Banish the Bags Under Your Eyes

By Colette Bouchez
WebMD Feature

Reviewed by Brunilda Nazario, MD

Do you wake up looking more tired than when you went to bed? Do people tell you it's time for a vacation the day you get back? If so, it's a safe bet you've got some under eye "baggage" -- puffy eyes, eye bags, dark circles, and shadows. It's also a safe bet they're making you look more tired and older than you really are.

"It's not unusual to see women and men in their 20s and 30s who have this problem," says Ellen Marmur, MD, chief of dermatologic and cosmetic surgery at the Mt. Sinai Medical Center in New York. "And, it only gets worse as time goes on."

Plastic surgeon Darrick E. Antell, MD, agrees. He sought medical treatment for his problem.

"I was getting so annoyed hearing everyone ask me why I looked so tired when I wasn't tired, or if I had been out late the night before when I hadn't," Antell says. "So when I was 32 I had cosmetic surgery on my eyes."

Antell, a plastic surgeon in private practice in New York, is also an assistant clinical professor of surgery at Columbia University. "I'm 57 now," he says, "and next to marrying my wife, it was the best thing I ever did."

Although cosmetic surgery is certainly an option -- and we'll tell you more about that below -- there are other ways to treat under-eye bags and sags, dark circles, and puffiness.

Before looking at the remedies, though, it's important to know a little something about how and why these eye problems occur -- and how you might avoid them to begin with.

Puffiness and under-eye bags: Why they occur and what you can do

The problems with eye bags usually start small. You may notice a barely visible "pillow" of puffiness just below the lower lid. If you leave it untreated, it can billow out further. Then, over time, it gives way to a full-blown bag.

But how and why does the puffiness start? One cause, experts say, is the natural aging process. "There is a certain amount of fat naturally in the under-eye area," Antell says. "It's held in place by ligaments. As you age, the ligaments get weaker, allowing the fat to push forward, forming that little puffy pillow under your eye."

As time goes on, the puff gets bigger, he says. Then skin loses elasticity, allowing the formation of those loose wads of skin we call "bags." How soon that happens, however, depends a lot on how many bags Mom and Dad had -- and when their problems began.

"A lot of it has to do with heredity," Marmur said. "It can be a structural, anatomic, genetic issue that simply causes some people to develop this problem sooner than others."

But it's not just heredity. Lifestyle factors matter too. Do you consistently cheat yourself of sleep? Do you eat a lot of salty food snacks and retain a lot of water? Are you getting enough exercise? Marmur tells WebMD all these things can cause bags to form a lot sooner.

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