Bags under the eyes: How? Why?

Originally Published: March 23, 2007
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Dear Alice,

I was wondering what physiological phenomenon makes the pockets below our eyes swell or go blue/dark when we are really tired? I suppose it is blood, but I don't understand why they appear only there, and what makes them come about. I know the best way to get rid of them is sleep, but are there other ways to alleviate them?

Dear Reader,

Some people seem to always look like they're refreshed and ready to seize the day; others have bags under their eyes that could dwarf some of the luggage that comes out of JFK airport. These dark circles or bags are formed by fat and fluid that settles into the area, and there are a number of reasons they appear, including genetics, aging, fluid retention, and allergies. Moreover, they can appear darker under the eyes because the skin under the eyes is especially thin; this thin skin sits on top of areas that are dark red or purple in color; and the area is more likely to become puffy, casting shadows that make the bags look even more pronounced.

The way the genetics play out, some people are born into families where the skin color under the eyes is likely to be darker or bags are more likely to appear earlier in life. As people grow older, their skin tends to get thinner and lose some elasticity, making their bags look bigger and darker. The fun doesn't stop there: fluid retention from lack of sleep, monthly hormonal changes, or eating too much salt can make matters worse.

Another possible contributing factor is that when you're tired, your face muscles are tired, too, making the skin around your eyes less toned and droopier.

If hearing this is making you lose even more sleep, the good news is that there are ways to help reduce the swelling and get rid of your excess baggage:

  • Reduce the amount of salt you consume.
  • Apply cool compresses to your eyes for a few minutes while sitting upright.
  • Sleep with your head elevated.
  • Cut back on or eliminate dehydrating drinks from your diet, including tea, coffee, and alcohol.
  • Drink lots of water.

For the most part, puffiness under the eyes probably isn't anything to worry about. If your droopy under-eyes are accompanied by itchiness, redness, and teary eyes, you might want to get checked out for allergies. In some cases, swelling in general may be a symptom of a more serious problem. If you notice fluid retention in other parts of your body, or if it becomes severe or persistent, see a health care provider as soon as possible. S/he can check to see if you have an underlying medical condition. Students at Columbia can call Primary Care Medical Services at x4-2284 or log-in through Open Communicator to schedule an appointment.

Alice