Bags under eyes are mild swelling or puffiness under the eyes. They're common as you age and the tissues around your eyes weaken, including some of the muscles supporting your eyelids. Fat that helps support the eyes can then move into the lower eyelids, causing them to appear puffy. Fluid may also accumulate below your eyes.

Bags under eyes are usually a cosmetic concern and rarely a sign of a serious condition. At-home remedies, such as cool compresses, can help improve their appearance. For persistent or bothersome under-eye puffiness, eyelid surgery may be an option.

Symptoms of bags under eyes can include:

• Mild swelling
• Saggy or loose skin
• Dark circles

When to see a health care provider

You may not like the way they look, but bags under eyes are usually harmless and don't require medical care. See your health care provider if the condition causes vision problems, irritation or headaches or is accompanied by skin rash.

Your health care provider will want to rule out other possible causes that can contribute to the swelling, such as thyroid disease, infection, connective tissue disease or an allergy. You may be referred to a health care provider who specializes in the eyes (ophthalmologist), plastic surgery or plastic surgery of the eyes (oculoplastic surgeon).

Bags under eyes are caused when the tissue structures and muscles supporting your eyelids weaken. The skin may start to sag, and fat that's usually around the eye can move into the area below your eyes. Also, the space below your eyes can gather fluid, making the area look puffy or swollen. Several factors cause or worsen this effect, including:

• Aging
• Fluid retention, especially upon waking or after a salty meal
• Lack of sleep
• Allergies
• Smoking
• Genetics — under-eye bags can run in families
• Medical conditions, such as dermatitis, dermatomyositis, renal disease and thyroid eye disease

The following tips can help you reduce or eliminate bags under your eyes:

• Use a cool compress. Wet a clean washcloth with cool water. While sitting up, apply the damp washcloth to the skin under and around your eyes for a few minutes using light pressure.
• Cut down on fluids before bedtime and limit salt in your diet. This will reduce the fluid retention that can cause bags under eyes.
• Don't smoke. Smoking can aggravate the problem of bags under your eyes.
• Get enough sleep. For most adults, 7 to 9 hours is a good amount of sleep.
• Sleep with your head slightly raised. It may help to add an extra pillow or prop up the head of your mattress. Or elevate the entire head of the bed a few inches. This helps prevent fluid from accumulating around your eyes as you sleep.
• Reduce allergy symptoms. Avoid allergens when possible. Try nonprescription allergy medications. Talk to your health care provider about prevention strategies if you develop under-eye reactions due to hair dyes, soaps, cosmetics or other allergens.
• Use cosmetics. If you wish to mask your under-eye circles, try using makeup.

Preparing a list of questions will help you make the most of your time with your health care provider. For bags under eyes, some basic questions to ask your health care provider include:

• What's likely causing my symptoms?
• Is my condition likely temporary or chronic?
• What treatment approach do you recommend, if any?
• What will the treatments cost? Does medical insurance cover these costs?
• What results can I expect?
• Can I do anything at home to improve my symptoms?
• What kind of follow-up, if any, should I expect?

Don't hesitate to ask other questions that occur to you.

What to expect from your health care provider

Your health care provider is likely to ask you a number of questions, including:

• When did you first notice the puffiness under your eyes?
• Have your symptoms been continuous or occasional?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• What medications do you use?
• Do you smoke?
• Do you consume alcohol?
• Do you use recreational drugs?
• What herbal supplements do you use?
• What other medical conditions do you have?
• Have you ever had bleeding disorders or blood clots?