Full moon face – causes, treatment

Full moon face

The full moon face usually develops as part of a redistribution of body fat due to hormonal causes. It is a typical guiding symptom in medicine. As a rule, it occurs together with other characteristic symptoms.

What is a full moon face?

When a full moon face appears, it must usually be assumed that there is a pathological redistribution of fat in the body. However, it is not an independent disease, but is a characteristic key symptom of various hormone-related disorders in the organism. It manifests itself in a plump face shape with flushed cheeks. It is also characterized by a slanted position of the eyes, a so-called carp mouth and a double chin.

It occurs mainly in the context of Cushing’s syndrome , which is based on an increased cortisol level in the blood. But a full moon face can also develop in extreme forms of obesity ( obesity ) and Pickwick syndrome . It often develops as a side effect of drug treatment for rheumatic diseases , allergies or autoimmune diseases . The formation of a full moon face should always be used as an opportunity to consult a doctor to clarify the cause.


The full moon face typically occurs in what is known as Cushing’s syndrome. This syndrome is caused by increased levels of the stress hormone cortisol in the blood. This leads to a redistribution of body fat with the development of trunk obesity with bull neck and full moon face. Cortisol has the task of supplying the organism with energy quickly in stressful situations. It mobilizes the existing body reserves in the liver (glucogen) and muscles (protein breakdown).

It causes the conversion of glucogen and amino acids into glucose. This increases the blood sugar level . As a result, the production of insulin is stimulated, which transports the glucose into the cells for energy production. Unfortunately, in Cushing’s syndrome, the increased need for glucose is not responsible for the increase in cortisol levels, but rather the pathological overproduction or the additional administration of cortisol as part of drug treatment. The body’s energy requirements have not increased.

The released glucose is then stored as fat. Cortisol breaks down muscle mass and converts it into fat. At the same time, bone density also decreases. Since cortisol also has an immunosuppressive effect, the immune system is also weakened. In the drug treatment of allergies, rheumatism and other autoimmune diseases with drugs containing cortisone, however, this is exactly what should be achieved in order to weaken the excessive reaction of the immune system against parts of one’s own body. Other causes of a full moon face can also be extreme forms of obesity such as Fröhlich syndrome.

diseases with this symptom

Symptoms, Ailments & Signs

As already mentioned, increased cortisol concentrations in the blood cause the so-called Cushing’s syndrome with a full moon face as a typical key symptom. Regardless of the cause of the increased hormone levels, the same characteristic clinical picture is evident. So the patient suffers from a truncal obesity with bull neck and full moon face. Furthermore, infections often occur due to the weakened immune system.

Bones and muscles are broken down. This can lead to osteoporosis and muscle wasting . The connective tissue is also affected. So-called striae rubrae , stretch marks , form . These are red strips of skin caused by tearing of the connective tissue. High blood pressure is also a typical symptom of Cushing’s syndrome. Furthermore, virilism (masculinization) can occur in women and erectile dysfunction in men .Depending on the cause of the increased cortisol levels, a distinction is made between exogenous and endogenous Cushing’s syndrome. The more frequently occurring exogenous Cushing’s syndrome is the result of therapies with drugs containing cortisol for allergies, rheumatic diseases and autoimmune disorders. The rarer endogenous Cushing’s syndrome is caused by overactive adrenal glands or the pituitary gland. The adrenal glands produce cortisol directly, while the pituitary gland stimulates cortisol synthesis in the adrenal glands via its hormone ACTH. Both benign and malignant tumors can cause hormone overproduction.

Diagnosis & History

To diagnose the exact causes of the full moon face, the doctor first examines urine samples to determine whether there are increased cortisol concentrations. If this is the case, in the case of endogenous Cushing’s syndrome, a dexamethasone inhibition test and a CRH test must be used to determine where the control loop is disrupted. Imaging methods such as CT , ultrasound or MRI can detect any tumors in the adrenal glands or pituitary gland.


A full moon face is a sign of Cushing’s Syndrome, which carries many different complications. On the one hand, the increased cortisol level leads to increased brittleness of the bones (osteoporosis). This severely restricts the quality of life, those affected have to be careful and usually require care as the disease progresses.

This can lead to severe psychological problems, especially depression. Depression can be characterized by strong addictive behavior. There are also sleeping and eating disorders. It is not uncommon for chronic depression to have suicidal thoughts. Furthermore, the immune system of those affected is suppressed, which increases their tendency to infections.

In the worst case, these can spread and lead to sepsis, which can then end in septic shock. This condition is life-threatening and, if left untreated, leads to death in more than half of those affected. The increased reabsorption of water also usually causes high blood pressure (hypertension) in those affected. This increases the risk of cardiovascular disease and the development of atherosclerosis.

Cushing’s patients also usually develop diabetes . This clogs smaller vessels and leads to a lack of blood flow, especially to the kidneys and eyes, which can ultimately lead to kidney failure or poor eyesight, kidney failure or blindness.

When should you go to the doctor?

A moon face can definitely be a family thing. It does not necessarily have to have a disease value. However, it is also known that people develop a full moon face after prolonged treatment with cortisone. This can be reversed in the medium term by changing your diet. The increased appetite caused by cortisone can be effectively counteracted with nutritional advice.

A full moon face can also occur in Cushing’s syndrome. The doctor consulted can determine that the cause is an overproduction of adrenal cortex hormones. If this disease or hypercortisolism is suspected, it must be determined whether it is a possible consequence of long-lasting cortisone administration or the effects of a (benign) tumor. This can have formed in the adrenal cortex, the pituitary gland or the bronchi.

In addition to the full moon face, the attending doctor usually notices an increase in weight on the upper body. In addition, based on other typical characteristics, he can conclude that Cushing’s syndrome is present. The cause of the full moon face can be determined through various examinations such as a 24-hour urine check. After that, there is either a transfer to a hospital for surgery or radiation of a tumor, or drug treatment is also conceivable.

Alternatively, attempts are made to lower the cortisol concentration in the blood. If a full moon face occurs repeatedly, permanent medical supervision is necessary.

Treatment & Therapy

The treatment of the full moon face depends on the respective cause. If there is an increased cortisol concentration due to the intake of cortisol-containing medication, their application must be gradually reduced if Cushing’s syndrome is severe. However, the medication must not be discontinued abruptly because the hormone control circuit would not react immediately. Your withdrawal must be gradual.

If the high cortisol level has endogenous causes, surgical intervention on the adrenal glands or the pituitary gland may be necessary if a tumor is present. If this is not possible, radiation or chemotherapy is an option. Drug treatments to inhibit cortisol formation can also be used in certain forms of Cushing’s syndrome. After the normalization of the cortisol level, the symptoms of Cushing’s syndrome, including the full moon face, disappear very quickly.

Outlook & Forecast

In itself, a full moon face is harmless. This is especially true if it is due to hereditary reasons or is due to being overweight . A full moon face does not have to have a disease value. If you are very overweight, it is to be seen as a result of increasing obesity. Here, clinically accompanied diets or a stomach reduction over a longer period of time can ensure that the obese patient develops a better prognosis.

However, if the full moon face is Cushing’s syndrome , the outlook is worse. This is a hormonal full moon face. This is related to increased cortisol production. In this rare condition, the full moon face can be a symptom of adrenal dysfunction or pituitary gland problems . It is often the result of a benign tumor of the pituitary gland, a so-called adenoma. The prognosis for full moon face is quite good if the underlying condition or disorder is treated professionally.

A full moon face can also occur if cortisone-containing medication is administered over a long period of time. This can be necessary, for example, in the case of a chronic inflammatory bowel disease or bronchial asthma. Cushing’s syndrome with a full moon face can then occur as a side effect. This disappears again as soon as the medication is stopped. Overall, with appropriate treatment, the prognosis is good.


Prevention is only possible against the full moon face in the context of extreme obesity. Hormone-independent obesity can be prevented through a healthy diet and sufficient physical exercise. However, even with prevention, Cushing’s syndrome is unavoidable.

When administering medication containing cortisol, however, the patient should be monitored constantly. If symptoms such as truncal obesity with a full moon face and stubborn neck and frequent infections occur during the use of the drug, an adjustment of the drug treatment is urgently required.

You can do that yourself

A so-called full moon face can occur as part of various diseases. Characteristics are a round, reddened face, often puffy, bluish cheeks, slanting eyes and a double chin. The mouth is also deformed, and hirsutism often occurs in women in this context .

In addition to medical treatment, those affected can do some things themselves to alleviate their suffering. On the one hand, cosmetic treatments such as make-up are conceivable, whereby patients should seek advice from professional beauticians regarding their specific problems. The right haircut can also reduce optical disruptive factors somewhat, since it can make the face appear narrower or even conceal it in places. Excessive hair growth in women can also be treated cosmetically, e.g. by laser therapy, epilation , waxing or plucking).

Even if the facial and body deformities that occur as part of the diseases associated with a full moon face are medically justified, regular, targeted exercise can alleviate the worst manifestations. This is especially true when obesity is the reason. The same is the case if taking a certain medication is the cause. In the latter case, it should also be considered whether the preparations should be changed. Sport can also help reduce the production of the stress hormone cortisol , which also has a positive effect on the distribution of fat in the body.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.