Bags under the eyes: How? Why?

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 may wake up with bags under their eyes that feel as heavy as luggage. 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 may 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. In addition to rest, there are a number of ways to help reduce their appearance (more on this in a bit).

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. Other contributors may also include fluid retention from lack of sleep, monthly hormonal changes, excess salt in the diet, allergies, or consistent smoking. Another possible contributing factor is tiredness or fatigue. In fact, when you're feeling tired, your face muscles are tired, too, making the skin around your eyes less toned and droopier.

If learning this is making you lose even more sleep, the good news is that there are options to try 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.
  • Avoid drinking lots of fluids before bed.
  • Stay hydrated during the day.

Additionally, some people may choose a variety of treatments to try to reduce the bags under the eyes. There are a variety of nonsurgical options. In addition to cold compresses, various creams that have caffeine or are used for hemorrhoids can be useful for swelling in the under-eye area. Some people may also opt for dermatological treatments like fillers, laser treatments, or chemical peels. These results can be longer lasting, ranging from six months to years, depending on the type of treatment selected. And finally, some people may get a surgical treatment to eliminate their under-eye bags. 

For the most part, puffiness under the eyes isn't indicative of a health concern. If your droopy under-eyes are accompanied by itchiness, redness, and teary eyes, you might want to speak with a health care provider about possible 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, seeking out medical care as soon as possible may help you get to the root of any underlying issues that can be addressed.

Last updated Dec 16, 2022
Originally published Mar 22, 2007

Submit a new comment


This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

The answer you entered for the CAPTCHA was not correct.