This might be a common scenario for you, or maybe you've experienced it a couple of times: You wake up after what you thought was a pretty good night of sleep, but when you look in the mirror, your eyes look so damn puffy. What gives? You weren't up until 3 a.m. You weren't crying your eyes out. You don't feel sick.
Or you could have been doing one or all of the above and are wondering how in the world you can de-puff your eyes before you have to show face in public. To find out some common causes of puffy eyes and what to do about it, I spoke to Ashley Brissette, MD, MSc, FRCSC, an ophthalmologist at Weill Cornell Medicine/NewYork-Presbyterian Hospital and a spokesperson for the American Academy of Ophthalmology (AAO), to get some info.
It might be annoying to hear this, but there's not just one cause and solution for puffy eyes. So you might have to put in the detective work to figure out the why and what to do. "There are a number of things that can really lead to puffy eyes, and some of them might be related to the eye health, and some might actually be related to health elsewhere in the body," Brissette says.
Brissette says one of the main causes of puffy eyes is allergies. "This is a really common problem that is also pretty easy to treat, which is what's great about it," she says. "And this can be due to allergies in the environment, so during springtime with different pollens or allergens that are in the air."
This is related to allergies in that there might be things around you, like cigarette smoke, perfume, and other things in the environment, that can bother your eyes. "That can actually really affect the eyes because the skin around the eyes is so thin, and so it's very sensitive to any irritants, more so than elsewhere in the body," Brissette adds.
According to Brissette, the second main cause of puffy eyes is dry eye or blepharitis. "Blepharitis refers to inflammation of the eyelids," she explains. "This can be related to certain skin conditions like rosacea or sensitive skin, and so this can lead to puffy eyes as well."
And speaking of rosacea or sensitive skin, Brissette said if you have these skin types or conditions, you might be more prone to getting styes. "A stye can cause a localized puffiness of the eyelid," she explains. "That's an infection or an inflammation of one of the oil glands that lines the eyelashes, so that can appear as a bump or puffiness to the lid."
"The last common cause is really just skin—kind of sagging skin and what we call prolapsed fat because the skin around the eyes is very thin," Brissette says. "As we get older, the skin can become a little bit more stretched, and then the fat, which is usually around the eye, can migrate forward and it can become more apparent. This is usually the kind of puffiness or the bags under the eyes that people really complain about as they get older. And it's really just an aging change around the eyes."
For these cases, she says it often requires surgery to remove, which you can discuss with your ophthalmologist or healthcare professional.
Fortunately, there are a number of options to relieve or reduce puffy eyes, depending on the cause. And you might be happy to know that a lot of them are low-effort. Brissette gives some tips below.
Brissette recommends this especially for people experiencing puffy eyes due to allergies. Hold it to your eyes for a couple of minutes. It's kind of a great way to destress, too, since you can't exactly look at your phone or get distracted.
This one is recommended, of course, for those with allergies. Brissette says you can find these over the counter or ask your ophthalmologist for a prescription.
This is another tip if you have allergies. "I also tell my patients to avoid allergens that might be causing this," Brissette says. "So sometimes [that means] keeping a diary of your symptoms and seeing what's happening at the time that your eyes are getting puffy. You can find out what might be contributing to this."
This rule is pretty much the same whether you have puffy eyes or not. But it's also a rule a lot of us have trouble following. "Often, if the eyes are kind of puffy, people are tempted to touch the skin or pull on the skin above the eyes," Brissette says. "And as I mentioned before, the skin around the eyes is so sensitive, so it's really important not to rub the eyes and it can just actually make it a lot worse."
If dry eyes are the reason, artificial tears to lubricate the eyes can help, Brissette says. When looking for drops, opt for ones that are preservative-free if you're using them four to six times a day since they're gentler.
Unlike the allergy situation, for blepharitis, you'll want to apply a warm compress instead of a cold one. "The heat can actually soften some of the clogged oil from the oil glands and that can actually improve the appearance of puffiness," Brissette explains.
"I always tell my patients, really try hard not to sleep on the face," Brissette says. "The reason is that the pillow can pull the eyelid skin, and that skin is so sensitive, so that can lead to wrinkles, stretched skin, or puffiness around the eyes over time. I know it's hard to change your sleep position, but if you can, I usually recommend sleeping on your back, and that'll really protect the face from premature wrinkles as well."
In some cases, you might need to see your doctor, as it might be a sign of another condition. "I would say if you have any pain, if you have any decrease in your vision, or if the puffiness is not improving with some of the things that we mentioned, then I think that's a good reason to visit an ophthalmologist," Brissette recommends. "Because again, there are many things that can cause puffiness."
