Saggy / puffy under eye bag causes. What nonsurgical treatments will help? (Photos)

Thank you for sharing your concerns and photos. At 24, it's understandable to seek non-surgical options for addressing under-eye issues. Here are some potential causes and treatments to consider:

Causes:
Allergies: Since you mentioned a history of dust allergies and are currently receiving immunotherapy, allergies can contribute to puffiness and fluid retention. Ensuring your allergies are well-managed is a crucial first step.
Fluid Retention: This can often result from lifestyle factors such as diet (high salt intake), sleep patterns, or even hormonal changes.
Fat Herniation: This occurs when the fat that naturally supports the eyes moves into the lower eyelids, creating a puffy appearance. This can happen asymmetrically.
Muscle Twitching: The twitching could be related to stress, fatigue, or even caffeine intake.

Non-Surgical Treatments:
Topical Treatments: Consider using eye creams with ingredients like caffeine or retinol, which can temporarily reduce puffiness and improve skin texture.
Dermal Fillers: Hyaluronic acid fillers can help even out the under-eye area and reduce the appearance of puffiness by smoothing the transition between the cheek and the under-eye.
Laser Therapy: Treatments like fractional lasers can improve skin texture and promote collagen production, which may help in tightening the skin.
Radiofrequency or Ultrasound Therapy: These treatments can help in tightening the skin and reducing minor fat bulges by stimulating collagen production.
Lifestyle Modifications: Ensure adequate hydration, reduce salt intake, and get sufficient sleep. Cold compresses can also help reduce temporary puffiness.

Consultation:
A consultation with a dermatologist or a cosmetic specialist is recommended to determine the exact cause of your unilateral puffiness. They can perform a physical examination and may suggest imaging if necessary to rule out any underlying conditions.

Addressing these concerns with a professional can help you choose the best treatment tailored to your specific needs.

I hope this helps you explore the non-surgical options available and provides a path forward in managing your under-eye concerns.