All About Eyes - What Causes Under Eye Bags and How to Treat Them

Not even Hermès could make under-eye bags desirable. While they may all look similar at a glance, not all under-eye bags are the same.

What Are the Leading Causes of Under-Eye Bags?   

According to Dr. Nikki Hill, board certified Atlanta based dermatologist, "under eye bags are a common term for volume changes under the eye." These volume changes can happen as a result of age, genetics, hydration level, sodium intake, alcohol consumption, allergies, sleep deprivation, and more. 

How Are Under Eye Bags Treated?

Discover & share this Kiehl's Since 1851 GIF with everyone you know. GIPHY is how you search, share, discover, and create GIFs.

Topical Solutions for Under Eye Bags

The treatment for under-eye bags varies based on the severity of the under-eye protrusion. So let's start with the very basic -- If your bags appear after a long night of partying and overindulging in salty snacks and alcohol, your under-eye puffiness is likely just fluid retention. Be sure to drink lots of water and get plenty of rest. You can also use a cold compress, cold tea bags, cucumber slices, or an ice roller to help reduce bags. For those with mild puffiness that lingers, you might consider the continued use of eye creams that contain caffeine. Caffeine is vasoconstrictive -- it restricts blood flow, thereby reducing puffiness. 

Radio Frequency for Under Eye Bags

Topical solutions and dietary changes are the first steps to treating under-eye puffiness. When that puffiness turns into something a bit more permanent, it's time to go beyond the surface of the skin. "Bags can be caused by the fat pads protruding through the skin. Tightening this area with a good RF (Radio Frequency) device such as the EndyMed iFine becomes an essential and effective treatment," Dr. Gold. EndyMed's iFine uses non-invasive radiofrequency to reduce fat pads and improved eye contour. It also helps to reduce the appearance of fine lines and wrinkles.

What are the Side Effects of Using Radio Frequency to Treat Under Eye Bags?

In general, "treatment with the iFine by EndyMed is relatively safe; a patient might feel some warmth to the area. With a skilled provider, this is a very safe, low-risk treatment," Dr. Gold. However, in rare cases, some people experience unintended fat and volume loss in other areas of the face.  

Fillers to Treat Under Eye bags

If you look in the mirror and it seems like you are losing volume in your face or that your face is sagging slightly, causing the under eye area to be more pronounced, you may want to consider some filler. Dr. Hill states, "I love treating under eye volume loss with facial fillers. It helps with restoring the volume that has naturally diminished under the eye and the mid cheeks (think apples when you smile). Building up this platform can give a nice contour around the eyes, transitioning into the cheeks." It might take you several months of research to find someone you trust enough to inject your face. However, according to Dr. Hill, the procedure itself takes 20-30 minutes with a downtime of 3-7 days, depending on bruising or swelling. 

What are the Side Effects of Fillers to Treat Under-Eye Bags?

"The risk for any procedure that makes incisions into the skin is bleeding, bruising, swelling, pain, infection, scarring, and rarely, but I always make sure to mention blindness. We use certain safety methods to make sure we are in safe zones so we can reduce these risks," Dr. Nikki Hill.

Blepharoplasty to Treat Under-Eye Bags

According to Dr. Scarpidis, board-certified plastic surgeon, "while fat grafting (fat removal) or fillers can restore the youthful volume of the midface and under eyes, it may not be enough to treat under-eye bags adequately. A blepharoplasty (a surgical procedure to correct eyelids and for aesthetically modifying the eye region of the face) is a same-day surgery that can remove under-eye bags. A small incision is made in the inner aspect of the lower eyelid facilitating the removal of the fatty bulges leaving no visible scars."

What are the Side Effects of Blepharoplasty? 

“The risks of surgery include bleeding, scarring, and poor results in inexperienced hands. Bruising and swelling are minimally after blepharoplasty and last only a few days,” Dr. Scarpidis.

Questions to Ask Before Any Procedure to Correct Under Eye Bags

I'm a Black woman so, I always want to know the level of experience a doctor or esthetician has working with skin like mine. I also want to know if I'm at increased risk for hyperpigmentation given my melanin-rich skin. While the procedures mentioned here have few side effects, it's essential to understand them and to make sure you know what will be done if you experience one or more. In addition to those questions, here are some other questions Dr. Hill recommends asking before getting any injections or surgical procedure done to your face.

Braxton Family Values, Thursdays at 9/8c only on WEtv

  1. What's the downtime?

  2. If you are prone to keloids, this should be discussed.

  3. When can you wear makeup, exercise, go into saunas, have facials, etc.?

  4. How to cleanse your face afterward? (There are typically restrictions for the first 24-48 hours after the procedure.)

If an eye cream doesn't work or irritates your eyes, you can simply stop using it. It's different for more invasive procedures. In considering any invasive modification to the face or body, it is imperative to do your research. Ensure the professional has the credentials and expertise to perform the procedures you seek. Ask questions about the process, and be sure there is a plan of action in place should there be unwanted side effects. We all want to look our best, but we should also be smart about how we get there.

Check out our post on dark circles!


Dr. Nikki Hill, Founder of Skin of Culture and Hair (SOCAH) Center is an Atlanta native, who is a nationally recognized expert in the diagnosis and treatment of medical hair loss disorders. Dr. Hill has extensive training and expertise in traditional dermatology and is very sensitive to those who wish to follow a more holistic path to healing.

Dr. Michael H. Gold is the founder and medical director of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center in Nashville, Tennessee.

Dr. Ulysses D. Scarpidis is a leading board-certified plastic surgeon who sits at the helm of Scarpidis Aesthetics in New York City. He specializes in cosmetic procedures that enhance all areas of the face and body.