Puffy eyelids. Dark circles. It’s a look often associated with looking tired or sick. That isn’t always the case, however.
“Dark circles under the eyes can be caused by several different reasons,” says Salvatore Pacella, MD, a plastic surgeon at Scripps Clinic. “It can be due to genetics, aging, allergies, dermatitis, pigmentation, smoking, sun overexposure and even stress,” he says.
Puffy eyelids and dark circles are usually not cause for medical alarm. But they are something you may want to hide or make disappear for cosmetic reasons. After all, who wants to look tired, older or unhealthy?
Fortunately, there are a number of methods — including home remedies and medical treatments — that can be used to address the problem.
“Understanding the underlying reasons for eye swelling or dark under the eyes circles is important when searching for a solution,” Dr. Pacella says.
Aging is the most common reason people develop bags under the eyes and shadows.
As we get older, we lose elasticity and volume in our skin. One of the most visible places where this occurs is under the eyes. Bags develop in the lower eyelid as a result of displaced fat. Shadows are cast by swollen or puffy eyelids.
“Sometimes dark circles are simply a consequence of physics,” Dr. Pacella says. “How the light shines on the lower eyelid has a profound impact on how the eyes look. If there is excess fatty tissue or a deep groove in the lower eyelid — commonly called a tear-trough — ambient light can create an unflattering shadow around the eyes.”
People can use several ways to erase or conceal the appearance of dark circles under the eyes.
Simple fixes include:
- Getting extra sleep helps if lack of sleep is causing eye swelling and dark circles.
- Elevate your head on a few pillows to help prevent fluid from building up under the eyelids.
- Antihistamines can help if allergies are to blame.
- Makeup concealers can cover shadows under the eyes.
- Noninvasive and surgical treatments are options if there are no simple fixes.
“Depending on the cause, there are a number of approaches, including bleaching creams, laser treatment, chemical peels, injectable fillers and cosmetic surgery,” Dr. Pacella says.
Lower-eyelid surgery, also known as blepharoplasty, is one of the most effective ways to treat baggy eyelids and dark circles. “If the problem is the shape of the lower eyelid and how light is hitting that area, surgery may be the best solution to improve the appearance of the eyelids,” Dr. Pacella says.
A blepharoplasty can be performed on the lower and upper eyelids or both. In a lower eyelid surgery, a plastic surgeon removes excess skin and removes or repositions excess fat in the lower eyelid, which has the effect of making dark circles disappear and giving the face a rejuvenated look.
At Scripps, the procedure treats the following:
- Puffy eyes or fatty deposits above and below eyelids
- Bags under eyes that make you look tired or older
- Droopy lower eyelids that reveal the white below the iris
- Baggy skin around eyes that can reduce peripheral vision
- Loose or sagging skin that disrupts the natural shape of the upper eyelids
Eyelid surgery results are meant to be long-lasting, which is why it’s important to select a board-certified plastic surgeon and to follow his or her instructions on how to prepare for the surgery and how to care for yourself afterward.
“Your plastic surgeon will evaluate your general health status, discuss surgery options, including any potential risks, and recommend the best course of treatment,” Dr. Pacella says.