Are you wondering why you have puffy eyes or how you can make under-eye bags disappear? Good news: Although they can be bothersome, bags under your eyes don’t usually impact vision or health. But if you want to reduce the puffiness around your eyes, there are temporary and long-lasting solutions.

What causes bags under the eyes?

There are several reasons people get puffy eyes, including:

• High-salt diet: Eating a lot of salty foods causes you to retain water and leads to swelling.
• Allergies: Congestion and inflammation from allergies can sometimes exacerbate under-eye puffiness.
• Medical conditions: Some health conditions such as thyroid problems can cause the eyes to become swollen.
• Genetics: Having under-eye bags can be a physical characteristic that runs in your family. 
• Natural aging process: Loss of firmness in the skin and muscles happens as you age.

Why under-eye bags form when you get older

“The most common cause of under-eye bags or puffiness is natural aging,” says Shaun Desai, M.D., a facial plastic and reconstructive surgeon at Johns Hopkins Center for Facial Plastic and Reconstructive Surgery. “Older skin becomes too lax and tends to fall or wrinkle. The muscles and tissues around the eye can also weaken and contribute to the baggy look. This weakening allows the fat surrounding the eye to bulge out, creating that bubble-like appearance.” 

Ways to Get Rid of Eye Bags

There are different approaches to reducing under-eye puffiness, depending on the cause. At-home treatments can temporarily shrink lower lids that are sometimes swollen from fluid pooling in the undereye area.
But, says Desai, home remedies and over-the-counter products can only do so much, “To effectively get rid of under-eye bags that are prominent and permanent, medical treatment is oftentimes necessary.” 

At-home treatments for puffy eyes

If you occasionally wake up with puffy lids, these quick fixes may help. They work to reduce swelling until it naturally subsides over the course of the day.

• Cold compresses: Cooling the area lessens inflammation and swelling by reducing blood flow. You can place anything cold, such as an ice pack, frozen bag of vegetables, chilled cucumber slices or refrigerated spoons, over closed eyes for a few minutes.
• Hemorrhoid creams: Some people pat over-the-counter creams designed for hemorrhoid treatment under their eyes. Product ingredients such as phenylephrine narrow blood vessels to reduce swelling. But use these products with caution: They may cause irritation in this sensitive area. Also, it’s important to keep this medication from getting in your eyes. 
• Caffeine: Caffeine is a vasoconstrictor, meaning it constricts blood vessels. Many cosmetics companies sell eye creams with caffeine to reduce under-eye puffiness. You can also try resting chilled tea bags (caffeinated black tea) on closed eyes.

Medical options for under-eye bags

If you’re fed up with under-eye bags, these medical treatments can improve and even eliminate them: 

Nonsurgical options
These noninvasive treatments smooth the under-eye area:

• Filler: This treatment places a filler material (usually hyaluronic acid, which is a jelly-like substance) where the under-eye area and cheek meet to create a smooth transition. The injection is performed in a doctor’s office under local anesthetic. Results last six to 12 months. 
• Laser resurfacing: This treatment uses a laser to remove surface layers of wrinkly skin in the under-eye area and stimulate new collagen growth, resulting in firmer skin. Results can last years, depending on your skin type and sun exposure. 
• Chemical peel: A chemical peel also treats wrinkly under-eye skin by removing superficial top layers. An in-office application of a chemical solution dissolves old skin cells to reveal tighter, brighter skin. Depending on your skin type and sun exposure, results can last a few years.

Surgical option
A lower eyelid lift (blepharoplasty) is an outpatient procedure where the surgeon readjusts the fat in the lower eye area and tightens the muscle and skin to create a smooth appearance. In most cases, a lower eyelid lift gets rid of under-eye bags for life — it’s rare for people to need future touch-ups.

However, says Desai, sometimes patients require multiple therapies to treat under-eye bags, such as combining laser resurfacing with filler or an eyelid lift.

How to Choose a Doctor

The eye area is a very delicate part of the face. Serious complications can arise if procedures are done improperly. It’s crucial to find a highly experienced, board-certified surgeon who specializes in treatment of the eyelid area.