What Causes Puffy Eyes—And How Do I Get Rid of Them?

You might have eaten too much sodium or not gotten enough sleep if you woke up with a swollen under-eye. Several other causes of puffy eyes include allergies, an eye injury, and pink eye. Puffiness usually goes away with home remedies and lifestyle changes like applying a cold compress, getting enough sleep, and reducing sodium intake.

Puffy eyes happen when fluid builds up in the areas around or near your eyes. You might also notice dark circles under your eyes, itching, or redness. Read on to learn about puffy eyes, including possible causes and how to get rid of them.  

Symptoms 

Puffy eyes are usually a symptom of certain behaviors, such as a lack of sleep, or health conditions. The hallmark sign of puffy eyes is temporary swelling of the tissues around or under your eyes.

You might have other symptoms with puffy eyes, including:

• Burning
• Changes in your skin color
• Dark shadows under your eyes
• Fat pockets near your eyes
• Itchy, red eyes
• Loose skin
• Sensitivity to light
• Teary eyes

What Causes Puffy Eyes?

The underlying cause of eye puffiness has to do with fluid build-up. Fluid might collect around your eyes and the surrounding skin tissue. Any swelling there is easy to see and hard to hide because that tissue is among the thinnest in your body.

Underlying health conditions that might cause puffy eyes include:

• Allergies: An allergen, such as dust, mold, and pollen, might irritate your eye. Your eyelids and conjunctiva (the thin membrane that protects your eye) may become itchy, red, and swollen.
• Blepharitis: This is inflammation of the eyelid, sometimes caused by an overgrowth of bacteria. In addition to swelling, you might notice debris build-up on your bottom eyelashes.
• Conjunctivitis (pink eye): This is inflammation of the inside of your eyelid and outer eye layer, typically caused by a virus.
• Chronic kidney disease (CKD): Your eyes might be puffy if your kidneys eliminate excess protein into your urine, an early sign of kidney damage.
• Endophthalmitis: This is an infection of your eye's fluids and tissues. Endophthalmitis is a medical emergency that may cause blindness if untreated.
• Eye injury: Blood and fluids collect around your eyes after an injury to or near the area. As a result, bruising and swelling may occur.
• Eyelid bumps: These include chalazia and styes, which are blocked or inflamed oil glands.
• Graves' eye disease: This is a common sign of an overactive thyroid, the butterfly-shaped gland in your neck. Swelling causes your eyes to bulge out.
• Orbital cellulitis: This infection affects the fat and muscles around and near your eyes.
• Retinoblastoma: This is cancer of the eyes. People with retinoblastoma might look like their eyes are looking in opposite directions.

Risk Factors for Puffy Eyes

Anyone can develop puffy eyes. Some might be more likely to have puffy eyes than others, especially due to genetics and older age. 

Of note: The type of puffiness and swelling you might notice in the morning differs from bags under the eyes. Puffy eyes are usually temporary. In contrast, baggy eyes are a permanent result of several factors, like aging. Still, bags under the eyes might increase the risk of puffy eyes.

Several other factors might increase your risk of puffy eyes, such as:

• Aging: The tissues around your eyes weaken as you age. As a result, your skin sags, allowing fat and fluids to build up in the area. Fat build-up results in baggy eyes, whereas fluid build-up may cause puffy, swollen eyes.
• Genetics: You might be more likely to have weak skin around your eyes if it runs in your family. 
• High-sodium diet: Eating a lot of salty foods causes your body to retain fluid that may build up around your eyes.
• Lack of sleep: You might have dark circles under your eyes and swollen eyelids if you do not sleep enough.
• Smoking: Tobacco might trigger an allergic reaction that affects your eyes.

How To Get Rid of Puffy Eyes

Treatment depends on the cause of your eyelid swelling. A healthcare provider will likely consider your health history and other symptoms to figure out the cause. For example, some people have headaches or a temperature intolerance.

A healthcare provider may complete a physical exam to get more information about the following:

• Swelling color and location
• Tenderness or warmth
• Vision changes (i.e., double or less sharp vision)

A healthcare provider will advise at-home treatments or surgical or non-surgical procedures to treat the underlying cause. There are a few options that help reduce eye puffiness.

Home Remedies

Home remedies for eye puffiness include:

• Cold compresses: Applying a cool compress—like a cold washcloth, cool tea bag, or cucumber slices—to your eyes for a few minutes might de-puff your eyelids.
• Concealer: This can reduce the appearance of dark circles under your eyes that make them look puffy.
• Eyelid treatments: Look for an eye cream containing anti-inflammatory ingredients, like caffeine or chamomile.

Lifestyle Changes

Lifestyle changes that may reduce the appearance of swollen eyes include:

• Avoid exposure to allergens when possible.
• Avoid or quit smoking.
• Do not rub your eyelids too much.
• Get enough sleep, and sleep with your head raised.
• Limit your sodium intake.
• Reduce your fluid intake before bedtime.

Medications

You might require over-the-counter (OTC) or prescription medications if an underlying health condition causes your puffy eyes. Medication will depend on the cause but may include antibiotics for bacterial infections (i.e., bacterial pink eye or a stye), eye drops, gels, and ointments.

There are different types of eye drops. For example, antihistamines and decongestant eye drops help alleviate allergies. Some eye drops reduce the number of mast cells (white blood cells), which cause swelling.

Skin Treatments

You might consider chemical peels, fillers, or laser resurfacing to help reduce the appearance of puffy eyes. Those treatments work by tightening your skin, which helps get rid of pockets where fluid can build up.

Chemical peels and laser resurfacing work by removing old skin cells. The new skin cells that grow in their place help smoothen your skin. A healthcare provider injects fillers into areas of your skin to restore its fullness. Consult an ophthalmologist, who specializes in eye health, to decide whether one of those therapies is right for you.

Surgery

Blepharoplasty (an eyelid surgery) might reduce puffy eyes. An eye surgeon will make a small cut inside your lower eyelid or under your eyelashes. They can remove or reposition extra skin or fat to lessen pockets where fluid can build up. The eye surgeon will then use small stitches to close the cuts. An ophthalmologist can help figure out if a blepharoplasty is appropriate for your case.

When To See a Healthcare Provider

Eye puffiness generally does not raise concerns. Seek care from an ophthalmologist if your puffiness or swelling sticks around for a while or if your eyes are itchy, painful, or red. These symptoms may point to a possible eye disorder or infection that immediately requires medical attention.

See a healthcare provider if you have symptoms like:

• Double vision
• Eyes that appear to be bulging
• Fever
• Loss of sharp vision
• Problems with eye movement

A Quick Review 

A build-up of fluid might cause puffy eyes. Several factors, such as a lack of sleep and excess sodium intake, may increase your risk of having puffy eyes. 

Treatment depends on what's causing your puffy eyes but might include at-home remedies, lifestyle changes, skin treatments, and surgery. Check in with a healthcare provider about options that may be helpful for your case. Seek medical care right away if you have other symptoms, such as fever or vision changes.