Under-eye bags, puffiness, pooch—call it what you will, but most of us will inevitably deal with this super common issue at some point. For some, it's a transient problem (think waking up occasionally with puffy peepers). For others, it's a more chronic situation that seemingly won't go away no matter what you do.
This brings us to an important point: Not all under-eye bags are the same, and, as such, treatment tactics vary. "Under-eye bags can be one of two things. They're either a result of mild swelling underneath the skin below the eyes, or they're herniated fat pads," explains board-certified dermatologist Shereene Idriss, MD. The former is the type of puffiness that only shows up on occasion—think after you've had a poor night's sleep or eaten a super salty meal, or if you're dealing with allergies. The latter is typically caused by a combo of genetics and age, and, as mentioned, are always present. As we get older, the ligaments, tendons, and skin covering the fat pad underneath the eye all start to relax. Without this support, the fat pad pooches or bulges out, explains board-certified dermatologist Whitney Bowe, MD.
It bears mentioning that under-eye bags are NOT the same as dark circles, though the two do have some overlap, and many people have both. "Patients will come in and say their eyes look tired, or that they're looking old, and often times that's because they have a combination of both bags and dark circles," notes Ranella Hirsch, MD, a board-certified dermatologist.
Meet the Expert
- Shereene Idriss, MD, is a board-certified dermatologist, founder of Idriss Dermatology in New York City, and the creator of the #pillowtalkderm series on Instagram.
- Whitney Bowe, MD, is a New York-based board-certified dermatologist and the author of The Beauty of Dirty Skin: The Surprising Science of Looking and Feeling Radiant From the Inside Out. She specializes in skin rejuvenation, laser dermatology, and the link between nutrition and skincare.
- Ranella Hirsch, MD, is a board-certified dermatologist in Cambridge, MA, and the co-founder of Atolla, a custom skincare brand. She often lectures on the topics of laser surgery and cosmetic dermatology and is currently involved in a number of clinical studies of laser technologies and skincare.
Dark shadows are caused either by thinning skin that makes the underlying vasculature more apparent or actual hyperpigmentation on the skin under the eyes, explains Idriss. In other words, the causes aren't the same as bags. That being said, "if you do have fat pad herniation, that can actually create shadowing," says Bowe. And vice versa: "Dark circles can also cause an optical illusion that makes under-eye bags appear more prominent. They create the look of a deeper valley and the fat pads look more herniated as a result," adds Idriss.
Long story short, it's important to separate under-eye bags from dark circles, and even more so to figure out what is the underlying cause of your under-eye baggage. Once you do that, you can try the appropriate option from this list of dermatologist-recommended solutions.
Make Some Lifestyle Changes
If your bags are in fact a result of temporary swelling and fluid retention, a few simple lifestyle tweaks can make a big difference. For starters, Bowe suggests sleeping on your back and/or with your head elevated; this position lets gravity do its job and prevents excess fluid from building up in your face and around your eyes while you snooze.
Salt and alcohol are big contributing factors to swelling and puffiness, including in the under-eye area, adds Idriss. (It's why you're very likely to wake up with crazy bags after a night of chips and margs at your fave Mexican restaurant.) Cutting back on both of these and simultaneously increasing your water intake can be very helpful, she says. A lack of sleep can also increase the odds of under-eye bags, so aiming to get those magical eight hours of shut-eye is always a good idea.
Try Over-the-Counter Meds
Allergies can be a big culprit of puffy eyes. If that's the case, Bowe notes that taking an over-the-counter antihistamine (AKA an allergy pill) can be very helpful. Hirsch's secret trick? "I send people to the aisle in the drugstore where they sell PMS pills that help with bloating," she says. They work as a diuretic to help flush out excess fluid, she explains. (As always, do check with your doctor before taking any type of meds.) Though if your bags truly are just a result of temporary swelling (technical term: edema) try not to stress too much. "Let gravity do its thing and you really will see an improvement over the course of the day," says Hirsch.
Reach for Anything Cold
Cold temperatures help constrict blood vessels and bring down swelling, fast. Cold metal is ideal (the material conducts the cold the best), which is why both Idriss and Hirsch recommend chilling two spoons in the freezer and pressing the backs against your eyes. "It's the simplest thing you can do and it really does work wonders," says Hirsch. Jade rollers or eye creams with metal rollerball applicator tips (again, both chilled) can also help.
For the best results, Bowe advises swiping from the inside corner of the eye moving outward; this way the fluid is pushed toward the direction of the lymph nodes that help flush it out, she says.
Use Caffeine-Based Eye Creams for a Quick Fix
The key ingredient in your beloved cup of morning coffee is also a good option to seek out in your morning eye cream. Both Idriss and Bowe say caffeine is one of the best topical ingredients to look for to tamp down swelling. "It's a vasoconstrictor, meaning it constricts blood vessels and gives you a transient, short-term de-puffing effect," explains Bowe, who also likes green tea extract for the same reason. The other added plus? "Both ingredients act as antioxidants, so you'll also get the long-term benefits of protection against skin-damaging free radicals," she adds. Idriss likes this affordable, caffeinated eye cream.
Use Eye Creams With Retinol, Vitamin C, or Peptides for Long-Term Benefits
If your under-eye bags are the more permanent kind, there's admittedly no topical ingredient that will get rid of them. However, using collagen-boosting ingredients—retinol, peptides, and vitamin C—can help bolster the skin, leaving it stronger and thicker so that (eventually) the herniated fat pad becomes slightly less prominent. (This can also help better camouflage underlying blood vessels that can be contributing to the look of dark circles, notes Idriss.) One major caveat: Retinol and even vitamin C are notoriously irritating, so make sure you're using them in a formula specially made for the delicate skin around your eyes, cautions Bowe. This eye cream from First Aid Beauty fits the bill.
Consider Injectable Fillers
Injectable fillers can be a good way to address under-eye bags caused by herniated fat pads, particularly for those seeking an alternative to surgery. However, not all fillers are created equal, and they're not necessarily a one-size-fits-all solution. "If your skeletal structure allows it, hyaluronic acid fillers can help mask the protrusion of the fat pad from the demarcation of your cheek," says Idriss. "Think of these as re-stuffing a limp sofa cushion," adds Hirsch. "By adding more 'stuffing,' the skin will all lay at the same level."
However, both she and Bowe are quick to caution that HA fillers tend to be best at addressing hollowing and dark shadows. Hyaluronic acid attracts water, and if someone is already prone to puffiness and swelling under the eyes, this type of filler can just make it worse, notes Bowe. She tends to do a two-step process of fillers, starting first with a biostimulatory filler, such as Sculptra. "This helps rebuild the scaffolding of the skin, to build it up and tighten it, and then you add the hyaluronic acid filler after the fact," she explains. However, this process can take anywhere from six to eight months to achieve full results, she says.
Discuss a Surgical Solution With Your Doctor
"If your under-eye bags are truly caused by a bulging fat pad, then you can have a surgical procedure to remove that fat pad entirely," says Hirsch. For these types of bags, this is the most effective and permanent solution, but again, a few caveats. Hirsch notes that it's very rare that it's only the fat pad that's contributing to a puffy or generally aged appearance. More often than not, there's other stuff going on, such as some temporary swelling, dark circles, and the like. Plus, Bowe points out that when the fat pad is surgically removed, people can sometimes end up with prominent hollows under their eyes that then require injectable filler.
How Do You Get Rid of Under-Eye Bags Fast?
Applying something cold (ideally metal, like a spoon) to the area will help quickly tamp down swelling and puffiness. However, that's only going to help if your under-eye bags are in fact a result of transient puffiness and not a herniated fat pad.
How Do You Permanently Get Rid of Under-Eye Bags?
Surgery is the only permanent way to get rid of bags that are caused by a bulging fat pad, given that the fat pad is removed entirely.
Why Won't My Under-Eye Bags Go Away?
If your under-eye bags are always there, no matter how much sleep you get, how much water you drink, or what eye cream you use, it's likely that they're a result of herniated fat pads. Some people are more genetically predisposed to this condition than others, and it tends to become more prominent as you get older, though it can occur even in young people.
Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. Dermatoendocrinol. 2012;4(3):308-319.