Puffy eyes vs sunken eyes: What's the difference?

How can you tell them apart?

Dark circles can also come from pigment or thin skin, so darkness alone cannot tell you which problem you have. Many remedies sold for dark circles lack evidence of benefit, even if the jar has mastered looking clinical.2

What helps temporary puffiness?

1. 1Remove contact lenses if your eyes or eyelids are swollen.
2. 2Place a cool, damp washcloth over closed eyes. Wrap an ice pack in a towel rather than putting it directly on skin. For swelling after crying, try a cold compress for 10 minutes and remove it sooner if uncomfortable.
3. 3Avoid rubbing or forceful massage. Touching the delicate eye area can irritate it and worsen swelling.
4. 4At bedtime, raise your head slightly with an extra pillow to reduce fluid buildup. Limit salty foods if salt seems to contribute to swelling.

Swelling after crying can fade within minutes or remain the next morning. If eye makeup or cream seems to trigger swelling, stop using the suspected product for at least a couple of weeks. Antihistamine eye drops help only when allergies are the cause; steroid eye drops should be used only as prescribed. Avoid hemorrhoid cream around the eyes.14

What helps sunken eyes?

Sunken eyes can be a sign of dehydration, especially alongside thirst, a dry mouth, dark yellow urine or peeing less often. Drink fluids; if nausea makes drinking difficult, start with small sips and gradually drink more. After vomiting or diarrhoea, ask a pharmacist about an oral rehydration solution to replace lost fluids, salts and minerals. Drinking more is not a treatment for every under eye hollow.5

Hollows linked to tissue loss can be assessed for fillers or fat grafting. These procedures require considerable training and experience, and improvement can be partial. For cosmetic camouflage, apply concealer in the shadow rather than on puffy skin, because makeup is camouflage, not landscape renovation.2

True enophthalmos means the eyeball sits deeper in its socket. Causes include fractures, sinus problems, ageing related tissue changes and certain glaucoma medicines. An eye examination helps identify the cause, and treatment can involve medication changes or surgery.3

Eyelid surgery, called blepharoplasty, can correct puffy bags and drooping upper lids, but it does not eliminate dark circles or wrinkles around the eyes. Removing bags is not the same job as removing darkness, despite their shared address.6

When should you get medical help?

• Seek urgent assessment for a red, hot, painful or blistered swollen eyelid, eye pain, sudden drooping, light sensitivity or changes in vision.
• See a healthcare provider after a blow to the eyes or face, or if you develop blurred or double vision.
• Arrange an eye care appointment if swelling lasts longer than 24 to 48 hours.
• Get urgent help for dehydration with persistent dizziness on standing, unusually marked tiredness or reduced urination. Confusion, difficulty breathing or difficulty waking require emergency help.