Bags under eyes — mild
swelling or puffiness under the eyes — are common as you age. With
aging, the tissues around your eyes, including some of the muscles
supporting your eyelids, weaken. Normal fat that helps support the eyes
can then migrate forward into the lower eyelids, causing the lids to
appear puffy. Fluid also may accumulate in the space below your eyes,
adding to a swollen appearance.
Bags under eyes are usually a cosmetic concern and rarely a sign of a
serious underlying medical condition. At-home remedies, such as cold
compresses, can help improve the appearance of bags under eyes. For
persistent or bothersome under-eye puffiness, cosmetic treatments are
Bags under eyes can include:
* Mild swelling
* Saggy or loose skin
* Dark circles
When to see a doctor
You may not like the way they look, but bags under eyes are usually
harmless and don't require medical care. However, see your doctor if the
* Is severe and persistent
* Is accompanied by redness, itching or pain
* Affects other parts of your body, such as your legs
Your doctor will want to rule out other possible causes that can
contribute to the swelling, such as kidney or thyroid problems,
infection, or an allergy.
As you age, the tissue structures and muscles supporting your eyelids
weaken. The skin may start to sag, and fat that is normally confined to
the area around the eye (orbit) can migrate forward below your eyes.
Also, the space below your eyes can accumulate fluid, making the
under-eye area appear puffy or swollen. Several factors can lead to
* Fluid retention due to changes in weather (for example, hot, humid days), hormone levels or eating salty foods
* Sleeping flat on your back
* Not getting enough sleep
* Allergies or dermatitis, especially if puffiness is accompanied by redness and itching
Preparing for your appointment
Because appointments can be brief, and because there's often a lot to
cover, it's a good idea to be well prepared for your appointment.
Preparing a list of questions will help you make the most of your
appointment. List your questions from most important to least important
in case time runs out. For bags under eyes, some basic questions to ask
your doctor include:
* What is likely causing my symptoms?
* Is my condition likely temporary or chronic?
* What is the best course of action?
* What treatment approach do you recommend, if any?
* What will the treatments cost? Does medical insurance cover these costs?
* What results can I expect?
* Is there anything I can do at home to improve my symptoms?
* What kind of follow-up, if any, should I expect?
Treatments and drugs
Bags under eyes are usually a cosmetic concern and don't require
specific treatment. Depending on the cause of the swelling, home and
lifestyle treatments, such as cold compresses or sleeping with your head
raised, can help reduce or eliminate puffy eyes.
Medical treatments are available if you're concerned about the
appearance of under-eye swelling. Treatment may not be covered by
medical insurance if it's done solely to improve your appearance.
Skin treatments traditionally done to treat wrinkles, such as laser
resurfacing or chemical peels, may improve skin tone and tighten the
skin. This may lessen the appearance of under-eye swelling and improve
Eyelid surgery (blepharoplasty) is an option to remove bags under eyes.
During blepharoplasty, the surgeon cuts just below the lashes in your
eye's natural crease or inside the lower lid. The surgeon removes excess
fat and sagging skin. Depending on where the initial incisions are
made, stitches may follow the lower lid's natural crease or be placed
inside the lower eyelid.
In addition to correcting bags under eyes, blepharoplasty can also repair:
* Baggy or puffy upper eyelids
* Excess skin of the upper eyelid that interferes with your vision
* Droopy lower eyelids, which may cause white to show below the iris — the colored part of the eye
* Excess skin on lower eyelids
Lifestyle and home remedies
The following tips can help you reduce or eliminate bags under eyes:
* Use a cool compress. Wet a clean washcloth with cool water. While
sitting up, apply the damp washcloth to the skin under and around your
eyes for a few minutes using mild pressure.
* Get enough sleep at night. For most adults, seven to eight hours a night appears to be the best amount of sleep.
* Sleep with your head slightly raised. Add an extra pillow or prop
up the head of your mattress. Or, elevate the entire head of the bed a
few inches. This helps prevent fluids from accumulating around your eyes
as you sleep.
* Reduce allergy symptoms. Avoid allergens when possible, and ask
your doctor about over-the-counter or prescription allergy medications.
Talk to your doctor about prevention strategies if you develop under-eye
reactions due to hair dyes, soaps, cosmetics or other allergens.