Puffy Eyes

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11 Reasons You Have Puffy Eyes—And What To Do About Them, According To Dermatologists

There’s something fundamentally uncomfortable about waking up in the morning with puffy eyes. You look a little funny, you can often feel the liquid retention in your face, and many times you can’t pinpoint the exact cause of the swelling.

Conditions such as angioedema, a serious allergic reaction, dermatomyositis, an inflammatory disease, and thyroid conditions such as Graves’ disease can lead to puffy eyes. Although there is a chance that your puffiness may be related to a more serious medical issue, swollen under-eyes are typically very manageable and your body’s natural response to a high-sodium diet, sleep cycle, or gradual aging, among other causes. Many notice their enlarged bags first thing in the morning and the condition should improve as the day goes on and resolve over time.

“Generally speaking, if something doesn’t happen in a day, it can’t go away in a day. So, swelling from eating salty food can resolve quickly, whereas swelling from an underlying medical condition can be expected to take longer to resolve,” says Noëlle Sherber, MD, a dermatologist and the cofounder of SHERBER + RAD.

Temporary puffiness can also be caused by hormonal medications used in fertility treatment, so it’s not uncommon in women undergoing IVF, she adds. If your swollen eyes are persistent and significant, (i.e., they last longer than your hangover), then they’re definitely worth seeing a doctor about.

However, age is still the most common reason for under-eye swelling. “The shape of the bony structure of your face, including the orbital rim, or the area that holds your eyeballs, determines how much the tissue inside that rim projects outside of the plane of the face,” says Zenovia Gabriel, MD, a board-certified dermatologist and hormonal skincare expert. And for most people, the pillow of fat that cushions the eyeballs tends to stick out more over time, since the muscle that attaches it to the skull loosens with age, she explains.

But here’s the good news: Reducing the swelling isn’t very hard! Learn about the reasons you may be experiencing puffy eyes and how to help them get back to normal ASAP with dermatologists-approved fixes.

What Causes Puffy Eyes?

1. You didn’t sleep well last night.
We know you know this already, but it bears repeating: A bad night’s sleep could make your eyes appear swollen in the morning, especially if you’re stressed. “When you’re under stress, you release cortisol from your adrenal glands, and that changes the salt balance in the body,” says Mike Swann, MD, a dermatologist at Swann Dermatology. Because your salt balance is off, you might retain water and swell.

2. It’s allergy season.
Puffy eyes are a common symptom associated with seasonal allergies. When you have an allergy, your body goes into full-on attack mode by releasing histamine into your system. This causes inflammation and swelling under the eyes, explains Claire Wolinsky, MD, a dermatologist based in New York City.

Allergies can also cause mast cell degranulation, which can cause a hive-like reaction, especially around the eye area, notes Dr. Sherber.

3. It’s that time of the month.
Blame it on PMS! Similar to how the rest of your body bloats during your monthly cycle, your eyes can retain water as well because of higher levels of hormones, says Dr. Swann. Like belly bloat, eye swelling caused by your period generally goes away after a few days.

4. You were crying.
We know it’s a no-brainer, but here’s the science behind it: Puffiness from crying is a result of your eyes’ lacrimal glands working overtime to produce tears. “When this gland is churning out tears, the [tear] fluid is less salty and more watery,” says Dr. Swann. “Differences in salt concentration between these tears and the surrounding tissues causes some swelling of the eyelid.”

5. You’re eating too much salt.
You already know this one, but you may not realize salt is in just about everything even when you can’t taste it. “High salt intake causes the kidneys to retain water, which leads to swelling in general. The skin under the eye is very delicate and puffiness is more significant in that location,” Dr. Wolinsky explains.

She also notes that the swelling caused by salt is most prominent in the mornings and should decrease as the day goes on. If you can’t seem to determine what is causing your puffy eyes, try taking a sodium break and re-evaluating.

6. You overdid it at happy hour.
Alcohol can cause fluid shifts in your body, and their “effects can be compounded by the tendency some have to snack on salty foods when drinking alcohol for a double whammy,” Dr. Sherber notes. The fluid shifts and water retention caused by alcohol and salty foods make the eyes appear puffy. Alcohol also often causes your body to become dehydrated and make your eyes dry too.

7. You have a thyroid problem.
Most of the time, puffy eyes aren’t a big deal, but they can be a side effect of a bigger health issue. “Patients with some types of hyperthyroidism can get thickening of the fat around their eyes, causing puffy eyes,” says Dr. Swann. “Puffy eyelids can also be seen in lupus, dermatomyositis, and other connective tissue diseases.”

8. You’re stuffed up.
When you’re sick with a cold, your eyes will naturally look puffier. That’s because the cavities that drain fluid out of your face are blocked with sinus congestion, so the eyes have a puffy look to them, explains Dr. Gabriel. Chronic sinus congestion is a bit more complicated, and it’s best to see an ear, nose, and throat specialist to treat it.

9. You’re not moving enough.
“If you’re too sedentary, you can have fluid retention,” Dr. Gabriel says. If you’re sick or injured and lying down often, fluid can collect in your face. In this case, it’s a good idea to sleep as upright as possible so that fluid can drain.

Also, Dr. Gabriel suggests moving around and exercising regularly to promote circulation and move fluid out of the face.

10. You’re getting older.
The most common cause of your puffy eyes may simply be a product of your body’s age. “Aging causes tissues and muscles to weaken around the eyes and the fat pads descend and bulge, causing puffy under eyes,” says Dr. Wolinsky. Fortunately, this is totally manageable and there are plenty of preventative options available for minimizing this bulge.

11. You have a kidney problem.
Although it’s more likely that your diet or sleep schedule is causing your eyes to swell, it’s not impossible that there is something going on inside that needs to be addressed. Kidney and liver issues could be an explanation for puffy under-eyes “since they are essential to regulating electrolytes and health conditions that lead to the retention of fluids,” says Dr. Wolinsky.

If you feel as though your body is retaining water past a reasonable degree, it may be worthwhile to seek medical assistance to check your kidneys. “​​As soon as the blood electrolytes are normalized with kidney or liver dysfunction, fluid retention would improve and under-eye swelling should improve,” Dr. Wolinsky says.


How To Get Rid Of Puffy Eyes

Whether you naturally have puffy eyes or are dealing with one of the issues above, here’s what you can do to reduce swelling around your eyes. (And check out the ahh-mazing products that can help lessen the appearance of eye puffiness at the bottom!)

  • Cooling gel pads or a cold compress. Here’s where a spoon in your freezer comes in! Dr. Sherber recommends dunking your face in an ice-water bath, or applying cold spoons over the area. Putting cold water or ice on a compress on your eyes could help deflate some of the puffiness, says Dr. Gabriel. You could also use a regular cold cloth, or experiment with cooling gel pads.
  • Caffeine eye creams. There’s really no miracle beauty solution to stop puffiness in its tracks, but you can apply a couple of products to help minimize wrinkling and hollowing of the under-eye area. Dr. Gabriel recommends a Glytone red tea eye cream that contains caffeine, which is great for combatting dark circles. Dr. Wolinsky recommends Neocutis Lumiére Illuminating Eye Cream, which has caffeine and other ingredients that help with fine lines and other common under-eye issues. She’s also a fan of Skinceuticals AOX+ for its caffeine and other evidence-backed anti-aging ingredients, like 5% l-ascorbic acid and 0.5% ferulic acid.
  • Tightening eye creams. Dr. Gabriel suggests coupling a red tea cream with Lifeline Eye Firming Complex to fight that crepe-like look of the under-eyes and wrinkles in the lower lids. Dr. Sherber finds the cooling applicator of La Mer’s The Eye Concentrate to be especially effective in de-puffing. Another pro tip: Keep an eye cream in the refrigerator, so that it’s cold when applied in the morning, says Dr. Wolinsky.
  • Multiple pillows. If you struggle with swollen eyes in the morning, increase the number of pillows you sleep with. This helps keep the head elevated throughout the sleep cycle. Also, getting a full eight hours of sleep helps,Dr. Wolinsky notes.
  • Derma rollers. “Rollers are great for collagen stimulation, and reducing wrinkling and crepiness,” Dr. Gabriel says. The puffiness is a bit deeper under the skin, so it may not really get into that as much since it’s only mainly working on the top layer of skin. Just be careful not to roll too much, as too much trauma to the skin can create more puffiness, she warns.
  • A good concealer. Obviously, a concealer isn’t going take away your puffy eyes, but one that’s a little bit lighter than your skin tone can make a world of difference in reducing the appearance of puffiness. For a concealer that’s light in texture and has a nice highlighting look, Dr. Gabriel recommends YSL Beauty Touche Eclat High Cover Radiant Concealer.
  • A solid moisturizer. “Concealer often cakes into the creases of the under-eyes—as a fix, go ahead and put a hyaluronic acid cream, like Neutrogena Hydroboost eye cream, under your concealer,” Dr. Gabriel says. Make sure it goes on your lower eyelids before you apply concealer to prevent it from caking into the lines, she says. Your under-eye area will have an overall smoother look that way.
  • Cucumbers. Don’t knock the classic spa staple. It’s a great option if you don’t want to splurge on cooling under-eye gel pads but want a similar remedy. “Cucumbers have a high water content and stay cold—there’s nothing in the molecule that decreases puffiness, but they act like a natural ice pack,” Dr. Gabriel says. They’re a perfect DIY eye mask that you’ll probably have in your fridge already and shouldn’t be too cold for your eyes.
  • Minimizing sodium. If you’re feeling especially puffy due to something like allergies or hormonal water retention, Dr. Gabriel advises sticking with a low-salt diet for about a week to help you feel less swollen.
  • Drinking less. The same goes for alcohol. Sipping on fewer cocktails will reduce dehydration and fluid retention. Hydrating after consuming alcohol or salt will also help minimize eye swelling, Dr. Sherber says.
  • Anti-histamines. A daily anti-histamine should do the trick when it comes to helping with allergy-related puffiness; if allergy season is particularly brutal for you, it’s best to take allergy meds as a preventative measure.
  • Medical procedures. “Blepharoplasty is the plastic surgery of choice to remove herniated fat pads under the eyes,” says Dr. Wolinsky. If you’re fighting a losing battle with aging, this may be something to consider. But “fillers under the eyes in patients with puffiness is usually a bad idea,” and Dr. Wolinsky advises her patients to try other remedies first.

Do I need to see a doctor for my puffy eyes?

Probably not, Dr. Gabriel says. “With increased salt intake or alcohol, fluid retention, especially first thing in the morning, will be increased. If the puffiness improves throughout the day and is reversible with improved sleep and diet, then it’s of no medical concern,” Dr. Wolinsky explains. Normally, your puffy eyes are not a red flag for a more serious condition.

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