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Under Eye "Bags" - Causes & Treatment

Most of us have experienced undereye puffiness and dark circles, especially after sleeping — or due to too little sleep. This is generally temporary and usually associated with fluid build-up or inflammation — which can also be caused by pollution, smoking, allergens, certain medications, and even a salty meal before bed. This type of puffiness under the eye can be reduced with little intervention.

Of course, removing the allergen or trigger when possible is the first step. Then, cold compresses and massage (especially lymphatic drainage) can be helpful to reduce fluid build-up and mild swelling. As for topical skin care, ingredients that are known vasoconstrictors — such as caffeine — can help. Vasoconstrictors narrow the blood vessels, reducing blood flow to the area associated with the body’s inflammatory response.

However, there are the undereye bags and puffiness associated with aging — and these can be much more stubborn.

The structural tissues of our skin, like collagen and elastin, break down as we age, and the muscles around our eyelids weaken. This loss of structure and support allows fatty tissue around our eyes to fall and bulge — resulting in what we see as undereye bags. This is the result of normal aging, but more prominent undereye bags can be hereditary or a result of excessive sun exposure.

Since the skin surrounding the eye area is the thinnest on the entire body, it’s common to begin seeing the signs of collagen breakdown here first — especially since we are constantly using our eyes to express ourselves. At the same time, the thinness of this skin, as well as the delicate area and proximity to our eyes, makes our under eye area a particularly difficult place to treat. But it’s not hopeless! It may just require a multi-pronged approach.

The primary treatment for undereye bags associated with aging should be to rebuild and strengthen the tissues surrounding the eyes, while preventing further degradation as much as possible.

Retinoids are a very effective topical ingredient for stimulating collagen production. However, due to the sensitive nature of the eye area, sensitization, dryness, and peeling is especially likely. Take a “low and slow” approach when it comes to retinoids to reduce side effects as the skin acclimates.

Further, as with all topical eye creams and products, be sure to apply only around the orbital bone — the product will naturally migrate and spread with facial movement.

Vitamin C, peptides, growth factors, and AHAs are all effective at supporting, strengthening, and firming the skin surrounding the eye area to help reduce the appearance of undereye puffiness. Humectants (such as hyaluronic acid) can also be used for plumping and light reflectivity under the eyes.

To prevent further degradation of the structural tissues around the eyes, SPF is always a must. And don’t forget to wear your sunglasses! Proper eyewear is an important source of protection and prevention — as application of SPF around the eyes, as well as natural wear-off can make this area particularly difficult to protect.

Finally, it's important to mention that some under-eye bags are simply genetic. While you may help improve the appearance of genetically inherited undereye bags with the strategies above, more invasive measures may need to be taken if the goal is for more dramatic, permanent results. For example, there is surgical removal of orbital fat pads or excess skin below the eyelids (blepharoplasty), tear trough filler, and promising results for Endolift laser. Obviously, as the eye area is especially delicate and there are risks associated with vision, you should talk to a medical professional before undergoing any invasive treatments.

Under Eye Causes & Treatment Summary:


· Appearance of puffiness surrounding the eye area

· Padded "bags" below the eye accompanied by a mild or deep line underneath

Dark Circles:

· Purple / bluish darkness in the inner corners of the eyes and within the tear trough region


Puffiness or under-eye "bags" are the result of the breakdown of fatty tissue and collagen around the eye area. As we age, weakening muscular structure around the eyelids can also release its hold on the fatty tissues surrounding the eyes. This can be hereditary, from sun exposure, or a result of normal aging. Since the skin surrounding the eye area us the thinnest on the entire body, it's common to begin seeing the signs of collagen breakdown here first.

Puffiness / bags:

· UV damage

· Intrinsic normal aging

· Medications

Dark Circles:

· Thinning skin (collagen loss)

· Fatty tissue loss

· Allergies

· Medications

· Lack of sleep/fatigue

· Anemia

· Smoking

· Hyperpigmentation (most commonly seen in higher Fitzpatrick types)

· Genetics

· Dehydration

· Sinus congestion

· Inflammation


Primary treatment should be to rebuild and strengthen the tissues surrounding the eyes, while preventing further degradation from occurring. We can also review lifestyle factors that may lessen the appearance of bags and puffiness.

(Stay tuned - our Fruit Acid Peel is the ***April Spa Special ***)


· Facial massage to increase circulation in the area (European Facial, Naturopathic Facial, Mini Facial)

· Superficial peels (Fruit Acid Peel, Glycolic, Lactic Acid Peels)

· Lymphatic drainage (Ultimate Facial, Vitamin C Treatment)

· LED therapy (Euro Light Stim treatment, Ultimate Facial, Mini Facial w/LED)

Skincare Ingredient Options


· Vitamin A (retinol) — best option for night

· Vitamin C + E

· Peptides

· Stem cells

· AHAs

· Niacinamide

· Humectants for plumping and light-reflectivity — such as hyaluronic acid

· SPF — preventative


· Vitamin C + E

· Retinol

· Bearberry

· Licorice root

· Alpha arbutin

· Azelaic acid

· Kojic acid

· SPF — Prevention & protection when using brighteners


· Omega 3

· Vitamin C

· Iron supplements (anemia)

· Allergy medication / antihistamines

· Improve sleep patterns

· Reduce or eliminate allergens and smoking/vaping

· Collagen supplements — primarily to support hydration retention

· Reduce alcohol, sugar, and caffeine consumption

· Manage stress

· Avoid excess salt

· Sleep with head elevated (extra pillow)

· Cold compresses

Home Care Guidance:

· Do not overuse products or bring too close to the eye cavity

· Apply ingredients gently with a tapping motion around the under eye area.

· Use Vitamin A / Retinol at night

· Use Vitamin C in the day

· Always use SPF

· Wear sunglasses and hats to protect the skin from UV rays

· Recommend: Blue Light shield glasses during screen time


article courtesy of Skin Care Literature - links provided by us!


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