Under Eye Bag Fixes: A Dermatologist Weighs In

Few things are scarier than looking in the mirror and seeing under eye bags or circles. Even if you apply concealer and do your best to distract from your tired looking eyes, the puffiness and dark shadows seem to stick around. While it’s practically inevitable that our eyes will look tired, especially in the morning, there are certain steps you can take to reduce your under eye bags and circles.

MORE: 17 Under-Eyes Masks That Hydrate and Brighten Tired Eyes

To get the full scoop on our puffy eyes—and how exactly to fix what’s going on south of our lashes—we went straight to an expert. Dr. Dendy Engelman, board certified dermatologist for Clearasil, explains what’s causing under eye bags, how to treat them, and the habits we need to quit if we want to prevent them.

StyleCaster: What’s causing under eye bags and puffiness to happen, and how can we reduce and/or prevent them?
Dr. Dendy Engelman: Infraorbital edema (under eye puffiness) is often caused by a collection of fluid in the delicate tissue that surrounds the eyes. Fluid retention can occur due to numerous factors: lack of sleep, allergies, certain medical conditions (kidney, liver, or thyroid disease, to name a few), excess salt or alcohol intake, smoking, etc. So, healthy lifestyle changes can help to minimize under eye puffiness, i.e., getting adequate sleep, minimizing salt and alcohol consumption, avoiding allergens, etc.

In extreme cases, the fat pad that protects the eye in the orbit (eye socket) actually herniates (or extends beyond where it should) and causes the appearance of under eye bags. This condition is ultimately correctable only through surgery (blepharoplasty) where the fat pads (or bags) are surgically removed.

MORE: 9 Creative Puffy-Eye Remedies Celebrities Use to Get Rid of Dark Circles

Do tea bags and cold spoons really work to get rid of bags under your eyes?
These remedies do help some to minimize the swelling that can occur under the eyes because they both cause vasoconstriction. This decreases the amount of fluid in the area and makes the swelling less. Unfortunately, they are only a temporary solution and not a permanent one.

When it comes to dark circles, what’s the best way to treat them?
I get asked this question at least five times a day! I wish there were an easy answer. Obviously, if there were one easy fix, we wouldn’t be having this conversation.

In the majority of cases, the biggest contributor to under eye darkening is actually not in the skin. It is caused by the vasculature lying underneath the skin. Through a phenomenon called the Tyndall effect, the overlying under eye skin looks dark because of how the light is refracted when it hits the vessels deep to the skin. That’s why it is often hard to treat with lightening creams and most chemical peels. Some of the newer lasers and devices help tighten the skin and lessen the Tyndall effect, thus making the dark circle less apparent (CO2, ultrasound therapy, or radio frequency).

In the cases where there is actually darkened skin under the eyes, lightening creams or lasers that decrease pigment can be helpful (Hydroquinone, Elure, or Luminaze). If there are superficial blood vessels that contribute to the discoloration, this is treated with a laser that targets the vasculature. If the appearance of darkness is from hollowing along the lower orbital rim (tear trough), this is best corrected using a dermal filler. This gives an immediate correction, and patients are so pleased with this procedure. Your dermatologist can help you decipher the cause and the best approach to treatment.

I do want to point out that dark circles are very hereditary and, in most cases, there is little (if anything) that can be done to prevent them.

MORE: The Underrated Trick Lara Stone Uses to Brighten Her Eyes

Are there any products we can use overnight to wake up without tired-looking eyes?Teamine Eye Cream is one of the best eye creams I have encountered for combating under eye wrinkling. The studies show that patients using Teamine had visibly younger looking eyes in as little as 12 weeks. Botulinum toxin (Botox) in the crow’s feet and infraorbital region also helps to make eyes look more open and less-fatigued.

Are there habits we can quit to make our eyes look better?
Yes! Quit smoking, limit alcohol and salt intake, review your prescription, herbal, or OTC medications with your physician in order to make sure that they are all safe to take at the same time. Also, watch eye strain from looking at your computer or smart phone. Get your eyes checked annually in order to make sure you aren’t straining your eye—which can lead to squinting which leads to wrinkling.

At what age do you recommend women start using anti-aging products on their eyes?
The earlier the better! It can’t hurt, and it definitely helps! The peri-orbital skin is the first place to show age because the skin is so thin. So, the more hydrated it is, the better.

A version of this article was originally published in May 2015.