Understanding the Causes and Treatments for Lupus Moon Face

Understanding Lupus Moon Face

Lupus is an autoimmune disease that can cause a wide variety of symptoms. One potential symptom that patients may experience is called "lupus moon face." In this comprehensive guide, we will explain what lupus moon face is, what causes it, how it is diagnosed, and potential treatment options.

What is Lupus Moon Face?

Lupus moon face refers to facial swelling or puffiness that can occur in some lupus patients. It causes the face to appear rounded or full, like the moon. The swelling is most noticeable in the cheeks and around the eyes, giving the face a moon-like appearance.

Moon facies is the medical term used to describe this swelling or rounding of the face that can arise from a variety of medical conditions. In lupus patients specifically, moon face is considered one of the many potential symptoms of the disease.

What Causes Lupus Moon Face?

There are a few possible causes for moon face in lupus patients:

• Steroid treatment - One of the most common treatments for lupus is corticosteroid medications like prednisone. These drugs reduce inflammation but can also cause fluid retention and fat deposits in the face.
• Inflammation - Lupus causes inflammation throughout the body, including in the skin and facial tissues. This swelling and inflammation can lead to a puffy or moon-like facial appearance.
• Fat deposits - The inflammation and steroid medications may cause a redistribution of fat, leading to fatty deposits in the cheeks and around the eyes.
• Fluid retention - Lupus and the medications used to treat it may also cause the body to retain excess fluid, some of which can build up in facial tissues.

Who Gets Lupus Moon Face?

Lupus moon face can occur in both men and women with lupus. However, it appears to be more common in women. This may be because lupus overall is more common in women than men.

Moon face seems to occur more frequently in people who have more severe or active lupus. Mild lupus cases may not lead to noticeable facial swelling.

People who are taking higher doses of corticosteroid medications like prednisone also appear more prone to developing moon face. The higher the steroid dose, the greater the risk of moon face and other side effects.

When Does Lupus Moon Face Develop?

Lupus moon face can develop at any stage of the disease:

• At diagnosis - Some people with lupus notice facial swelling at the same time as their initial lupus symptoms and diagnosis.
• With a flare-up - Facial swelling may appear or worsen during a lupus flare when disease activity increases.
• On steroids - Moon face often arises within weeks or months after beginning steroid treatment.
• Over time - Gradual facial swelling may occur over years as the disease progresses.

In many patients, the timing of moon face is closely tied to their steroid treatment. It typically occurs within weeks or months of starting corticosteroid therapy.

Lupus Moon Face Symptoms

The main symptom of lupus moon face is swelling that causes the face to appear rounded or puffy. Specific signs may include:

• Full cheeks
• Puffy eyelids
• Swelling between the nose and upper lip
• A rounded or "moon" appearance
• Obvious facial fullness compared to old photos
• Indention marks or pits on the skin after pressing on the swollen area

The swelling is usually painless and develops gradually over hours, days or weeks. It often appears on both sides of the face evenly. However, some people may experience more puffiness or swelling on one side.

In addition to the visible swelling, some patients notice tightness, numbness or tingling in the face. These sensations arise from pressure on the facial nerves from the fluid and inflammation.

Diagnosing Lupus Moon Face

Doctors can often diagnose lupus moon face with a simple visual examination. The swelling and rounded facial appearance gives it away as moon facies.

They will also take into account the patient's medical history, including:

• Active lupus diagnosis
• Recent lupus flare symptoms
• Current medications like prednisone
• Dosage level of corticosteroids

With this information, it becomes clear the moon face is related to lupus disease activity and/or treatment with steroids.

The doctor can confirm their suspicion by pressing gently on the swollen cheeks or around the eyes. This should leave small indents in the skin that remain for a short time after removing pressure. This pitting edema indicates fluid retention in the facial tissues.

No special imaging or blood tests are required to diagnose moon face. However, some additional tests that may be helpful include:

• Complete blood count (CBC) - Elevated white blood cell count can indicate inflammation or active lupus.
• Erythrocyte sedimentation rate (ESR) - This blood test can detect active inflammation associated with lupus flares.
• Kidney function tests - Lupus-related kidney inflammation may cause fluid retention.
• Urinalysis - Helpful for assessing kidney function.
• Complement levels - Low levels often seen with active lupus.
• Antinuclear antibody test (ANA) - Most lupus patients have a positive ANA.

Lupus Moon Face Treatment

Treating lupus moon face involves addressing the underlying causes of the swelling:

• Steroids - Lowering the steroid dose can reduce or eliminate moon face in many cases. Topical steroids may also be used for temporary symptom relief.
• Lupus inflammation - Immunosuppressive drugs will be used to control inflammation and reduce disease activity.
• Fluid retention - Diuretics may be prescribed to eliminate excess fluid from the body.

Doctors will try to keep patients on the lowest effective dose of steroids to help prevent side effects like moon face. If the disease remains active, steroid-sparing immunosuppressants like azathioprine or methotrexate may be added.

For quick temporary relief, applying cool compresses can help reduce facial swelling and discomfort. Warm compresses may worsen fluid retention.

It can take weeks or months for lupus moon face to completely resolve, even after treatment. Patience is needed while waiting for steroids to be tapered or immunosuppressants to take effect.

What About Surgery for Lupus Moon Face?

In rare instances where lupus moon face is significantly impacting quality of life, plastic surgery may be an option. Procedures like:

• Buccal fat removal - Taking out fat from the cheek area
• Facelifts - Tightening loose, swollen facial skin
• Liposuction - Surgically removing fat deposits

Can potentially reduce facial swelling and puffiness.

However, these procedures do carry risks, may not help in all cases, and should only be considered if other medical treatments are not improving moon face symptoms.

Coping with Lupus Moon Face

Lupus moon face can understandably have social and emotional effects on patients. Some tips for coping with moon facies include:

• Avoiding excess salt, refined sugars, and fatty or processed foods to minimize fluid retention and inflammation.
• Not smoking and limiting alcohol which can worsen swelling.
• Using cosmetic tricks like darker blush higher up on the cheeks or matte makeup to create facial contours.
• Wearing scarves, hats or hairstyles that frame or conceal the face.
• Joining a lupus support group to connect with others experiencing similar symptoms.

While moon face can be distressing and impact self-confidence, always keep in mind that it is a temporary condition. With proper treatment the swelling will gradually resolve.

The Takeaway

Lupus moon face refers to facial swelling that causes a rounded, puffy or "moon" appearance. It is due to a combination of inflammation, fluid buildup and fat redistribution.

Moon face arises from the lupus disease process itself and from steroid medications used to treat it. It often develops during flares or after starting steroids.

To treat moon face, doctors reduce steroid doses when possible and use immunosuppressants to control inflammation. With treatment, the swelling usually resolves gradually over weeks or months.

While waiting for improvements, cool compresses, low-salt diets, cosmetic tricks and support groups can help patients cope with moon facies. In severe cases, plastic surgery may very rarely be considered.

Being aware of lupus moon face as a potential complication can help patients and doctors address it quickly and effectively if it arises.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.