What Causes Puffy Eyes?

Puffy eyes can affect your appearance and may feel uncomfortable. There are many causes of puffy, swollen eyes. Sometimes puffy eyes aren’t caused by anything serious and might be more of a cosmetic nuisance than anything else. However, they can occur due to illnesses, such as Graves’ disease, that require medical treatment. 

Aging

While aging doesn't cause eye swelling, it can cause bags under the eyes that have a puffy, swollen appearance. As you get older, the skin on your body, including around your eyes, loses its elasticity and firmness.

Eye bags are a normal part of aging and nothing to worry about. The skin around your eyes is thinner than elsewhere, so it’s more susceptible to sagging. Because the skin is more delicate, fluid is also more likely to build up under it. This causes it to sag and can cause bags to form under the eyes.

• If your puffy eyes are giving you self-confidence issues, you can try over-the-counter (OTC) anti-aging creams to try to firm up your skin. Most OTC products won’t produce drastic results, though.
• If you want to get rid of the bags completely, you can book an appointment with a dermatologist to discuss your options. Medical treatments for saggy skin under the eyes include laser resurfacing treatments, dermal fillers, chemical peels, and plastic surgery. 

That said, while surgery is one of the most effective options for eliminating bags under the eyes, it also comes with potential risks. Some medical treatments, like chemical peels, are less invasive and carry with them fewer risks.

Lack of Sleep

According to the American Academy of Ophthalmology, lack of sleep can contribute to bags forming under the eyes. Sometimes lying down causes retained fluid to collect in the under-eye area, causing swelling and puffiness.

This kind of swelling usually dissipates as the day goes on.

• You can reduce swelling by applying a cold compress with a clean, cold, damp cloth to your closed eyes.
• You can also prevent swelling by raising your head slightly while in bed. Drinking less liquid before bed might help reduce puffiness that occurs first thing in the morning.

Allergies

Sometimes eye allergies can affect the skin around your eyes. Inflammation and stuffiness from allergies, like pollen, pet dander, and pollutants can cause puffiness under the eyes. 

Eye swelling can also be the result of contact dermatitis, which is a reaction to an irritant. Ask yourself if you’ve recently tried out a new eye cream or makeup product. Could it be causing a reaction? Some medications, like medicated eye drops, can also cause adverse reactions. 

• OTC allergy medication can help reduce inflammation and clear up congestion.
• You can also try a cold compress to provide some puffy eye relief. 
• Stop using a product that could be causing your eyes to swell.

Sinus Congestion

Blocked sinuses can cause swelling around the eyes. The pressure can cause a headache and leave you feeling lousy for the rest of the day.

• Treating the congestion with OTC decongestants can help.
• At-home remedies, like a hot, steamy shower, can also relieve sinus pressure. 

Genetics

Some people are genetically predisposed to getting bags under their eyes. This type of puffiness is permanent. Medical treatments, like an eyelift, are usually the only effective options for resolving the saggy appearance.

High Salt Intake and Dehydration

Eating a lot of salt can cause you to retain water, causing puffiness in your hands and fingers and under your eyes. Ways to resolve the swelling include reducing salt (sodium) in your diet or making sure you’re adequately hydrated throughout the day.

Graves’ Disease

Problems with the thyroid caused by Graves’ disease can also result in eye puffiness. This condition produces hyperthyroidism (overactive thyroid). In some cases, it primarily affects the eyes. 

Graves' disease can cause muscles around the eyes to swell and the eyes to protrude, causing a puffy appearance. Unlike other causes of eye puffiness, it can also produce vision problems such as double vision. 

Treatment involves managing symptoms by:

• Using protective eyewear to help with light sensitivity
• Applying cold compresses to reduce swelling
• Wearing special eyewear to help with double vision 
• Taking medication as prescribed by your doctor to prevent swelling and bulging of the eyes 

A medication called Tepezza (teprotumumab-trbw) may also help with eye problems related to thyroid disease. It is a monoclonal antibody approved in 2020 and is given by intravenous infusion.

Styes

A stye (hordeolum) is an inflamed lump that is usually found on the lash line of the eyelid. A stye will usually go away on its own, but in the meantime, it can cause uncomfortable swelling.

Using a warm compress can help the blockage to clear. In some cases, styes require medical treatment. If the swelling is getting worse and doesn't improve with at-home treatments, see a doctor.

When To See a Doctor

If the swelling and puffiness around your eyes are accompanied by pain, itching, or crustiness, it’s time to see a doctor. These symptoms may indicate the presence of an infection.

Similarly, if you’re experiencing problems with your vision, you should seek medical attention. Puffy eyes from allergies or aging shouldn’t affect your sight. 

Most swelling goes away within a day or so. However, if you wake up with puffy eyes day after day, it may be because you’re retaining fluid. If this happens once in a while, it’s not usually anything to worry about, but if you’re retaining fluid on a daily basis, it can be a sign of a more serious issue like heart or kidney disease. 

In rare cases, eye swelling can be a sign of eyelid cancer. But cancer of the eye may also produce other symptoms—like vision problems.