How To Tell If Your Puffy Eyes Are The Sign Of A Medical Issue Or Not

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Whether you had a good cry session last night or stayed up scrolling on your phone and didn't get a ton of sleep, waking up with puffy eyes is never fun. But what causes puffy eyes, exactly, and is it a cause for concern?

Having puffy eyes is a common experience, and some cases are more serious than others. For example, temporary swelling from salty food might resolve quickly. But if you have an underlying medical condition, it could take longer, says Noëlle Sherber, MD, a dermatologist and the cofounder of SHERBER + RAD.

If your puffy eyes persist, it may be time to see a doctor. But in the meantime, it's possible to reduce the swelling with at-home remedies. Ahead, dermatologists share the potential reasons for your puffy eyes and how to (safely) help them get back to normal ASAP.

Meet the experts: Noëlle S. Sherber, MD, is a dermatologist, co-founder of SHERBER+RAD, and clinical associate professor of dermatology at George Washington School of Medicine and Health Services. Clare Wolinsky, MD, is a dermatologist based in New York City. Zenovia Gabriel, MD, is the founder and head dermatologist of ZENA Medical. Mike Swann, MD, is a dermatologist at Swann Dermatology.

Causes Of Puffy Eyes

1. Lack Of Sleep

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, which can show up in the eyes.

2. Allergies

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, which causes inflammation and swelling under the eyes, says Claire Wolinsky, MD, a dermatologist based in New York City.

3. Your Period

Similar to have you experience period bloating 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 due to your period generally goes away after a few days.

4. Crying

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. Salty Foods

“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. Alcohol

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.

7. Thyroid Issues

Sometimes, puffy eyes 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. Stuffy Nose

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 Zenovia Gabriel, MD, a board-certified dermatologist and hormonal skincare expert. If you're concerned you might have chronic sinus congestion, it's best to see an ear, nose, and throat specialist to treat it, she says.

9. Lack Of Movement

"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. Moving around and exercising regularly can also promote circulation and move fluid out of the face, she says.

10. Age

The most common cause of your puffy eyes may simply be a result of getting older. “Aging causes tissues and muscles to weaken around the eyes and the fat pads descend and bulge, causing puffy under eyes,” says Dr. Wolinsky. But no need to worry—there are plenty of preventative options available for minimizing the bulge (more on that soon).

11. Kidney Issues

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 "essential to regulating electrolytes and health conditions that lead to the retention of fluids,” says Dr. Wolinsky.

If you feel like you're retaining water significantly more than usual, 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.

Risk Factors For Puffy Eyes

Many people experience swelling in the morning that subsides throughout the day. But if you notice persistent or severe puffiness, it could be a medical condition like angioedema (a serious allergic reaction), dermatomyositis (an inflammatory disease), or a thyroid condition like Graves' disease, says Dr. Sherber. Hormonal medications used in fertility treatment can also cause puffy eyes, so it's not uncommon for women undergoing IVF, she adds.

That said, age is still the most common reason for under-eye swelling. 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, Dr. Gabriel explains.

How To Treat And Prevent Puffy Eyes

Try a cool compress or eye mask.

Try dunking your face in an ice-water bath or applying cold spoons over the eye area, says Dr. Sherber. You can also use a regular cold cloth, or experiment with cooling gel pads. Better yet, DIY an eye mask with cucumbers straight out of your fridge for a refreshing and cooling effect.

Prop yourself up with pillows.

If you struggle with swollen eyes in the morning, increase the number of pillows you sleep with at night. This helps keep the head elevated throughout the sleep cycle. Also, getting a full eight hours of sleep helps, Dr. Wolinsky notes.

Use a derma roller.

"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.

Minimize sodium and alcohol consumption.

Try a low-salt diet for about a week to help you feel less swollen, says Dr. Gabriel. Cutting back on drinking can also help reduce fluid retention (and prevent dehydration). If you choose to drink and/or consume salty foods, staying hydrated during and after can help minimize eye swelling later on, Dr. Sherber says.

Take an antihistamine (in moderation).

A daily antihistamine 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.

Use 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.

Moisturize your under-eye area.

"Concealer often cakes into the creases of the under-eyes, so 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.

In serious cases, consider a medical procedure.

“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.

When To See A Doctor

If your eye puffiness remains despite a healthy diet, good sleep hygiene, and other remedies, experts recommend seeking medical attention. If you suspect your puffy eyes may be linked to a thyroid issue, or if you're having pain behind your eyes, or an abnormally severe case of water retention, you should seek medical attention immediately.

If one eye is more swollen than the other, you may have an infection, Dr. Sherber explains. It could be caused by shingles, so you should seek out a dermatologist or ophthalmologist ASAP.

Otherwise, occasional eye puffiness is typically normal and nothing to be worried about or embarrassed of. If you do want de-puff and minimize the appearance of under-eye bags, the products below can help.

6 Products For Puffy Eyes

Beauty by Earth Jade Roller

IT Cosmetics Bye Bye Under Eye Concealer

Under Eye Patches

IT Cosmetics Bye Bye Under Eye Concealer

Dongyu 5% Caffeine Eye Serum And Under Eye Roller

Neutrogena Hydro Boost Hyaluronic Acid Gel Eye Cream

Eye Firming Complex

Beauty by Earth Jade Roller

Under Eye Patches

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