What Causes Puffy Eyes? Plus, How to Treat Puffy Eyes

One of the more common skin changes you might notice as you age is a phenomenon known as puffy eyes. There are a few ways that puffy eyes can manifest. There could be a puffiness above your eyelid, caused by extra skin and fat. It could mean large bags under your eyes that extend all the way to your cheeks, most common in smokers and others with skin damage. "But the most common type of puffy eye is a puff right under your eyelashes that doesn't go away," says Brian Brazzo, MD, an oculoplastic surgeon in New York City. Puffy eyes don't pose any health risks, but they can be a nuisance and are usually unwanted, says Dr. Brazzo. If you have puffy eyes and would like to decrease their puffiness, read on for Dr. Brazzo's tips.

What causes puffy eyes?

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Genes

According to Dr. Brazzo, most people who have puffy eyes are genetically predisposed to them, so there isn't much you could do (or not do) to prevent them. "Simply put, they are caused by fat," he explains. "It gets worse as we age—as the years go on, those fat pads get a little bit larger and sink down a little bit lower as skin loses its elasticity, so they become more noticeable."

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Lack of Sleep

While not sleeping enough is a problem for many reasons, it can negatively impact your skin, including causing puffy eyes. "If you already have some puffiness, you almost certainly will have mornings after you didn't sleep well where you wake up and it's worse," says Dr. Brazzo.

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Drinking Alcohol

Overdoing it on cocktails can also make puffiness worse, since alcohol dehydrates skin and contributes to inflammation.

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Allergies

If you're an allergy sufferer, allergic reactions can exacerbate puffy eyes since there's a chronic swelling in your nasal area that doesn't go away, and you may be able to see this in your eye area. Even if you don't have allergies, your environment can contribute to puffy eyes—they may be worse in dryer, colder times of year and less noticeable in warmer, more humid months.

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Smoking

There are also a few lifestyle factors that contribute—smoking is a big one, since smokers lose collagen in their skin more quickly than nonsmokers.

Are there any ways to fix puffy eyes?

How to treat puffy eyes depends a bit on what caused them. If they're from not sleeping enough or drinking alcohol, the best solution is, unsurprisingly, to sleep more and drink less. You can also try scaling back on how much salt is in your diet, and make sure you're getting enough potassium, as puffy eyes can become worse when these minerals are out of balance.

Applying something cold will also help, says Dr. Brazzo. "Usually the cold will shrink them for a few hours—when skin is cold, it's tighter, and this holds [the puffiness] back," he explains. You could use a cold compress or slices of cucumber, applied for five to 15 minutes.

Topically, there's not much else that reliably works, says Dr. Brazzo. "Some people like an OTC serum called Plexaderm every now and then," he says. He does warn that Plexaderm is a plaster-like substance that can feel sticky, heavy, and tacky on skin when applied. He has had patients who have asked about other OTC substances, like caffeine serums and even Preparation H (a hemorrhoid treatment), but he doesn't believe either of these options deliver results.

In more persistent cases of puffy eyes, the fix may need to be more permanent—but this will ultimately come down to personal choice. "If you have the puffs and don't like them, almost always, the most effective treatment is surgery," says Dr. Brazzo. "The skin goes flat again and [the bags] almost never come back." The procedure is called lower eyelid blepharoplasty, and it is an outpatient procedure where a surgeon will remove the lower eyelid fat in small pieces. While surgery is a big commitment, it is effective and has minimal healing and downtime—Dr. Brazzo says you can drive home from the procedure, and may have a week or two of bruising.

Puffy eyes may be an inevitable part of aging for some people, but by taking care of your skin—and yourself—you can help to minimize them.

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