Unpacking Your Eye Bags

Karen tackles the puffy eye predicament that's turning well-rested people into walking advertisements for concealer. From the cruel reality of aging to your body's dramatic reaction to that late-night pizza binge, Karen breaks down the reasons your under-eyes are staging their own little rebellion.

Visit our website itchyandbitchy.com to read blog posts on the many topics we have covered on the show.

Episode Transcript

Speaker 1 (00:00):
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello, this

(00:21):
is Karen Nickel, family nurse practitioner, and you are listening
to Itchy and Bitchy podcasts that provides answers to your
mini unanswered health questions. Under eye concerns are definitely trending
on social media these days, and people who experience under
eyebags will tell you that it can take a toll

(00:42):
on their confidence and self esteem. Often, in an effort
to correct the problem, they will undergo lymphatic massages, facials,
and topical treatments, and, depending on the severity of the
under eyebags, for some people, surgery may be the only
way to permanently remove the look of puffiness. However, there

(01:05):
are skin care products and tools that can help. During
this episode, I will be getting into the causes, treatments
and products that can help with under eye bags, so
stay tuned. So, the main cause of developing bags under

(01:25):
the eyes is yep, you guessed it, aging, which causes
a loss of collagen, fat, pad, and elasticity. The most
common cause of your puffy eyes may simply be a
product of your body's aging. Aging causes tissues and muscles

(01:48):
to weaken around the eyes, and the fat pads descend
and bulge, causing puffiness around the eyes. We also lose
collagen and elasticity that causes a weakening of the skin
around the eyes. Fatigue, lack of sleep, or oversleeping. I
know you know this already, but I've got to say

(02:11):
it again. A bad night's sleep could make your eyes
appear swollen in the morning, especially if you're stressed. When
you're under stress, you release cortisol from your adrenal glands.
How many times have I talked about that? And that
changes the salt balance in the body. And when your
salt balance is off, you might retain water and have

(02:33):
swelling allergies. This is a very common cause of dark
under eye circles. We call these allergic shiners because they
have the appearance of someone who has been socked in
the eyes. Puffy eyes are also a common symptom associated
with seasonal allergies. When you have an allergy, your body

(02:56):
goes into full on attack mode by releasing histamine into
your system. This causes inflammation and swelling under the eyes.
Allergies can also cause masked cells to release inflammatory mediators
like histamine and cytokines, which can cause a hive like reaction,

(03:18):
especially around the eye area. Sinus problems. When you're sick
with the cold, your eyes will naturally look puffier. That's
because the cavities that drain fluid out of your face
are blocked with sinus congestion, so the eyes have a
puffy look to them. Chronic sinus congestion can cause the

(03:39):
same type of eye puffiness and needs to be addressed
by your PCP or E and T. Lifestyle factors like
smoking or drinking alcohol can be a problem. Alcohol can
cause fluid shifts in your body, and their effects can
be compounded by the tendon sees. Some have to snack

(04:01):
on salty foods when drinking alcohol, and this creates a
double whammy. The fluid shifts and water retention caused by
alcohol and salty foods make the eyes appear puffy. If
you're not moving enough, you can have fluid retention. If
you're sick or injured, or lying down, often fluid can

(04:23):
collect in your face. If you are unable to increase
your activity level due to health problems. It's a good
idea to sleep as upright as possible so that fluid
can drain from your face while you sleep. Moving around
and exercising regularly promotes circulation and moves fluid out of

(04:44):
the face. So if you're able to move around move around,
you may already know this, but you may not realize.
Salt is in just about everything, even when you can't
taste it. High salt intake us the kidneys to retain water,
which leads to swelling. In general, the skin under the

(05:05):
eye is very delicate and puffiness is more significant in
that location. Swelling caused by salt is most prominent in
the mornings and should decrease as the day goes on.
So if you see that pattern, it's likely due to
high sodium in your diet. How do you determine if

(05:26):
the bags under your eyes are caused by fat pads
under the eyes or excess fluid under the eyes. Actually,
there's an easy test you can do. You can film
yourself on your phone or have someone watch your eyes.
During this test, First you look down and observe how
the bags under your eyes appear. Then you look up

(05:49):
towards your eyebrows. If the bags under your eyes get
bigger when looking up. The bags are caused by fat pads.
There is no change in the size of the bags
when you look up. Then the bags are caused by
fluid under the eyes. In addition to allergies, the following
can cause dark circles under the eyes. Prescription eye drops

(06:14):
to treat glaucoma eyestrain strain can enlarge the blood vessels
around your eyes, potentially causing dark circles. Dehydration, the skin
beneath your eyes begins to look dull and your eyes
look sunken. Sun exposure. Prolonged sun exposure can cause dark
circles to form under your eyes. Too much sun can

(06:37):
increase melanin production genetics. Sometimes we have dark circles under
eyes because everybody in our family has those. Anemia is
another cause of dark circles under the eyes. After this
quick break, I will talk about home remedies, non surgical

(06:57):
and surgical procedures to correct under oth eye bags. So
stay with me, welcome back. I'm going to start with

(07:23):
going through some at home remedies to help with under eyebags,
and the first one is to use a cold compress
for twenty minutes. There are cold compresses that are often
marketed for migraines that work nicely to cover the upper
and lower eyelids. These are designed to be kept in
the refrigerator and are cloth covered so you can put

(07:46):
them directly over your eyes for twenty minutes. They're very
easy to find online. Get adequate sleep, which I know
you keep hearing from me, which is about seven to
nine hours a day. Drink more fluids. Recommended daily amounts
of fluid are one hundred and twenty four ounces for
men and ninety two ounces for women, and that can

(08:10):
vary based on a lot of factors, but this is
a starting point, one hundred and twenty four ounces for
men and ninety two ounces for women. I have a
sixteen ounce YETI travel cup that I use daily. So
if you have a sixteen ounce travel cup of some sort,
you have to fill and drink the contents of your

(08:30):
travel cup eight times a day if you're a man,
and women have to do the same thing nearly six
times a day. It's ten in the morning and I
have had thirty two ounces of fluid so far today,
two of my travel cups, so I should be on
track to meeting my ninety two ounce goal for the day.

(08:51):
So if you only fill and drink the contents of
your sixteen ounce travel cup twice a day, that ain't
cutting it. Although water is the option, water is not
your only choice when it comes to hydration. All beverages
containing water contribute towards your daily needs, and some people
even tout the benefits of milk for hydration. Now, milk

(09:13):
contains calories and water doesn't, but many people tout the
benefits of milk for hydration. Also, it's a myth that
caffeinated beverages or those containing alcohol are dehydrating because they
make you urinate. They do make you urinate, but over
the course of the day, the water from these beverages
still leads to a net positive contribution to your total

(09:37):
fluid consumption. Again, there are many reasons why water is
the better choice. So I'm not telling you to drink
beer all day. I'm not saying that. Remember that sugary
drinks can lead to weight gain and inflammation, which can
increase your risk for developing diseases such as diabetes, and
too much caffeine can give you the jitters or disturb

(09:59):
your slaf, so keep that in mind. When choosing your
fluid replacement, it is important to remember that there are
people who need to be careful about their fluid intake,
like those with heart or kidney disease, so make sure
to check with your health care provider if you are
not sure about how much fluid intake is right for you. Also,

(10:22):
your hydration needs change when you're exercising for long periods,
have increased sweating, or are spending time outside in hot
temperatures for instance. Another thing you can do to decrease
swelling around your eyes is to elevate your head while sleeping.
This helps prevent fluid from collecting in your facial tissues.

(10:43):
You can use two pillows or a wedge pillow to
keep your head elevated. Use I creams, preferably I creams
containing caffeine. Caffeine in I creams helps reduce puffiness by
constricting blood vessels, which decreases fluid build up and swelling
around the eyes. Additionally, caffeines antioxidant and anti inflammatory properties

(11:08):
can improve discoloration and overall appearance. There are lots and
lots of caffeine containing I creams out there. Sarah v
and Nutrigena make under I creams and gels with caffeine
so you can get something at your local pharmacy. You
can also place chilled, soaked black or green tea bags

(11:33):
over your eyes for ten to twenty minutes. These act
as a cool compress and contain caffeine. Yay double benefit.
Use a retinol over the counter or retinoid prescription product.
These skin care products that are Vitamin Aid derivatives improve
skin firmness and reduce the appearance of puffiness. They achieve

(11:57):
this by boosting collagen production, which helps to thicken the
skin and make it more resilient. Retinoids also encourage cell turnover,
which can help to fade dark circles and smooth out
uneven texture around the eyes. Prescription hydroquinone cream specifically helps

(12:19):
with dark circles under the eyes, versus helping with bags
under the eyes. Hydroquinone works by inhibiting the production of melanin,
the pigment that gives skin its color. The online company
called Museli has an online prescription cream option that contains caffeine, hydroquinone,

(12:39):
and a retinoid to help with puffiness and dark circles.
The way the Museli website works is you have an
online visit with a dermatologist, you complete a three minute
medical questionnaire, a doctor reviews your images that you've uploaded,
a prescription formula is compounded and shipped directly to you,
and you have a follow up check in with an

(13:02):
e nurse to stay on track with your medication course. So,
if you have dark circles under your eyes as well
as under eye bags, a prescription combination cream like this
may very well be just the ticket for you. If
you have allergies, make sure they are appropriately treated as
recommended by your PCP, allergist or E in T. Usual

(13:25):
treatment involves taking an anahistamine and or a nasal steroid spray.
If you tend to have sinus conditions, you can use
a netty pot to clear out your sinuses. However, if
you are having symptoms of chronic signu situs, make sure
to see your PCP or E and T to get
that treated. Sinus congestion can lead to puffy eyes. I

(13:48):
know this is gonna seem like a simple thing that
everybody knows, but wash your face before bed. When you
sleep in makeup, you're exposing your skin to free radicals.
This has the potential to create what's called oxidative stress,
which may cause your skin to show signs of aging earlier.

(14:11):
We do not want that, so just wash your face
and get your makeup off before you go to bit.
Eat more iron rich and cauision rich foods. Cut back
on salty foods. If you can't seem to determine what
is causing your puffy eyes, try taking a sodium break
and reevaluate. Patients often told me that they no longer

(14:33):
salt their food, and that may be true, but more
and more people are eating meals out several times a week,
and trust me, the vast majority of the time those
meals served in restaurants are high in sodium, and foods
like cheese are high in sodium. Cut back on alcohol again,
because the fluid shifts and water retention caused by alcohol

(14:56):
make the eyes appear puffy. Quit smoke if you smoke
enough said. Some non surgical medical procedure for smoothing the
under eye area include fillers. This treatment injects a filler,
typically hyaluronic acid, under the eye to create a smoother appearance.

(15:19):
A laser resurfacing procedure uses a laser to remove the
top layers of the skin beneath the eye, stimulating new
collagen growth. A chemical peel treats under eye skin by
removing the older top layer of skin cells, revealing tighter,
brighter skin beneath. Surgical options include a lower eyelid lift,

(15:43):
which is called a blepheroplasty. An e int specializing infacial surgery,
an ophthalmologist or a plastic surgeon can do this, or
a fat transposition is a technique which involves shifting the
fat from the lower eyelids to fill in the hollows
and smooth the transition between the lower lid and the cheek.

(16:07):
They do this because the fat pad tends to fall
toward the cheek and so they just move it up
toward the eye again. So if bags under your eyes
are bothering you, the good news is there are lots
of treatment options, most of which you can do yourself.
If you need or want treatment option beyond what you
can do at home, there are those options too. Thank

(16:31):
all of you for listening. Wherever you listen to this podcast,
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I encourage you to visit our Facebook page imbat Podcasts,
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(16:51):
or questions for me. Our website is itchyanbitchy dot com,
where there are blogs with some of our subjects available
for you to read. As always, thank to Forest Winzl,
my son, our producer and composer of Arthy Music, and
the person who does all the behind the scenes work
to make this podcast possible. Thank you, Forest. Forest is
gearing up to begin his second year of his master's

(17:13):
degree in music composition at Peabody Music Conservatory. It's amazing,
it's already starting. I'm so proud of him. And remember
that your health is in your hands.