Is it possible to win the battle of the eye bag? Preventing bags under eyes isn't easy, and certain home remedies are ineffective. But as we report here, there are things you can do to keep that look under control.

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Do people often ask you if you’re tired or recovering from a late night, even when you’re well-rested? You may have a case of chronic eye bags—persistent bagginess or drooping under the eyes. And let’s not sugarcoat it: Bags under eyes make you look a bit longer in the tooth.

You’re not alone. Legions of people experiencing bags under eyes are always in search of cures, both homespun and medical. Self-help treatments (like cool cucumber slices perched on your puffy eyes) make little difference.

Prominent eye bags are stubbornly resilient, and they tend to run in families. But at the same time, you are not condemned to lose the battle of the bag. You can take steps to prevent or reduce eye bags—like not smoking and protecting your face from unfiltered sunlight to guard against premature skin aging.

How Do Bags Under Eyes Form?

Bags are bulges of fat from around the eyeballs. This so-called orbital fat (fat in the eye sockets) provides a soft cushion for your eyeballs. The fat is held in check by a supporting sheet of skin, muscle, and connective tissue. With aging, things get slack and the fat pooches out. A bag is born.

It’s also common to have general puffiness when waking. As you lie asleep with your head at body level, the orbital fat sucks up a bit of the water circulating in your system. Over the course of the day, the body takes the water back, and the puffiness subsides.

The bags can become discolored, forming dark crescents in the bags. That’s partly from thinning of the skin that allows underlying blood vessels to show through.

Other factors besides aging are involved. Baggy eyes are partly genetic, running in families. Chronic lack of sleep leads to persistent eye bags, as does smoking and heavy alcohol use.

What You Can Do

Prevention is the best cure, so take steps to keep bags under eyes from forming or from getting worse. Steps include:

• Get enough sleep and maintain good sleep hygiene, including sleeping on a steady schedule.
• Avoid heavy alcohol consumption.
• If you can, use an extra pillow to elevate your head to prevent fluids from accumulating under the eye.
• Wear a hat to protect your face from solar radiation. Ultraviolet radiation in sunlight contributes to general photo-aging and resulting thinning of the skin. Otherwise you could trade a healthy glow for wrinkles and bags later in life.

You’ll see plenty of creams and other products on the market promising to do away with bags under eyes. But beware of claims that seem to good to be true, because they probably are. Prominent, persistent eye bags are not going to yield to over-the-counter creams, cool compresses, or cucumber slices.

Cosmetic Surgery and Treatments for Bags Under Eyes

A cosmetic surgery called blepharoplasty can reduce eye bags by removing or repositioning fat behind the lower eyelid and shoring up loose or sagging lids. Blepharoplasty can also be done on upper eyelids, a procedure often called an eyelid lift.

In lower-lid blepharoplasty, surgeons often do the work from behind the eyelid. If the eyelid skin and muscles are especially saggy or slack, the surgeon may have to make incisions on the outside surface to tighten things up.

Blepharoplasty is usually an outpatient procedure, but expect a total recovery period of seven to 10 days. Like all surgeries, eyelid reduction comes with a risk of complications, including dry or watery eyes, pain, swelling, and bruising. More rarely, blepharoplasty can lead to vision loss, damage to eye muscles, eyelid drooping, inability to fully close the eye, and a noticeable shift in the position of the eyelid.

In short, consider blepharoplasty “real” surgery with real risks. The other caveat is cost. Unless the sags and bags significantly interfere with vision, it is likely to be considered cosmetic and health insurers may consider it elective and deny coverage.

Other Treatments

Cosmetic dermatologists can offer non-surgical options, too. These include laser treatment and injecting fillers to tighten the skin over the bags or smooth out the edges of the bags to make them less noticeable.

These are temporary solutions, but many people are willing to pay the premium price for cosmetic treatments.