Causes of Under-Eye Bags

Sep 12, 2021 Source: Cainiu Health

Dr. Cui Xin

Introduction

1. Genetic factors: For example, simple orbicularis oculi muscle hypertrophy–induced under-eye bags result from hereditary factors and typically appear at a young age. 2. Impaired blood circulation: Poor microcirculation around the periorbital area can contribute to the development of under-eye bags. 3. Sleep deprivation: The periorbital region contains numerous small blood vessels; insufficient sleep prevents the eyelids from resting adequately, leading to sustained vasoconstriction and vascular tension.

As people age, skin laxity inevitably leads to various visible changes—such as under-eye bags and wrinkles—which most individuals find undesirable. Under-eye bags, located beneath the eyes, often impart an especially aged and fatigued appearance. Consequently, an increasing number of people opt for blepharoplasty (eyelid surgery) to remove them. So, what causes under-eye bags? Below, we address this question.

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Causes of Under-Eye Bags

1. Genetic Factors

For example, “orbicularis oculi muscle hypertrophy–type” under-eye bags result from inherited traits and may appear even in youth. Their hallmark feature is a smooth, arc-shaped, continuous bulge near the lower eyelid margin, with no associated skin laxity. Other genetically influenced types include “simple skin laxity–type” and “mild-to-severe lower eyelid protrusion–type,” primarily caused by congenital overdevelopment of orbital septal fat. Due to gravity, this excess fat prolapses (herniates), and in severe cases, the lateral canthal ligament becomes lax, leading to ectropion (outward turning of the eyelid) and lid–globe separation—often accompanied by excessive tearing.

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2. Impaired Blood Circulation

Poor microcirculation around the eyes can contribute to under-eye bag formation. For bags caused by circulatory insufficiency, it’s essential to allow the eyes adequate rest, perform gentle acupressure on periocular points, or apply cold compresses to alleviate swelling. Additionally, consuming excessive fluids before bedtime may induce temporary periorbital edema: when the kidneys cannot promptly excrete surplus water, fluid accumulates around the eyes, resulting in puffiness and apparent under-eye bags.

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3. Sleep Deprivation

The periorbital region contains abundant capillaries. Chronic sleep deprivation prevents the eyelids from resting adequately, causing prolonged vasoconstriction and sustained increases in local blood flow. This results in venous stasis and edema within the subcutaneous tissues—manifesting as under-eye bags. However, persistent or long-standing under-eye bags may signal underlying chronic disease—for instance, chronic liver disorders, particularly those involving impaired hepatic function or hepatomegaly. In such cases, prompt medical evaluation is strongly advised.

The above outlines the primary causes of under-eye bags. We hope this information proves helpful to you.

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What causes under-eye swelling?

Under normal circumstances, eye bag swelling may be caused by excessive water intake before sleep, crying, allergic conjunctivitis, hypothyroidism, glomerulonephritis, or other factors. If discomfort occurs, it is recommended to seek medical examination and treatment at a hospital promptly. In daily life, one should maintain good living habits, avoid staying up late for long periods, control salt intake, and maintain a balanced diet.