What Causes Puffy Eyes?

Puffy eyes don’t just affect your appearance, they can feel really uncomfortable, too. Puffy, swollen eyelids aren’t usually the result of a blow to the face, but they can still bother you significantly.

There are many reasons your eyes are puffy and swollen. Some causes of puffy eyes aren’t serious and are more of a cosmetic nuisance than anything else. Other causes, like Graves’ disease, may require a visit to the doctor. 

bags under the eyes

Getty Images / Srisakorn

Aging

While aging won’t cause swelling per se, it can cause bags under the eyes. The lumps can have a puffy, swollen appearance. As you get older, the skin on your body, including around your eyes, loses its elasticity and firmness. This causes it to sag and can cause bags to form under the eyes.

It’s 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 gravity. Because the skin is more delicate, fluid is also more likely to build up under it. 

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 is a factor that can contribute to bags forming under the eyes. It’s possible that lying down causes retained fluid to collect in the under-eye area, causing swelling and puffiness.

Thankfully, this kind of swelling usually dissipates as the day goes on. You can reduce swelling by applying a clean, cold, damp cloth to your closed eyes, which called a cold compress.

You can also prevent swelling by raising your head slightly while in bed. Cutting out liquids before bed is another way to stop puffiness that occurs first thing in the morning.

Allergies

Many people feel the effects of allergies on their eyes and the tissue around them. Exposure to allergens like pollen, pet dander, and pollutants can cause you to wake up with eyes that feel like they’re going to pop out of their sockets.

Inflammation and stuffiness from allergies can cause puffiness under the eyes that can make you feel completely rotten. OTC allergy medication can help reduce inflammation and clear up congestion. In the meantime, you can also try a cold compress to provide some puffy eye relief. 

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? Stop using the product. Some medications, like medicated eye drops, can also cause adverse reactions. 

Sinus Congestion

As with allergies, blocked sinuses can cause swelling around the eyes. The pressure can, in turn, cause a headache and leave you feeling lousy for the rest of the day. The cure involves treating the congestion with OTC decongestants. 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. Unfortunately, this means that 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 or 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 steroids 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 lower 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 encourage the blockage to clear. In some cases, styes require medical treatment. If the swelling is getting worse and isn’t helped by at-home treatments, see a doctor.

When To See a Doctor

If the swelling and puffiness around your eyes are accompanied by pain, itching, and 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 cancer. But cancer of the eye often also produces other symptoms like vision problems. 

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Article Sources
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  3. Stepko B. What’s causing your puffy lids and watery eyes? AARP. January 2, 2020. 

  4. Boyd K. What is Graves’ Disease? American Academy of Ophthalmology. December 1, 2020.  

  5. Harvard Health Publishing. Ask the doctor: baggy eyes. May, 2011.