Bags under eyes — mild swelling or puffiness under the eyes — are common as you age. With aging, the tissues around your eyes, including some of the muscles supporting your eyelids, weaken. Normal fat that helps support the eyes can then move into the lower eyelids, causing the lids to appear puffy. Fluid also may accumulate in the space below your eyes, adding to the swelling.
Bags under the eyes are usually a cosmetic concern and rarely a sign of a serious underlying medical condition. At-home remedies, such as cool compresses, can help improve the appearance of bags under the eyes. For persistent or bothersome under-eye puffiness, eyelid surgery may be an option.
You may not like the way they look, but bags under the eyes are usually harmless and don’t require medical care. See your doctor if the swelling is severe, persistent, painful, itchy, or red.
Your doctor will want to rule out other possible causes that can contribute to the swelling, such as thyroid disease, infection, or an allergy. He or she may refer you to a doctor who specializes in the eyes (ophthalmologist), plastic surgery, or plastic surgery of the eyes (oculoplastic surgeon).
As you age, the tissue structures and muscles supporting your eyelids weaken. The skin may start to sag, and fat that is normally confined to the area around the eye (orbit) can move into the area below your eyes. Also, the space below your eyes can accumulate fluid, making the under-eye area appear puffy or swollen. Several factors cause or worsen this effect, including:
Fluid retention, especially upon waking or after a salty meal
Lack of sleep
Heredity — under-eye bags can run in families
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