From the Guidelines
Cushingoid Facies Resolution
Yes, the Cushingoid facies associated with prednisone therapy typically resolves over time, especially after the medication is stopped or the dose is reduced 1. This side effect, also known as facial swelling or moon face, is usually seen with long-term use of prednisone at doses of 10mg or higher per day, and for durations of more than 4-6 weeks.
- Cosmetic changes, including facial rounding, occur in 80% of patients after 2 years of corticosteroid treatment, regardless of the regimen 1.
- Severe side effects, such as osteopenia with vertebral compression, brittle diabetes, psychosis, hypertension, and malignancy, are uncommon but can occur after protracted therapy (more than 18 months) with prednisone alone (20 mg daily) 1.
- It is recommended to consult a doctor to discuss the benefits and risks of prednisone treatment and to explore options for minimizing side effects, such as tapering the dose or switching to a different medication.
- In general, it's advised to follow the prescribed treatment plan and not to stop taking prednisone without medical supervision 1.
From the Research
Cushingoid Facies and Prednisone Therapy
- Cushingoid facies, also known as "moon face," is a common side effect of long-term corticosteroid therapy, including prednisone 2, 3, 4.
- The incidence of Cushingoid facies due to exogenous steroid use is not well-established, but it is estimated that up to 80% of patients may experience some degree of Cushingoid features with long-term corticosteroid use 3.
- Risk factors for developing Cushingoid facies include high doses of prednisone (>20 mg/d), long duration of therapy (>3 months), female sex, younger age, and high body mass index 2.
Resolution of Cushingoid Facies
- There is limited evidence on the resolution of Cushingoid facies after discontinuation of prednisone therapy.
- However, one study reported that Cushingoid features, including moon face and buffalo hump, can resolve after treatment of Cushing's syndrome due to an adrenal adenoma 5.
- In this study, the patient's moon face and other Cushingoid features improved significantly after laparoscopic adrenalectomy and discontinuation of steroid medication 5.
Corticosteroid-Induced Side Effects
- Corticosteroids, including prednisone, can cause a range of side effects, including Cushingoid facies, weight gain, hypertension, hyperglycemia, and osteoporosis 6, 2, 3.
- The severity and incidence of these side effects can vary depending on the dose and duration of therapy, as well as individual patient factors 2, 3.