What’s really causing your eye bags and how can you get rid of them

Not enough sleep and trying to use cucumber slices to remove the eye bags? Myths to stop believing and doctor-approved ways to eliminate them

Not having enough sleep may cause you to develop dark circles, but it is not the cause of eye bags, which are primarily formed due to fat accumulation around the eye, skin looseness or a tear through due to ligament pulling on the skin. PHOTO: GETTY IMAGES

Tired of eye bags making you look perpetually exhausted, dull or older than you are? We're talking about the sagging, swelling or "puffiness" in your undereye area that does not seem to go away with natural remedies or after slathering on lots of expensive eye cream. Well, this could be due to common misunderstandings about what actually causes them.

"The eye is surrounded by fat tissue that acts as a cushion for the eyeball. As a person ages, the fat can sometimes accumulate or bulge out in the area just under the eyes, leading to the formation of an eye bag," explains medical director Dr Gerard Ee, co-founder of The Clifford Clinic, which recently expanded its services to include cosmetic and reconstructive surgery, in addition to a repertoire of non-surgical aesthetic and dermatological procedures.

So to help revitalise your eyes and restore a less tired and more youthful appearance, Dr Ee dispels three common myths about eye bags and recommends safe yet effective ways to remove them.

Myth 1: Eye bags are caused by insufficient sleep

"The lack of sleep can cause the capillaries around the eye to dilate. As the skin around the eyes is very thin, the increased blood flow results in the area under the eyes appearing darker," says Dr Ee. However, people often mistake these dark circles for eye bags, and Dr Ee notes that they are not the same thing.

He explains, "While dark circles form due to the dilation of capillaries, eye bags are primarily formed due to orbital (the area around the eye) fat accumulation, decreased skin laxity (looseness) or a tear trough (due to ligament pulling on the skin)." In addition, eye bags can also be hereditary, or caused by the accumulation of fluid under the eyes.

"Therefore, extra sleep may prevent the capillaries from dilating excessively, but it will not stop the accumulation of orbital fat or correct diminished skin laxity."

Dark eye circles or the discoloration under the eyes are instead treated with lasers such as the V beam laser to remove the pink and purple discoloration caused by venous congestion. Pico lasers are used if the skin has brown discoloration caused by skin hyperpigmentation and lastly Fraxel laser or using eye threads to stimulate collagen to improve the skin thickness around the eyes. Undereye fillers can be injected to restore any sunken or depression under the eyes.

Myth 2: Applying cool tea bags or cucumber slices gets rid of eye bags

"Tea and cucumber juice contain antioxidants or possess mild anti-inflammatory properties, which may help to slightly relieve surface level inflammation on the skin," says Dr Ee.

However, as mentioned, the puffiness and sag associated with eye bags are not caused by skin inflammation. "Eye bags are not a circulatory or surface level skin problem, so applying tea or cucumber juice to the surface of the skin will not remove them," says Dr Ee.

Instead, if the eye bags are mild, a non-surgical eye bag removal technique using radiofrequency (RF) treatment is a more effective way to help remove eye bags. This treatment allows the melting of the fat pad under the eyes with just tiny microneedles.

"The RF treatment uses microneedle technology to penetrate deep into the skin's layers. This not only breaks down subcutaneous fat to reduce the eye bags, but also stimulates the production of collagen to tighten the skin around the eyes, correct diminished skin laxity and combat saggy skin," explains Dr Ee. "At The Clifford Clinic, we use three-dimensional approach made possible with the use of a combination of RF treatments - the AGNES and the Secret RF - to result in far superior results than using a single technique alone." Results are said to last between three to five years.

"The procedure works best on individuals who have greater skin laxity or a smaller eye bag size," he adds, while those suffering from more severe eye bags are recommended to undergo eye bag removal surgery instead.

Non-surgical eye bag removal uses radiofrequency treatments to remove access fat under the eyes. PHOTO: THE CLIFFORD CLINIC

While RF treatment is minimally invasive to the delicate eye area with little downtime, there may be some mild bruising and swelling for the first two to three days following the procedure, so patients should avoid things like consuming alcohol or taking medications that may increase risk of bruising, such as vitamin E and fish oil.

Myth 3: Eye creams can remove eye bags

"Commercially available eye creams aim to reduce and repair surface level damage to the skin by encouraging skin cell proliferation, preventing skin inflammation, or by helping the skin's epidermis retain moisture," says Dr Ee.

However, he explains that these products are unable to penetrate the deeper layers of the skin in order to address the root cause of eye bags, which are due to subcutaneous fat accumulation and loss of skin laxity. Their moisturising effect may reduce the appearance of wrinkles, but they cannot fix or improve skin laxity in the long run. Although some creams on the market do claim to improve eye bags, their results are temporary acting more like an adhesive glue to tighten and stretch the skin.

So, for those with larger or more severe eye bags, Dr Ee suggests undergoing surgical scarless eye bag removal (also called blepharoplasty), where results can be seen immediately post-surgery and is said to last for more than 10 years.

Performed under local anaesthesia, the 20-minute procedure begins with an incision on the inside of the lower eyelid, so that no scars can be seen on the outside.

The Clifford Clinic recently expanded its services to include cosmetic and reconstructive surgery, in addition to a repertoire of non-surgical aesthetic and dermatological procedures. PHOTO: THE CLIFFORD CLINIC

"Excess fat is then removed to give the eyes a sag-free look after surgery," explains Dr Ee. "If required, the surgeon may also perform a tear trough ligament release which prevents pulling of the skin under the eyes that causes the 'tired' look."

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