Prednisone, a potent corticosteroid, causes fluid retention in the face, leading to the characteristic “moon face.” This occurs primarily due to increased cortisol levels mimicking the effects of naturally occurring cortisol.
Specifically, high cortisol levels stimulate fat deposition in the face, particularly in the cheeks and jawline. Simultaneously, cortisol affects water retention by influencing the kidneys’ ability to regulate sodium and fluid balance. This fluid accumulation further contributes to facial swelling.
The mechanisms are complex, but involve interaction with several hormonal pathways and cellular processes. Cortisol binds to receptors within fat cells, promoting lipogenesis (fat formation). It also impacts the renin-angiotensin-aldosterone system, affecting sodium and water reabsorption in the kidneys.
The severity of moon face depends on dosage and duration of prednisone use. Higher doses and prolonged use increase the likelihood of developing this side effect. Individual responses also vary, reflecting differences in metabolism and genetic predispositions.
Reducing prednisone dosage gradually under medical supervision is the primary method to mitigate moon face. Lifestyle changes, such as a balanced diet and regular exercise, might also help reduce overall fluid retention.
Consult your physician for personalized advice and management of this side effect. They can help determine appropriate dosage adjustments and discuss potential strategies to minimize facial swelling.