Does My Face Look Fat in This?

(Wearing Primark ‘Hate’ earrings, rest all Vivienne Westwood – World’s End shirt, Red Label shorts, Gold Label ‘Animal Toe Courts’)

These are photo’s you wouldn’t usually see. I have tons and tons of photo’s which go straight into the trash folder. Why? Well to be honest I’m just like everyone else, I cringe when I see a bad photo of myself. Who hasn’t panic jabbed the ‘untag’ button on facebook when a ‘friend’ posted a photo where you looked fat/ bad hair/ tired/ smudged make-up … insert issue of your choice. As it no doubt happens your friend thinks you are acting like a lunatic and she thought you looked gorgeous in the photo, so has no idea why you are screeching ‘How could you do this to me’ down the phone! But when it comes to body image we are always our own worst critic.

As most of you know I suffer from a disease called Psoriatic Arthritis, which is an inflammatory condition affecting the joins and tendons. I have spent the last two years battling this, there is no cure, only medication which can attempt to get it under control. For the last few months they only way I have been able to get out of bed every day is to be pumped full of steroids, injected in the butt. Each jab spot has left a half golf ball sized dint which may or may not go away over time – one of many possible side-effects I risk every day. Every time I trial a different drug there is a list of possible nasties which I might have to deal with but when the other option is to end up crippled and bed ridden you welcome a dimply butt with open arms.

We are lucky really that there are drugs on offer we can try, many diseases don’t come with that option. So yes I am grateful I can get access to health care – even though the drugs in themselves can leave us dicing with death, the untreated disease would be much, much worse. When you use steroids over a long period of time however there are two side effects which are almost unavoidable, weight gain and ‘Moon-face’.

I’ve spoken a lot already about weight gain and how with a lot of effort I managed to get it pretty much under control but the one thing which crept up on me which I have absolutely not control over is ‘Moon-face’. Had you asked me about Moon-face before my illness I would have only thought of the character in Enid Blyton’s The Magic Faraway tree, but it is a common side-effect of long term steroid use also know as Cushings syndrome. It is characteristic by unusual distribution of fat around the face, causing a round moon shape often with chubby ‘hamster’ cheeks. In addition to a build up of fat at the back of the neck a ‘hump’ and around the tummy. In very serious cases it can cause skin thinning where huge, gash-like stretch marks occur.

As I usually hide behind my mane of hair you wouldn’t notice that much of a change in my face, but I have been increasingly paranoid about the round, double chin effect which has started to happen. Since I had my hair up in these photos, under really bright sunlight you can’t disguise the fact I have Moon-face. On the plus side I have now stopped the steroids in order to trial yet another drug, they were only a temporary stop gap, so the face should go back to normal in a few weeks. I was going to ditch the photos and not mention it but that was until I read this article:

Steroids save lives, but we have to face-up to their side-effects

The author Dorthy Byrne also takes steroids for an auto-immune condition, she talks about her own experience with their side-effect. But also how we are very rarely really talked to by our doctors about this kind of side-effect, they aren’t going to actually harm us such as risk of stroke for example, so are often just included somewhere in the small print of the information leaflet in the bottom of the box. Yes of course we all realise we need to take these drugs, fact, but should that mean we shouldn’t be made fully aware of the way it can effect our bodies? Having to learn to accept you have an incurable condition is hard enough, but the emotional turmoil you suffer as you body changes out of your control is never broached. It isn’t just about looking fat either, hell I’ve been overweight of my own accord and whilst it got me down it was my own fault for doing no exercise and drinking pints of larger – oh yes traditional student life style. But deep down I knew I could do something to loose the weight, it was in my control and of course eventually I did. This is very different, the fact you can wake up one morning and hardly recognise your own face is very upsetting. It isn’t any thing to do with vanity, it is the feeling of loosing control which is the scary thing.

The first comment on that article was what made me want to write this, a rant about how vain the author was and how silly she was being scaring people and putting them off life-saving drugs. But she misses the point, anyone in enough pain to be given steroids, like me will know a puffy face is the last of their problems, however this does not mean they shouldn’t be prepared for it. So I felt it was important to share this, because there are so many people out there in the same position as me. We aren’t vain worrying about this, we are just dealing with yet another issue brought on by having an incurable medical condition and some times it is nice to know you aren’t alone in this.

20 thoughts on “Does My Face Look Fat in This?

  1. ugh I am so sorry to hear about this but boy can I understand I just came off steroids I am having a terrible time with my skin, steroids really make a difference for certain health conditions but they are brutal. I am just starting to get a normal sleeping pattern again. I did not get the shots, thankfully but they do that also for skin conditions. I have not heard of the moon face side effect but then there really are quite a few with the steroids. I hope your face feels sunny soon and less moony….Your beautiful you could probably grow a carrot out of the top of your head and still look gorgeous seriously!! I don’t think I have ever seen you look bad…Just remember to keep wearing that smile ~Love Heather

    • Thank you Heather, yes the steroids can be rotten I hope you feel better soon. I have had plenty of meds mess up my sleep so I really do sympathise. xx

  2. Vivienne,

    I’m sorry to hear about your health struggles and the medication side effects that you have had to deal with.

    I want to assure that you look wonderful, I really do not see the ‘moon face’ shaping that is characteristic of Cushing’s. You are so strong to address your condition in a head on manner..keep pushing on.

    I love your outfit today and those shoes….I adore them.

    • That is very kind of you to say but when you see your face changing in front of you I guess you are more in tune to small differences, I know I dont have it so bad as some people do for which I am grateful. These are definitely one of my favourite pairs of shoes 🙂 xx

  3. I have mixed feelings about this, being a rheumatology nurse. I can see both sides. There are side effects to every single drug given for every single condition. Even taking a tablet for a headache can have potentially lethal side effect, but does anyone really read all the information that comes in the packet of tablets? I know I never do.

    Doctors and nurses could, theoretically, go through every single side effect with every patient. That would take time that just isn’t available. As a nurse I’ll answer any questions my patients want answering, but many don’t want to know anything.

    There’s no correct amount of information to give to all patients. All the information is available to everyone, if they want it.

    And, I think you look fantastic.


    • I didn’t know you were a rheumatology nurse! But yes that is the problem, there is never going to be a right or wrong way to go about it, too much too little it is a tough call. Which is why I think any articles highlighting this kind of thing are really valuable, so that people who havent bothered to read the info booklets for their medication and suddenly find themselves with side-effects they weren’t prepared for have something they can relate too. Because lets face it talking to your doctor isnt the same as talking to other people going through the same thing. It is always nice to just have someone who understands and who you can have a moan too, which is why I think informal support groups are really valuable. Especially with side-effect that effect your physical appearance, there is no point bothering you doctor about getting a puffy face he cant do anything about it, but talking to other women going through it you can get make-up tips for example on how to help disguise it. I just think more value should be put on that kind of support xx

      • Support groups are great but I think they should be run by patients. When nurses or doctors run them, they become medical, not lifestyle orientated.

        I have scoliosis and my spine curves which affects what I wear, especially when I had to wear a spinal brace. No nurses or doctors could’ve helped with this, only other patients who had the ‘trauma’ of clothes shopping when nothing would fit over your brace.

        I feel a blog post coming on.

        • Yes I agree and also if they involved any one from the medical profession they do become more formal. Do you read Roz’s blog ‘clothes, cameras and coffee’? She has wrote some really touching posts about her scoliosis. x

  4. I know exactly this feeling, my doctor is a man and I just cant talk to him about things like this, I would rather talk to my girlfriends but of course they don’t have my medical problems so cant understand. They just say oh you look fine, which is nice of them to try to make me feel better but it doesn’t help me. I wish there was a way I could just talk to other women about things like this that are pretty trivial I know but can bother me so much.

    • Some hospitals do have support groups you can ask about, but if you want something more informal there are some facebook groups and forums I can send you the details of if you want to email me 🙂

  5. I just read the article, the woman making the first comment sounds like my friends and family, they dont undertand why I am upset about ‘silly things’ like gaining few pounds. One friend even said if I can worry about my weight I cant even be very sick at all. People who arent going through it just dont understand. I didnt even know I might gain weight I wish I was warned, not that it would stop me taking the drugs but because I would be wary of my gain in appetite and try eating helthy foods like fruit and not chips. I aks my doc he just said to loose wieght eat health and exersice he was not understanding at all. I feel very alone so thank you for writing this topic.

    • I know exactly what you mean about chips, when I got the hunger cravings I would eat biscuits and I never eat that kind of thing! Having fruit and carrot sticks and things like around are useful to let you have your snacks but keep healthy, hang in there Helen xx

  6. First of all, your outfit here is AWESOME beyond recognition. Head-to-toe Vivienne Westwood? I’m down.
    Second of all, your face doesn’t have that “moon” quality here at all! Before looking at what you’d written, I was thinking you looked just as pretty as always here, the sun on your face is nice :).
    But ugh, that sucks about your psoriatic arthritis, I hope the new medication you’re going to try works! Is it affected a lot by inflammation in your body? This might sound silly, but apparently going vegan and gluten-free helps with that by alkalizing your body? I’ve just heard that arthritis and inflammation are linked, sorry if I’m completely off! I just read this book by Kris Carr called Crazy Sexy Diet ( ) for other health reasons, and apparently it’s helped people with chronic diseases, inflammation, arthritis, etc… (I did it for stomach issues and it’s already better, I think!)
    Again, sorry if I’m being completely silly and ignorant! But who knows, it might help, you never know!

    Did I mention you look fab here? I’m especially coveting your top, and those shoesssss!!! (I so wish I could afford to buy Vivienne Westwood stuff. I’ve been wanting the Melissa X Vivienne Westwood jelly heels for ages!)
    – Laura

    • Hi Laura, I haven’t heard of that particular diet, but I do think changing your diet can help a lot, I actually follow the Harcombe Plan and cut out wheat and cows milk and feel a lot better for it. No diet can help my medical condition as its genetic, but this one has helped me control my weight which ballooned on the steroids and it has also helped me with food intolerance’s. Some people with inflammatory arthritis do say they feel plants from the Nightshade family make their inflammation worse, tomatoes, aubergine etc but I personally do not have any effect from them. I think a lot of processed foods and things stuffed full of salt and sugar are just so bad for you. I think it makes sense to eat healthily to give your body the best chance possible especially when you are in poor health. xx

      • I should just add for anyone reading to beware of any fad diets and websites which try to convince people they can cure incurable disease by eating or drinking a certain food, last one I saw was pushing cactus juice to cure cancer!! If you are on medication and / or have a medical condition never start any diet without consulting your GP and never stop taking your medications without consulting your doctor.

  7. Thank you Pearl for another incredibly thoughtful post acknowledging and honouring the range of life changes associated with chronic illness – many of which will involve grief in varying degrees and proportions. It’s hard to understand why people have such an urge to minimize, dismiss, or invalidate the experience of the very person having that experience, or try to dictate what should be important. So much judgement, when it’s already hard enough trying not to judge ourselves! Thanks again for your courage and wisdom, and all the best for your next phase of treatment.

    Your hairstyle with the draped neckline of your top are lovely together.

  8. Pearl I admire you SO much! Not only for your wealth of Westwood knowledge and awesome shoe collection but for this- your honesty and vulnerability in these matters. I know you’re not an over-sharer and feel that you do share because of the desire to help others, by being open about health issues, others suffering, perhaps won’t feel so alone.

    You look fabulous in that amazing gingham top and outfit. And even more beautiful by sharing your “moon face.”


  9. Hi there, many thanks for an especially engaging article,
    I wouldn’t generally post comments but valued your blog so decided I would say thank you – Lucy

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