"Moon Face" - can MLD reduce steroid swelling?

If you or someone you care for has experienced facial puffiness while taking steroid medication, you’re not alone. Often referred to as “moon face,” this type of swelling can feel frustrating, especially when it changes how you look and feel day to day.

I am often asked: Can MLD help with this?

The short answer generally is YES! 

Manual lymphatic drainage can be a supportive, gentle way to reduce fluid-related puffiness due to steroid medication, with some important context.

Important Note: Using steroid medication like prednisone for a long time is often the cause. But it can also be a sign of a health condition like Cushing’s syndrome or hypothyroidism. This article is speaking about swelling due to steroid medications, and not other health conditions.

Visit clevelandclinic.org more info: Cushing's & hypothyroidism.

UNDERSTANDING WHAT IS HAPPENING ...

​Steroid medications ~ especially when taken in higher doses or over longer periods ~ can lead to fluid retention in the face and neck. This is partly due to how steroids affect:

• Fluid balance
• Blood vessels
• The lymphatic system’s ability to keep things moving efficiently

This is why the face can appear fuller, swollen, or puffy, and often referred to as “Moon Face”.

It’s important to know that not all of this fullness is fluid. Some changes are related to fat redistribution from the medication, which behaves differently than swelling and congestion.

HOW CAN MLD HELP?

Manual Lymphatic Drainage is a light, rhythmic, and highly targeted technique designed to:

• Encourage movement of lymphatic fluid
• Reduce congestion in tissues
• Support the body’s natural drainage pathways

For steroid-related facial puffiness, MLD can:

• Decrease fluid buildup and congestion in the face and neck
• Help you feel less “heavy” or tight through the tissues, reducing pain or discomfort
• Create a more refreshed, less “full” appearance

This is similar to how MLD is used in post-surgical care: supporting the body in clearing excess fluid.

WHAT IT WON'T DO ...

MLD does not remove fat deposits caused by long-term metabolic effects of steroids. So results may be partial, but still meaningful, and a healthy treatment for supporting your lymphatic health and overall wellness.

PROFESSIONAL TREATMENT vs. AT-HOME SELF-CARE
  
Working with a trained MLD therapist ensures:

• Proper technique and pressure (this is not deep massage)
• Treatment tailored to your lymphatic pathways and overall (whole body) health
• Safe, appropriate care if you have other medical considerations

That said, gentle self-care techniques can be helpful between treatments. Simple, light movements, especially in the morning and before bed, can support daily fluid movement when done correctly.

If you’re unsure how to do this safely, this is something I often teach both patients and therapists in a clear, accessible way.

SUPPORTIVE HABITS THAT MAKE A DIFFERENCE
​ 
MLD works best as part of a bigger picture wellness plan. Small daily habits can support your lymphatic system to:

• Stay well hydrated ~ fluid helps fluid move
• Reduce excess sodium intake ~ helps minimize fluid retention
• Sleep with your head slightly elevated
• Incorporate light movement ~ especially deep diaphragmatic breathing and calf engagement -  even a short walk supports lymph flow!

These are simple, but they truly add up.

IS "MOON FACE" PERMANENT? 
 
In most cases, no - it is not permanent.

Facial swelling related to steroids is often reversible, particularly when medication is reduced or discontinued under medical guidance. However, this process can take:

• Several weeks
• Sometimes a few months

MLD can be a helpful support during this transition, making the process feel more comfortable along the way.

A FEW IMPORTANT CONSIDERATONS 

• Never stop or reduce steroid medication abruptly
  This can be dangerous and must always be guided by your healthcare provider.
• MLD is supportive care ~ not a replacement for medical treatment
  It works alongside your broader care plan.
• Always consult your healthcare provider
  Especially if swelling is new, worsening, or accompanied by other symptoms.

A GENTLE, SUPPORTIVE APPROACH 
 
One of the things I value most about MLD is that it meets the body where it is at. When you’re dealing with medication side effects, recovery, or chronic conditions, sometimes what you need most is a supportive, non-invasive way to feel more like yourself again, and give your body some support in finding balance.

If you’re navigating steroid-related swelling, know that there are options to support your comfort ~ and that even small shifts can make a meaningful difference.

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.

Yours in health and happiness,

Anne
Clinic: www.annethermt.com
Education: www.eluvettmethod.com

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Image: myclevelandclinic.org

Citations: 
​Ramadan F. Manual lymphatic drainage: the evidence behind the efficacy. Br J Community Nurs. 2024 Feb 2;29(2):83-84. doi: 10.12968/bjcn.2024.29.2.83. PMID: 3830024
Thompson B, Gaitatzis K, Janse de Jonge X, Blackwell R, Koelmeyer LA. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv. 2021 Apr;15(2):244-258. doi: 10.1007/s11764-020-00928-1. Epub 2020 Aug 15. PMID: 32803533.