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By Beth Longware Duff; reviewed by Gary Heiting, OD
Bags under the eyes, also called eye bags, form when weakened and sagging skin relaxes and creates a pouch. The fat pads under the eyes then slip down to fill the space, giving the appearance of a "bag."
Excess fluid in the body can also pool in this area, making the lower eyelids look even more puffy and swollen. Any shadows or discolored skin under the eyes will make eye bags look more prominent.
Under-eye bags are mostly a cosmetic issue. They're usually harmless, but can sometimes be a sign of an underlying medical condition.
Most eye bags under the eyes are more noticeable in the morning, after the fluid has had all night to settle in.
What causes bags under the eyes?
Aging is the most common cause of bags under the eyes. As we get older, we experience a loss of fat padding and collagen, the major component of connective tissues in skin, muscles and other body parts.
Lower collagen levels cause the skin and underlying muscles all over the body to lose elasticity and tone. This sagging is especially noticeable around the eyes because the skin there is very thin.
Other factors that can contribute to bags under your eyes include:
If the swelling becomes severe, painful, itchy, red or persistent, see an eye doctor.
How to get rid of bags under your eyes
To get rid of eye bags, you need to find out what's causing them in the first place.
When the bags under your eyes are a result of environmental or health issues, simple home remedies and lifestyle changes may help reduce their appearance.
Remedies include:
Get plenty of sleep; the CDC recommends at least 7 to 9 hours of sleep every night for adults, depending on your age.
Sleep with your pillow elevated a few inches to keep fluid from pooling around your eyes.
Drink enough water. Common guidance suggests adult women drink 2.3 quarts of water a day and adult males drink 3.2 quarts a day. But Cleveland Clinic recommends talking to your doctor to get the most accurate amount.
But avoid fluids before bedtime — and excess salt throughout the day.
Use a cool, damp washcloth as an eye compress, preferably while you're sitting upright. You can also use cucumber slices or cold, damp tea bags to help reduce swelling.
Keep your allergy symptoms under control by avoiding triggers and taking prescription or over-the-counter allergy medications, as directed by your doctor.
Use cosmetic concealers to cover up dark under-eye shadows.
One popular home remedy for reducing bags under the eyes is the use of hemorrhoid cream. (Yes, really.)
Hemorrhoid creams contain phenylephrine, which constricts blood vessels and can temporarily tighten the skin under the eyes. This can temporarily reduce some of the swelling, according to Johns Hopkins Medicine. But be very careful not to get the cream in your eyes.
If you're a smoker, make every effort to quit. Avoiding smoking is not only good for your general health and eyesight; it will also slow the collagen loss that thins the skin.
If you choose cosmetic surgery to remove the bags under your eyes, you'll also heal quicker if you don't smoke.
There are also wrinkle treatments and skin therapies designed to tighten under-eye skin and reduce puffiness. These include options such as:
Chemical peels
Laser resurfacing
Injectable dermal fillers
The benefits, side effects and risks associated with these options should be discussed with your ophthalmologist, oculoplastic surgeon or plastic surgeon.
SEE RELATED: Eye cream: Does it really work?
Surgical options
If you've tried some or all of the remedies listed above and aren't satisfied with the results, surgical procedures are available to help get rid of eye bags.
Cosmetic eyelid surgery, also known by the medical name blepharoplasty, can tighten and smooth out the skin under the lower eyelids. It can also be used to treat puffy or drooping eyelids.
If you're considering cosmetic eye surgery, keep in mind that procedures will not be covered by medical insurance when they're done solely to improve appearance.
Lower-eyelid blepharoplasty is usually done as an outpatient procedure under local anesthesia with sedation. In some cases, the surgeon will choose general anesthesia instead.
After surgery, you can expect some swelling, bruising and eye dryness in the days following the procedure. Most people find that swelling and bruising decreases significantly in about 10 to 14 days.
Complete recovery from eyelid surgery takes about six weeks or more.
FAQs
Q: Are eye bags permanent?
A: “Bags under eyes” are sometimes caused by acute inflammation — such as an insect bite or infection of the soft tissue — though these tend to happen on just one side. These cases usually resolve on their own, but more severe cases may require a doctor to prescribe medication. The more common under-eye bags result from a loss of firmness of the skin, a natural part of the aging process.
Several non-invasive techniques can help reduce the appearance of under-eye bags, ranging from cool compresses to topical creams (though results can vary). If you want to remove eye bags more permanently, a cosmetic procedure called blepharoplasty can tighten and smooth out the skin under your eyes.
Q: What foods can cause eye bags?
A: Foods that are high in sodium, such as canned meats and vegetables, cheese and processed foods, can cause puffiness under the eyes. Drinking caffeine and alcohol can also cause dehydration, which may lead to under-eye bags.
Q: Does Vaseline help eye bags?
A: There is no medical proof that applying Vaseline under the eyes will help eye bags caused by the natural aging process. The Vaseline website encourages applying a thin layer to help heal and protect dry or chapped skin around the eyes. However, they do not recommend the product as a means of reducing under-eye bags.
If you're considering surgery for the bags under your eyes, your surgeon will be able to lay out the process in detail, explain the risks involved, and answer any questions you have.
LEARN MORE about blepharoplasty and other eyelid surgery
Adam Debrowski also contributed to this article.
Page published on Monday, July 22, 2019
Under-eye swelling or puffiness is a common cosmetic concern. You usually don’t need treatment. However, in some cases, swelling beneath your eyes may also be a sign of a minor or more serious health condition.
Under-eye “bags” might just run in your family. Aging and genetics can cause tissues around the eyes to weaken. This leads to fat moving into the lower eyelids, making them look swollen. The skin around your eyes is very thin and delicate.
If you do have a health issue, treating the underlying problem can help smooth your eye area. Here are 10 causes of under-eye swelling and what you can do to prevent and treat them.
Too much salt or sodium in your diet is not good for your body or your appearance. Extra sodium can make your body retain water. The excess water causes puffiness in the face and body. This is especially common the morning after a salty meal.
The thin skin around your eyes is at higher risk of getting puffy. This leads to under-eye swelling or the appearance of under-eye “bags.” Your body will naturally get rid of the bloating and de-puff your eye area. This may take a few hours or longer.
Cut salt in your daily diet to help soothe under-eye swelling. Limit or avoid processed and packaged foods that have added salts. Drink plenty of water to help flush out the sodium.
Eating foods high in potassium also helps counter the salt. These include:
- bananas
- yogurt
- potatoes
- dried apricots
The American Heart Association recommends eating no more than 1,500 milligrams of salt a day. Most Americans eat more than double that amount of sodium every day.
Crying causes fluid to collect around your eyes, causing puffiness for a short time. Under-eye swelling that happens once in a while will likely go away on its own.
A research study found that not getting enough sleep can give you under-eye swelling. It can also cause droopy eyelids, red eyes, and dark circles under the eyes. Other signs are pale skin and a droopy mouth.
A lack of sleep can weaken the muscles around your eyes. It can also lead to a loss of collagen — the elastic tissue — under the eyes. This causes fluid to collect in the area, making the area beneath your eyes to swell up.
Under-eye swelling because of little sleep may last a few hours to 24 hours. Some signs can become permanent if you regularly have poor sleep. Most adults need seven to nine hours of sleep every night.
Allergies can cause fluid to build up in your sinuses and around your eyes. This can lead to under-eye swelling. An allergic reaction can also make your eyes red, itchy, and watery. Common eye allergies include:
- pollen
- dust
- mold
- smoke
- pollution
- dander
- animal fur
- chemicals
- perfume
Allergies are a common cause of puffy eyes. This happens because protective cells in your eyes, called mast cells, give off immune proteins called histamine to fight allergens. This makes your eyes sensitive and watery. Your eyes will also tear up to wash out the pollen or other allergen.
Eye allergies are also easy to treat. Avoid allergens as much as possible to help prevent symptoms. Washing out your nose and using artificial tear eye drops to rinse your eyes also helps. Over-the-counter medications can help ease under-eye swelling. Try:
- antihistamines (Claritin, Benadryl)
- decongestants (Sudafed, Afrin)
- eye drops (Visine, Alaway)
Your doctor may also prescribe a steroid or an allergy shot to make you less sensitive to the allergen.
Smoking cigarettes, shisha, or cigars can irritate your eyes. You may also have an allergic reaction if you’re around secondhand and even thirdhand smoke. This can make your eyes water triggering under-eye swelling.
Quit smoking of any kind and avoid secondhand smoke to help prevent eye puffiness and other symptoms. Clean surfaces and items in your home and car if you’re sensitive to leftover smoke particles. Wash your hair and clothing after being around people who smoke.
An eye infection can cause under-eye swelling in one or both eyes. You can have an infection in the eye or eyelid. The infection and swelling will usually happen in one eye first, but can quickly spread to the other eye.
Avoid touching or rubbing your eye. An eye infection usually goes away within a week. You may need antibiotic treatment.
Types of eye infections that can cause under-eye swelling include:
- Pink eye. Also known as conjunctivitis, this infection may be caused by bacteria, a virus, chemicals, and other irritants. Pink eye can happen at any age.
- Stye. A stye is an infection in an eyelash follicle or a tear gland. It usually begins as a tiny small bump along your lash line. A stye can lead to redness, swelling, and pus in the eye or eyelid.
- Chalazion. A chalazion is similar to a stye. It’s caused by a blocked oil gland in your eyelid. A chalazion usually looks like a small bump on the eyelid. It can lead to swelling if it gets infected.
- Periorbital cellulitis. This infection or inflammation around your eye usually spreads from the sinuses. It can also happen from a scratch or injury to the eyelid, and often requires medical attention.
You can relieve swelling and tenderness around your eye with a damp, clean towel. If you think you have an infection, see your doctor immediately. You may need antibiotics or other treatments to soothe the pressure.
Your tear ducts drain away tears and natural water in the eye. If they’re blocked, the fluid may collect around the eye. This can lead to under-eye swelling.
A blocked tear duct is common in babies, but it can happen in children and adults too. A blockage can happen due to an infection, makeup particles, or an injury to the eye. In most cases, it clears up on its own after a few days.
Normally, a warm compress and washing out the eye with sterile saline helps clear the blockage. In more serious cases, you may need treatment. In adults a blocked tear duct can sometimes happen because of a tumor.
Signs and symptoms of a blocked tear duct include:
- excess tearing or watery eyes
- blurred vision
- redness
- eye infection or inflammation
- pain
- swelling
- crusting
- pus or mucus
A small scratch or nick around the eye can happen from a fingernail or a makeup brush. An injury can lead to under-eye swelling as your body heals the thin, soft skin in the eye area.
Getting hit on or around the eye can also cause puffiness. A blow from a punch or a dull object causes the eye to move down slightly and then back in place. This brings blood rushing into the area. The blood and fluid triggers swelling or bruising beneath the eye.
Graves’ disease is also called thyroid eye disease. It happens when your thyroid gland does not balance thyroid hormones. Graves’ disease can also sometimes happen if you take too much thyroid medication. You will need treatment immediately. Your doctor may recommend medications or other treatment.
About 30 percent of people with this condition will have eye symptoms. These include bulging eyes and under-eye swelling. This happens because Graves’ disease causes changes in the tissue around the eyes. Other eye signs and symptoms include:
- gritty sensation
- pain or pressure
- redness
- light sensitivity
- double vision
- blurred vision or vision loss
Eye and vision changes, including under-eye swelling, may be a sign of mononucleosis. This infection is sometimes called the “kissing disease,” but you can also catch it from sneezes and coughs. Eye symptoms include:
- redness
- pain
- swelling
- seeing “floaters”
Mononucleosis is caused by a virus. Antibiotics won’t help to treat it. Signs and symptoms of this condition include:
- sore throat
- fatigue
- fever
- headache
- swollen tonsils
- swelling in neck and armpits
- skin rash
In most cases under-eye swelling goes away on its own. Whether or not you need treatment depends on the cause. Your doctor may prescribe treatment such as:
- anti-allergy medication
- antibiotic or antiviral medication
- antibacterial ointment
- antibacterial eye drops
- steroid eye drops
You can soothe your under-eye area in most cases. Try one of these home remedies to help your eyes bounce back after a late night, salty meal, or a bout of crying:
- Cold compress. Apply a clean, wet washcloth to your eye area. Or chill a spoon in the fridge and use the back of the spoon to gently massage the area. You can also keep your eye cream or serum in the fridge and apply as a cooling gel.
- Tea bags. Tea contains caffeine, which may help draw water out of your under-eye area and bring down swelling. Try soaking two tea bags in cold water. Place them over your closed eyes and lay back for 15 to 20 minutes.
- Facial massage. Use your fingers or a cold metal facial roller to massage your face. Gently massage or tap around your eyes and sinuses to help drain away extra fluid.
See your doctor if you have swelling around your eyes that doesn’t go away after 24 to 48 hours.
A mild eye infection can go away on its own. It’s important to have it checked in case it’s more serious. An infection can cause complications in your eye if left untreated.
Get immediate medical attention if you have symptoms of an eye infection or other health condition. These include:
- redness
- pain
- white fluid or pus
- swelling in only one eye
- pressure
- blurry vision
- loss of vision
- eye bulging
- fever
- watery eyes
- weight loss
Under-eye swelling is normal. It typically goes away without treatment. See your doctor if you have under-eye swelling that does not go away, or other symptoms. Early treatment is important to prevent damage to your eyes.