Try these simple tricks to improve dark circles and puffy eyes

Q. I often wake up with dark circles under my eyes. What can I try at home to improve their appearance in the morning?

A. Dark circles and puffy eye bags can be so unwelcome that treatments are popular, including expensive serums, cosmetics and procedures. But home remedies can also be effective.

There are two quick fixes I recommend:

• Caffeine: Try placing chilled, damp black tea bags under your eyes. Caffeine shrinks blood vessels, which is why your blood pressure might be a bit higher after your morning latte. Since caffeine is also absorbed through the skin, applying it topically can shrink the blood vessels that give eyes a darker and puffier appearance. In one small double-blind randomized controlled trial that evaluated topical caffeine use, researchers found that applying a cold caffeine-containing gel and a cold placebo gel were both effective at reducing under-eye bags. But for about a quarter of people, the caffeine afforded a noticeable boost on top of the cold alone.

• Cold spoon: Try putting a metal spoon in the fridge overnight, or pop it in some ice water while you go about your morning routine. Lay the convex side gently against the puffy area until the spoon becomes warm. Cold also shrinks blood vessels that can cause eye bags. If a putting a spoon on your face isn’t exactly giving spa, go for slices of cool cucumbers or even frozen peas and carrots — whatever you have handy. Just wrap it in cloth first. Placing freezing objects directly against skin isn’t advisable.

Under-eye changes are a normal part of aging. “Under-eye bags inevitably develop as we age and our facial structures change,” said Anisha Kumar, a facial plastic and reconstructive surgeon in New York.

As we get older, the skin beneath the eyes loses its firmness and elasticity, creating a puffy appearance, and the fat pads of the lower eyelid shrink, so they seem more hollow. Dark circles can be due to shadows cast by these changes, hyperpigmentation or enlarged blood vessels that appear prominent because of thin eyelids. Dark circles also run in families.

Home remedies can temporarily impact tissue swelling, Kumar said, and a common theme is that they seek to decrease inflammation, constrict blood vessels or reduce water retention.

How to prevent dark circles and puffy eye bags

We can’t change our age or genetics. But there are a few things that may help prevent dark circles and puffy eyes from happening in the first place.

• Topical retinoids: This is at the top of my list because it’s backed by the strongest evidence. It’s also part of my recommendation for a simple, science-backed skincare routine. Retinoids have been well studied to even out skin tone and improve skin elasticity, meaning they tighten the skin that can lead to under-eye bags and shadows. Make sure to couple retinoids with sunscreen, which helps reduce long-term risk of skin damage. And keep in mind that retinoids take time to work and are best used at night, since they can make your skin more sun sensitive.

• Reduce eyestrain and get better sleep: We’re all guilty of eyestrain during long days glued to our screens. But eyestrain can cause the blood vessels beneath our eyes to enlarge, making them more visible. Our blinking slows down profoundly when we’re staring at a screen; I tell my patients to set a timer every 20 minutes and to shut their eyes or step away for a minute. Poor sleep is also a classic risk factor. Getting seven to nine hours of sleep a night, Kumar said, is part of a healthy lifestyle that can optimize physical appearance at any age.

• Quit smoking and minimize alcohol use: Both of these factors are associated with increased puffiness underneath the eyes, regardless of age.

Other common advice makes some theoretical sense, but there haven’t been any studies confirming their effects. For example, sleeping at an incline with the head elevated is often recommended to help with fluid drainage that could accumulate underneath the lids, contributing to “bags.” Eating less salty foods is also advised, and it’s an easy and healthy idea to try overall.

Rubbing your eyes may also damage the fragile capillaries in your eyelids that can leak and contribute to dark circles. Try talking to your provider about eye drops and treating the underlying cause of your itchy eyes, like allergies.

What about hemorrhoid cream?

One so-called “red carpet secret” that has gotten people talking on social media for years? Hemorrhoid cream.

Yep. Hemorrhoid cream.

Hemorrhoid creams often contain two relevant ingredients: phenylephrine, which shrinks blood vessels, and a steroid to reduce inflammation. And, sure, both ingredients could help the appearance of weary eyes in a pinch, but the steroid carries the risk of weakening tissue in a delicate area. It’s why gastroenterologists don’t recommend people use hemorrhoid cream more than a week.

More concerning, applying steroids near the eye could theoretically increase the risk of glaucoma, a condition where the optic nerve is damaged and causes blindness. So, all things considered, let’s save the hemorrhoid cream for its originally intended zone of interest.

What I want my patients to know

Usually, the cause of dark circles or puffy eye bags is not alarming. But they also may be a sign of a medical condition. Allergies, for example, can congest the nasal passages, and that increased pressure causes blood to pool underneath the eyes. This can lead to a dark, puffy appearance. And medical condition or not, if the appearance of your eyes bothers you, it can be helpful to explore why with your provider and discuss whether advanced treatments or procedures make sense.