Treatment

Bags under eyes are usually a cosmetic concern and don't require specific treatment. Home and lifestyle treatments may help reduce or eliminate puffy eyes.

Medical and surgical 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.

Medications

If you think the swelling under your eyes is caused by an allergy, ask your doctor about prescription allergy medications.

Therapies

Various wrinkle treatments are used to improve the appearance of puffiness under the eyes. These include laser resurfacing, chemical peels and fillers, which may improve skin tone, tighten the skin and rejuvenate the look of bags under the eyes.

Eyelid surgery

Eyelid surgery (blepharoplasty) is an option to remove bags under eyes. During blepharoplasty (BLEF-uh-roe-plas-tee), the surgeon cuts just below the lashes in your eye's natural crease or inside the lower lid. The surgeon removes or redistributes excess fat, muscle and sagging skin. He or she then rejoins the skin with tiny dissolving stitches along the lid's natural crease or inside the lower eyelid. The procedure is usually done as an outpatient procedure.

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

Talk with your doctor about the risks of eyelid surgery, which include infection, dry eyes, and problems with vision, tear ducts and eyelid position.

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 is a good 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. Try over-the-counter allergy medications. Talk to your doctor about prevention strategies if you develop under-eye reactions due to hair dyes, soaps, cosmetics or other allergens.

Preparing for your appointment

Preparing a list of questions will help you make the most of your time with your doctor. For bags under eyes, some basic questions to ask your doctor include:

  • What's likely causing my symptoms?
  • Is my condition likely temporary or chronic?
  • What treatment approach do you recommend, if any?
  • What will the treatments cost? Does medical insurance cover these costs?
  • What results can I expect?
  • Can I do anything at home to improve my symptoms?
  • What kind of follow-up, if any, should I expect?

Don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • When did you first notice the puffiness under your eyes?
  • Have your symptoms been continuous or occasional?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Sept. 26, 2014
References
  1. AskMayoExpert. Eyelid surgery. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  2. Eyelid surgery. American Society for Aesthetic Plastic Surgery. http://www.surgery.org/consumers/procedures/head/eyelid-surgery. Accessed Feb. 7, 2014.
  3. Yanoff M, ed., et al. Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Feb. 7, 2014.
  4. AskMayoExpert. Eyelid surgery. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
  5. Neligan PC. Plastic Surgery. 3rd ed. Philadelphia, Pa.: Elsevier; 2013. https://www.clinicalkey.com. Accessed June 4, 2014.
  6. Goldberg RA, et al. What causes eyelid bags? Analysis of 114 consecutive patients. Plastic and Reconstructive Surgery. 2005;115:1395.
  7. Brain basics: Understanding sleep. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm. Accessed June 5, 2014.
  8. Goldberg DJ. Ablative laser surfacing for skin rejuvenation. http://www.uptodate.com/home. Accessed June 5, 2014.
  9. Bradley EA (expert opinion). Mayo Clinic, Rochester, Minn., July 22, 2014.