face” from stress real?

“Cortisol face” is a social media name for a puffy face that people blame on stress. It is not a medical term. [15] Cleveland Clinic notes that some people use it as another name for moon face. [1]

Most puffy faces are not caused by high cortisol. Here is what is known:

• Cortisol goes up and down every day with stress, illness and the time of day. These normal rises don’t usually cause symptoms. [15]
• If a round face is the only change, it is hard to say it comes from high cortisol. Most people with Cushing’s syndrome have other symptoms too. [15]
• Cortisol can be raised for a while by depression, anxiety, drinking too much alcohol, obesity or diabetes that isn’t well controlled. Doctors call this pseudo-Cushing’s syndrome. [5] [15]
• Cushing’s syndrome from your own body is rare. [5]

If your face has changed and stayed changed, and you have other signs from the list above, talk to your doctor. There are simple screening tests for high cortisol. [5] [15]

Is there a link between PCOS and moon face?

There is no strong evidence that PCOS itself causes moon face. A round face is not on the NHS list of PCOS symptoms. [16] The NHS now also calls PCOS polyendocrine metabolic ovarian syndrome (PMOS). [16]

The two get linked online for a few reasons:

• Weight gain, or finding it hard to lose weight, is a common PCOS symptom, and some of that weight can show in the face. [16]
• PCOS and Cushing’s syndrome share signs such as irregular periods and extra hair growth, so Cushing’s can be mistaken for PCOS. [5] [16]
• The international PCOS guideline says doctors should consider Cushing’s syndrome and rule out other causes when the picture suggests it, for example when male hormone levels are very high. [17]

If you have PCOS and your face has become red and round along with other Cushing’s signs, such as easy bruising, wide purple stretch marks or weak muscles, ask your doctor whether a cortisol test makes sense. [4] [5] Our PCOS page shows what is worth tracking.

What should you write down for your doctor?

Your doctor will weigh moon face against how well the steroid controls your condition. Notes help them see the whole picture. Write down:

• the name and dose of your steroid, and every date the dose changed
• when you first noticed your face changing
• your weight every week or two
• other changes, such as mood, sleep, bruising, stretch marks or muscle weakness
• how your condition has been on each dose

Photos taken in the same light every few weeks can help you see slow changes that are hard to notice day to day.

Our free treatment tracker has space for each medicine, how you responded, side effects and questions for your doctor.

If writing it down is too much, you can tell Juno about dose changes and how your face, weight and mood feel, by voice or text. Juno logs them and turns them into a dated summary to take to your appointment. See how the Juno symptom tracker works.

When should you get urgent help?

Moon face is not an emergency. But if you take steroids, or have recently lowered or stopped them, your body may not make enough cortisol when you are ill or under strain. This can cause an adrenal crisis, which is an emergency. [12] [14] Never stop steroids suddenly without talking to your doctor. [3]

This article is for general information only and does not replace advice from your own clinician. Juno is a health assistant, not a medical provider.

Last updated 22 October 2026