Reducing Puffy and Tired Eyes with Skincare

Raffy Karamanoukian, MD answers: Tired eyes - how do I get rid of them?

I have puffy eyes with dark circles under them, and everyone always says I look tired. What can I do?


Raffy Karamanoukian, MD
11 months ago

The quality of your skin will determine the appearance of your lower eyelids.  Most commonly, the lower eyelids appear tired because of the following two criteria:

  • Hyperpigmentation
  • Loss of collagen

The first important step in reducing the appearance of tiredness in the lower eyelids is to address these two factors with effective medical based skin treatments.  In doing so, the pigmentation of the lower eyelids improves, thereby reducing the dark skin and hallow eye areas. Second, prescription based topical eye creams improve the resiliency of the skin by promoting the production of linear collagen and elastin.

Surgical treatment is not the first stage in improving the lower eyelids.  If surgery is indicated, it should complement  radiant, glowing skin.

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A: Dark circles and puffiness

Brent Moelleken, MD
10 months ago

There are many causes and many treatments for dark circles, depending exactly what produces them.

If puffiness is caused by excess fat, this can be reduced by a transconjunctival blepharoplasty.

If dark circles are the result of hollowness, volume can be replaced temporarily with hyaluronic acid filler or more permanently with fat or LiveFill (nontraumatized fascial fat grafts).

If hollowness is the result of cheek descent and volume loss, various cheeklift procedures are available, with or without volume restoration or fat preservation.

The same is true if loose skin is present on the lower eyelids.  If properly supported with midface elevation and canthal support, the skin of the lower eyelid can be tightened to reduce the crepiness.  Also some laser resurfacing or fractional laser resurfacing may help.

Pigmentation is very difficult to treat but may benefit from laser treatments or possibly pigment lightening gels.

A few consultaitons with board certified plastic surgeons should sort out which, if any, would be the most beneficial.

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