Puffy , Dark Circles, and Bags: Dermatologists Explain the Difference

I’ve always been bothered by my dark under-eye circles. No matter how many hours I sleep a night, they’re always there, and no amount of serum or color corrector can make them go away. Recently I was talking to a bunch of my coworkers, and we all seemed to have some version of the same complaint. We all rolled our tired , remarking on how we’re perpetually sleep-deprived (it’s cool to be too busy to sleep, haven’t you heard?) and on the constant hunt for the best concealer.

Now, I know there’s nothing productive about sitting around complaining about “flaws” that aren’t actually flaws. We are aware of the way we’ve internalized idealized standards of beauty—and that articles about how to “fix” them can reinforce those standards. (The irony is not lost on me as I write this very article.) And yet there we were, comparing notes about our particular eye concerns, wondering what was causing them and what we could do about them, when suddenly we realized: We don’t actually know what we’re talking about. One person said she had “puffy eyes.” Another rued the “bags” under hers. We thought we were all talking about the same thing, but maybe we weren’t. We started to wonder: What are puffy eyes versus bags versus dark circles, anyway? And which ones were we actually complaining about?

We decided to call in the experts. First, we lined up in a conference room and took pictures of our tired-looking eyes—first thing in the morning, and makeup free. Then I called up a couple dermatologists and asked them to review the photos and tell me what we were looking at. I’m not saying that we needed to be diagnosed or that we had “problems” that needed to be “fixed.” But we knew we had these things that bothered us, and we wanted to learn about what we were working with, and what tricks we could use to minimize their appearance. The dermatologists I spoke to explained what makes eyes puffy, what causes dark circles, and what so-called bags even are. They pointed out the telltale signs in our photos, and gave their expert recommendations for how to treat them.

Here’s what we learned.

Dark Circles

What causes them? The main causes for dark circles are genetics and skin tone, Kenneth Howe, M.D., a board-certified dermatologist at Wexler Dermatology, tells SELF. The under-eye area can look purple or bluish because the skin there is so thin and translucent that you can easily see the underlying veins. It can be more apparent in people with fair skin, and those with very little subcutaneous fat supporting the area under the lower lid. Lack of sleep increases venous congestion; fluid build-up leads to pooled blood in those superficial blood vessels, making dark circles look even darker when you’re tired.

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Some people—especially those with darker skin tones—produce extra pigment around the eye area, which can cause a general darkening of the skin under the eyes and on the lids.

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The anatomy of your facial features also plays a role. A prominent “tear trough” or nasojugal groove, extending from the inner corner of the eye diagonally toward the cheekbone, can cause shadowing and make dark circles more apparent. This trough can appear or deepen with fat loss that often comes with age and can start around 25—or you can just thank bone structure and genetics.

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What can you do? Topical retinoids may help lighten the look of dark circles, Dendy Engelman, M.D., a dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in NYC, tells SELF. She says that using a prescription retinoid will help “thicken the skin and increase cell turnover,” which will make the underlying darkness less visible. Experts also recommend creams and serums with hyaluronic acid, ceramides, and peptides to hydrate and stimulate collagen and elastin production, plumping up the skin and pushing it away from the pooled blood. Antioxidants including vitamins A, C, and E can help to lighten dark under-eye circles. Try Insta Natural Eye Serum ($17) which is packed with vitamin C, hyaluronic acid, and peptides. Products with caffeine can also help “wake up” tired looking eyes by constricting visible blood vessels.

Hyaluronic acid filler injections can plump up the sunken under-eye area. Fillers are priced per syringe, typically between $1,000 and $1,400, and the results can last for a year and a half or up to five years. There are also laser procedures to destroy the superficial blood vessels that are showing through the skin, though experts say tread with caution as the wrong laser can cause hyperpigmentation (or even hypopigmentation, when the area lightens too much). Treatments range between $300 and $500, and may require two or three sessions to see results, plus annual maintenance.

Puffy or Swollen Eyes

What causes them? Puffy eyes are the result of temporary swelling that is often caused by seasonal allergies. Puffiness can also arise if you’ve had too much salt or alcohol, which can leave you dehydrated—that leads to water retention, which in turn leads to swelling in the face. Lack of sleep makes puffy eyes worse, too, because of the pooling of fluid in the area. As a result, puffiness is often worse in the morning and resolves itself by the afternoon as the accumulated fluid drains with the help of gravity and time.

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What can you do? Our experts recommend prioritizing good sleep to minimize the appearance of puffy eyes, as well as drinking enough water to keep fluid moving through the veins.

The vasoconstriction from products with caffeine can reduce puffiness, and cooling products can help reduce inflammation and promote blood flow. But keep in mind that any benefit you see is temporary. A metal roller ball—either on its own or as the applicator of an eye cream or serum—can gently distribute lymphatic build-up, helping it drain from underneath the eyes while also cooling the inflammation.

Dr. Engelman likes Elizabeth Arden’s Prevage Anti-Aging Eye Serum ($100), which uses a mix of peptides, antioxidants, and hyaluronic acid to reduce puffiness and plump skin away from pooled blood. Another option is Lavido Alert Eye Cream ($49) with plant-based hyaluronic acid and natural oils like rosehip. Dr. Engleman recommends dotting products from the inner corner of the eye moving outwards toward the temple with your ring finger, which is weaker than your other fingers, and so will be more gentle on the delicate area.

Bags

What causes them? Though you might hear the word “bags” used interchangeably with “dark circles” or “puffy eyes,” these distinct under-eye pouches are markedly different from either one. This structural puffiness is caused by a combination of fat herniation and skin laxity—they’re genetic and a normal sign of aging. They can appear as early as your late-20s or 30s—but apparently none of the SELFies who complained about bags actually have them, because the docs didn’t diagnose any instances of bagginess in our photos.

What can you do? There’s not a lot you can do for bags, though fillers may help raise the skin to counteract sagginess. Essentially, these fillers elevate the surrounding skin to the level of the fat to make the texture smooth and uniform again. Radiofrequency treatment is another alternative to tighten and smooth the area. The procedure heats the skin to induce collagen and elastin formation. Dr. Engelman recommends four rounds per treatment, and once a year maintenance. Each session costs around $500 to $600.

Bottom Line

It was pretty eye-opening (wink) to learn the differences between bags and puffy eyes and dark circles, since so many of us think we have them—even when sometimes we don't. I'm quite aware that $100 eye creams aren't for everyone (ditto for $1,000 fillers and other medical cosmetic procedures!), and for my own purposes, I'm likely going to stick with my already fairly intensive skincare regimen, rather than adding new products to the mix. I will rely on color correcting makeup and concealers when I'm looking for a quick bandaid for what seems to be a fact of life for most of us.

Meanwhile, it won't hurt to remember that the eyes are a window into the soul—and sometimes that soul is saying, "I'm tired and need to get better sleep." A message worth listening to, for sure, and not just because it might reduce my under-eye circles.

 

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