What Are Puffy Eyes?

Puffy eyes, marked by fluid retention around the eyelid and under the eye, can result from a number of different factors. The reasons could be as simple as not getting enough sleep or eating too much salt. You can get rid of puffy eyes in many ways, from improving your sleep or applying a cold compress to using topical medications or undergoing cosmetic surgery.

The terms "puffy eyes" (sometimes known as "bags under the eyes") and "swollen eyes" are used interchangeably at times, but they refer to two different conditions. Swollen eyes are caused by an inflammatory response to an allergen, infection or injury, while puffy eyes are soft and swollen eyelids that are due to water retention, lack of sleep, or genetic traits like age-related sagging or puffiness of the eyelids.

bag under the eye women

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Puffy Eyes Symptoms

You may experience puffy eyes after a late night, from eating certain foods, or from crying. Sometimes called periorbital edema or periorbital puffiness, puffy eyes are characterized by swelling under the eye, on the eyelid, or all the way around the orbit—the bony cavity that houses the eye.

Puffy eyes may also be accompanied by dark circles or bags under the eye and saggy or loose skin.

Causes

The cause of your puffy eyes might be obvious. If you've been crying, have allergies, or had feasted on salty snacks the night before, the reason for your puffy eyes may be clear-cut. But this condition can also be the result of other causes that are not so apparent.

Diet

A number of items in your diet can cause puffy eyes. These foods and drinks inflate the tissue around your eyes because they make your body retain water. The most common culprit is salt, or sodium. Foods and drinks that are high in sodium can cause fluid retention and swelling all over your body. Sodium can be hidden in a lot of what you eat, and you may not realize it—sodium doesn't always make things taste salty.

If you have puffy eyes, make sure you are reading food and drink labels carefully. Try to keep your total daily sodium intake below 2,300 milligrams—about one teaspoon of table salt—or even less if you have certain health conditions.

Some foods and drinks that can hide sodium and make you retain water include:

  • Processed or packaged foods
  • Fast food
  • Alcoholic drinks
  • Carbonated beverages
  • Sauces and seasonings
  • Lunch meat
  • Soups

The Food and Drug Administration offers guidance on how to locate sodium on food labels and how to reduce the sodium content of your foods. Some tips include:

  • Cook food from scratch.
  • Eat fewer processed foods.
  • Rinse certain canned items, like beans to reduce the sodium content.
  • Choose low-sodium versions of products, like low-sodium soy sauce.
  • Limit portion sizes of salty foods.

Allergies

Allergies can also cause puffy eyes, including seasonal allergies and more serious allergic reactions. They can cause a fluid buildup around the eyes and sinuses. Allergies can be triggered by hay fever or a reaction to foods, chemicals, or other irritants or allergens.

Some common allergens include:

  • Dust
  • Mold
  • Pet dander
  • Pollen
  • Tree nuts
  • Wheat

Aside from allergens, you should also be cautious when using certain topical treatments like cosmetics, creams, or chemicals around your eyes. These substances can cause irritation or even injury to the eyes. Be sure to use protective eyewear when spraying chemicals or other irritants, and use caution with cosmetics and tools like eyelash curlers.

Genetics

You may have inherited a tendency toward puffy eyes and dark circles from your family. If there are several people in your family with puffy eyes, this could even be a sign of a genetic condition that causes puffy eyes.

Aging

As we age, many parts of our bodies lose muscle tone, firmness, and elasticity. Your eyes are no exception. The collagen in your skin, which gives skin its tightness and elasticity, decreases with age. This happens all over your body, but the delicate skin around your eyes may show collagen loss more prominently than other areas.

The muscles around your eyes age too, causing tissues in that area to sag. When tissues sag and become lax, the fat layers under those tissues may start to bulge and create a puffy appearance.

Sleep Issues

When you have trouble sleeping, you may notice puffy eyes the next morning. You may be irritated, have trouble concentrating, or have a lack of energy. One study found that the people around you can tell if you're sleep deprived just by looking at your face, specifically at your eyes. Other noticeable signs of sleep deprivation noted in the study include:

  • Drooping eyelids
  • Redness
  • Swelling around the eyes
  • Dark circles under or around the eye

Lower Eyelid Fat Prolapse

Lower eyelid fat prolapse is the main cause of puffy lower eyelids. This condition occurs as connective tissue weakens as a result of aging or surgical trauma and the fat around the eye socket can come forward and appear in the lower eyelids.

Medical Conditions Causing Swollen Eyelids

As mentioned above, puffy eyes and swollen eyelids are different, and the latter could be a sign of an underlying condition, such as:

  • Blepharitis (inflammation of the eyelids)
  • Chalazion (a clogged gland at the base of the eyelashes)
  • Conjunctivitis (an inflammation or infection of the transparent membrane lining the eyelids and whites of the eyes)
  • Diabetic retinopathy (a complication from diabetes)
  • Thyroid eye disease (such as Graves' disease)
  • Hereditary angioedema (a skin reaction affecting the deep layer of skin)
  • Orbital cellulitis (an infection of the soft tissues and fat holding the eye in the socket)
  • Ocular herpes (a condition caused by the herpes simplex virus affecting the cornea)
  • Infections
  • Keratitis (inflammation of the cornea)
  • Optic neuritis (inflammation of the optic nerve)
  • Sty (inflammation caused by a clogged gland or follicle at the edge of the eyelid)
  • Traumatic injuries
  • Uveitis (inflammation affecting the middle layer of tissue in the eye wall)
  • Eye cancer
  • Kidney failure
  • Lymphedema of rosacea, or Morbihan syndrome (a late-stage complication of rosacea or acne)
  • Filler migration (when cosmetic eye fillers, such as hyaluronic acid or fat, travel away from the injection site)

Complications

Persistent or worsening swollen eyelids can result in serious complications, including:

  • Blindness or vision impairment
  • Eyelid dermatitis

You should get a comprehensive eye exam if you have blurry vision, decreased vision, pain in your eye, floaters, or a sensation that something is stuck inside your eye.

Diagnosis

Puffy eyes can usually be diagnosed through a physical exam. Your doctor may:

  • Ask you about any creams or lotions you use around your eyes
  • Ask about exposures to chemicals or other environmental pollutants
  • Discuss workplace hazards
  • Review your allergy history
  • Take a complete health history
  • Perform a physical examination

If your doctor believes you have swollen eyelids and not puffy eyes, they may perform additional tests to determine what is causing your symptoms.

If the swelling came from exposure to an allergen or pollutant or from a traumatic injury, a physical exam using standard eye examination tools may be sufficient. However, if the cause of your swollen eyelids is less obvious, your doctor may need to perform other tests, including:

  • Blood work to check electrolytes and kidney or liver function
  • Blood work to test for inflammatory conditions
  • Imaging studies like a computed tomography (CT) scan or magnetic resonance imaging (MRI)

Treatment

Puffy eyes are generally harmless and don't require treatment, but there are ways you can minimize the swelling and improve the appearance of your eyes. Depending on the cause, you may be able to get rid of puffy eyes completely.

Home Remedies

There are a few strategies you can try at home to alleviate or eliminate puffiness under your eyes and the appearance of shadows, including:

  • Using a cool compress: Wet a clean washcloth with cool water and place the damp washcloth around your eyes for a few minutes, applying very gentle pressure. Do this while sitting upright.
  • Keeping your allergies under control: Avoid allergy triggers whenever you can. Also, talk to your doctor about allergy medications.

Lifestyle

Lifestyle changes can also help reduce puffiness around your eyes, such as:

  • Making dietary changes: Avoid drinking fluids before bed and limit salt in your diet. This can help reduce fluid retention overnight that can lead to bags under your eyes.
  • Quitting smoking: Smoking can contribute to faster collagen loss. This makes the delicate skin under your eyes even thinner, leading to more visible blood vessels.
  • Getting enough sleep: Most experts recommend seven to nine hours of sleep daily. Also, sleep with your head slightly raised. This can help keep fluid from settling around your eyes while you are sleeping. Prop up the head of your bed a few inches, or simply add an extra pillow.

Medications

If your eye swelling is caused by allergies or irritation, you may want to try over-the-counter antihistamines. You may also want to see an allergist to find out exactly what you are allergic to. Some allergic reactions can be life-threatening, and you should seek immediate medical attention if you begin to have trouble breathing or swallowing.

Nonsurgical Cosmetic Treatments

Outside of cosmetics, there are a number of noninvasive options that may help with puffy eyes or bags, such as laser resurfacing. This treatment uses a laser, an intense beam of light, 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. 

Injectable doxycycline, or tetracycline antibiotic, is thought to help with noninvasive lower eyelid fat prolapse.

Cosmetic Surgery

If you've tried all these fixes and it's still not enough, surgical procedures may be an option. Every surgical procedure comes with its own set of risks. You should talk with your doctor about whether surgery is right for you.

Blepharoplasty is a procedure that lifts the lower eyelid. This is usually done on an outpatient basis, either under local or general anesthesia. The surgeon readjusts the fat in the lower eye area and tightens the muscle and skin to create a smooth appearance during this surgery.

A Word From Verywell

Puffy eyes can be caused by a number of factors from lack of sleep to too much sodium in your body to genetics. If you've tried home remedies and your puffy eyes won't go away, you may want to see a doctor for a more thorough examination to make sure you don't have swollen eyelids, which can be a sign of more serious medical conditions.

While annoying, puffy eyes are generally not life-threatening. They also don't require treatment unless you want to improve the appearance of your eyes.

There are many options, including over-the-counter products, lifestyle changes, and surgical procedures, that can help you lift and firm up the tissue around your eyes. Talk to your doctor if your puffy eyes are an ongoing problem or if you have any changes to your vision.

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Article Sources
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