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Causes of Eye Bags: Why You Have Puffy Eyes and What You Can Do About It

eye bags and puffy eyes in Singapore
eye bags and puffy eyes in Singapore

What Causes Eye Bags?

Eye bags, undereye bags or puffy eyes are a common cosmetic concern. While harmless, they can make you appear tired or older. Suffering from eye bags and puffy eyes? Here’s a list of the most common causes of eye bags and tips for managing them.

Causes of eye bags and puffy eyes

1. Natural Aging Process

As you get older, the muscles and tissues around your eyes weaken. The orbital septum weakens, leading to herniation of the orbital fat. Periorbital skin also loses collagen and elasticity, developing fine lines and becoming loose and saggy. For most people, eye bags start to develop in their 40s and become significant in their 50s and 60s.

Eye bags form as part of the ageing process
Eye bags form as part of the ageing process
Weakening of the orbital septum and bulging of orbital fat leads to formation of eye bags
Weakening of the orbital septum and bulging of orbital fat leads to formation of eye bags
Eye bag anatomy
Eye bag anatomy

2. Fluid Retention

Excess salt intake, alcohol consumption and hormonal fluctuations can cause your body to retain fluid — especially around your eyes. This puffiness often appears worse in the morning after lying down overnight. Fluid retention often worsens the appearance of pre-existing eye bags. In patients who have had undereye fillers, a common scenario is when Hyaluronic acid gel-based undereye fillers draw in water, known as the Tyndall effect.

Puffy eyes causing eye bags
Puffy eyes causing eye bags

3. Sleep Deprivation

Lack of adequate sleep contributes to fluid buildup and poor circulation, making eye bags more pronounced. Chronic sleep loss also contributes to dark eye circles, which often co-exist with eye bags

4. Allergies

Seasonal allergies or sensitivities to dust, mould, or pet dander can trigger inflammation and histamine release, resulting in red, itchy, and puffy eyes. This often happens in children and teenagers who have nose allergies (allergic rhinitis) and eye allergies (allergic conjunctivitis). When exposed to the allergen trigger, these individuals develop symptoms of red, itching, puffy and tearing eyes, stuffy noses and sneezing.

5. Medical Causes of eyebags and puffy eyes

In extreme cases, eyelid puffiness may be due to angioedema, where it is accompanied by sudden and severe eyelid, lip and tongue swelling. This is a potentially life-threatening condition and needs urgent treatment. Another rare but potentially serious condition that may present with eyebags and puffy eyes is thyroid eye disease, where the individual experiences gradual swelling and inflammation of the upper and lower eyelids, as well as the orbital (eye socket) tissues, leading to proptosis (eye bulging). This usually occurs in patients with established hyperthyroidism due to Graves' disease.

Allergies may cause the eyes to become puffy and swollen
Allergies may cause the eyes to become puffy and swollen
Thyroid Eye Disease
Thyroid Eye Disease
Angioedema results in eyelid, lip, tongue and airway swelling
Angioedema results in eyelid, lip, tongue and airway swelling

When to See a Doctor

Eye bags that form gradually due to the natural ageing process are harmless, with treatment only required for the purpose of improving the appearance of the individual (ie, cosmetic purposes). 

However, eye bags and puffy eyes may be a sign of a more serious medical condition

You should consult a doctor if:

  • Eye bags appear suddenly or worsen rapidly
  • Sudden development of eye bags and puffy eyes is accompanied by other symptoms such as difficulty breathing or a change in voice  may be angioedema with airway compromise
  • Puffy eyes are associated with itchy eyes, tearing, and blurring of vision  may be eye allergies (allergic conjunctivitis)
  • You are known to have hyperthyroidism and develop puffy, swollen and bulging eyes  may be thyroid eye disease

How to prevent eye bags and puffy eyes?

While some causes of eye bags—like getting older—can’t be changed, you can take some steps to reduce their appearance.

  • Get enough sleep to allow proper fluid circulation and skin recovery.
  • Reduce salt intake to minimise water retention.
  • Stop smoking to preserve collagen and skin elasticity.
  • Manage allergies with antihistamines or nasal sprays to reduce under-eye swelling.
  • Cold compresses (eg cold spoon) can reduce puffiness temporarily.
  • Eye creams with caffeine may reduce fluid retention and puffiness.

Treatment options for eye bags

At Bay Aesthetics Clinic, we offer evidence-based treatments tailored to the severity of eye bags. In general, early to moderate eye bags can benefit from in-clinic, minimally invasive treatments, while severe eye bags may require eyebag removal surgery (Lower blepharoplasty).

Non-Surgical Treatments

Undereye Fillers

Strategically placed undereye fillers improve the appearance of eye bags by providing structural support to the undereye, ‘pushing back’ against the bulging orbital fat. Results can be seen right away and last for up to a year. The current trend now is to inject Deusaderm Collagen Eye - a highly purified collagen that restores volume, improves skin quality and lightens dark eye circles without the risk of filler migration or fluid retention causing Tyndall's effect.

Radiofrequency (RF) Treatments

Loose and sagging skin is a key contributing factor to the formation of eye bags, hence, skin tightening treatments for the delicate eye area are helpful when treating early to moderate eye bags. Oligio RF Eye utilises monopolar radiofrequency and a specialised eye tip to target the delicate eye area. Oligio RF Eye treatment is a non-surgical treatment for: mild droopy upper eyelids, mild eye bags, fine lines and loose skin around the eye. The treatment is not painful and has no downtime, with results that can last for up to a year.

Oligio RF Eye treatment Singapore
Oligio RF Eye treatment Singapore
Oligio RF uses monopolar radiofrequency for skin tightening and lifting
Oligio RF uses monopolar radiofrequency for skin tightening and lifting

Surgical Treatment: Blepharoplasty

For more significant or persistent eye bags, we will recommend eyebag removal surgery, aka lower eyelid blepharoplasty. This minor surgery removes and repositions fat and tightens the skin. Downtime is minimal (about a week), and the scar can be kept hidden via internal incisions.

What to Expect: Your Treatment Journey

Pre-Treatment Consultation

During your consultation, we will assess your under-eye anatomy, skin quality and contributing factors (like volume loss or fluid retention). You’ll receive a tailored treatment plan that may include aesthetic or surgical options, depending on the severity of your eyebags and your preferences.

Procedure

Non-surgical treatments such as fillers and radiofrequency are performed in-clinic with minimal discomfort. Blepharoplasty is done under local anaesthesia and usually takes about 1–2 hours.

Post-Treatment Care

Expect mild swelling or bruising that resolves within days to a week for non-invasive options, or up to 1–2 weeks for surgery. 

We provide detailed aftercare instructions and support to ensure your recovery is smooth.

Take the First Step Toward Looking Refreshed

Eye bags don’t have to be permanent. Whether you prefer non-invasive treatments or are considering surgery, our team is here to guide you every step of the way.

Eye Bag Treatment at Bay Aesthetics Clinic

At Bay Aesthetics Clinic and Medical Spa, Medical Directors Dr Bernard Tan and Dr Hoe Ying Min are both experienced doctors with over 20 years of combined experience and thousands of patients. With their steady hands, deep knowledge of aesthetic medicine and a keen eye for beauty, they have accumulated a loyal following of patients. A high volume of Deusaderm Eye and Oligio RF Eye is performed at Bay Aesthetics Clinic. Eyebag removal surgery (lower blepharoplasty) is performed by our partner Plastic surgeon, Dr Jonah Kua 

Book a consultation with us today.

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