Treatment Options for Puffy Itchy Under Eyes

Eyes are the windows of the soul. Eyes not only convey your emotions but also determine how you look. Baggy under eyes obviously make you look old, tired and unhappy. However, this isn’t something you should worry more about how you look, but a lot about how can you reduce the swelling. While puffy itchy under eyes may be an indicator of poor sleep or an allergic reaction, rarely, in few cases it may be a dreadful symptom of any health condition. As you may know, this may be a sign of complicated health conditions like bleeding inside the eyes, skull fracture, etc.

When home remedies for puffy itchy under eyes don’t work, get the symptoms diagnosed with an ophthalmologist to identify the cause of puffy itchy under eyes. Puffy itchy under eyes has many treatment options. The treatment is generally based on the causes of puffy itchy under eyes. As long as you don’t suffer from any chronic diseases, both surgical and non surgical treatment methods provide good relief from the symptoms. However, treatment should be based on what caused puffy itchy under eyes.


Non Surgical Treatment Options for Puffy Itchy Under Eyes

Eye Drops for Puffy Itchy Under Eyes

In most cases, when the puffy itchy under eyes is caused by lack of sleep or mild allergy, the best treatment is putting eye drops and getting good sleep. However, frequent usage of eye drops even for mild irritation is not recommended. Inappropriate use of eye drops also lead to itchiness and inflammation of the eyes.

There are many types of eye drops available to treat different eye conditions.

Treating Puffy Itchy Under Eyes with Antibiotic Eye Drops

Antibiotic eye drops are specially designed to address the chronic inflammation of the eyes caused due to malfunction or damages to the nerves, cells, tissues and muscles of the eyes. In most cases, antibiotic eye drops address the issue fully and treats the puffy itchy under eyes, providing complete relief. Following are the different eye problems you can improve with antibiotic eye drops.

Blockage in the tear duct – It can be a partial or full blockage of the tear duct. Malfunction of tear duct leads to overflow of tears that accumulate as eye bags under the eyes. Administering antibiotic eye drops clear up the blockage and reduces the swelling as well as itching. However, a surgical invention may be required if the blockage doesn’t clear up fully.

Infection of the tear gland or oil gland – Similar to tear duct blockage, any viral or bacterial infection to the oil and tear glands may also cause swollen itchy eyes. Malfunction of these glands result with accumulation of tears under the eyes. The eye drops treat the infection, reduce the inflammation and enables normal function of tear and oil glands.

Stye – It is a type of bacterial infection of the eyes where the glands located at the corner of the eyelids are affected. The infection manifests in form of tenderness and pus filled cysts along with puffiness beneath the eyelids. When you grow bumps inside the eyelid, you may also shed tears incessantly and develop sensitivity to light. Although antibiotic drops may reduce the swelling to a great extent, frequent warm compress really helps to get rid of irritation and discomfort.

Eye Tumors – The tumor grows in pale yellow color under the eyelids. Eye tumors are classified into two.

  • Benign Tumors – Non-cancerous lumps
  • Malignant Tumors – Cancerous Lumps

High cholesterol is a major cause of growth of benign tumor that is called Xanthelasmas. No specific treatment is required as long as the tumor doesn’t affect the vision. Besides, reducing the cholesterol levels automatically shrink the tumor.

In other cases, followed by initial prescription medicine, a biopsy is performed to identify whether the tumor is benign or malignant. If the tumor obstructs the vision or if it is diagnosed as malignant, a surgery is performed to remove it.

The antibiotic eye drops also treat the puffy itchy under eyes in the following cases:

  • General eyelid swelling and itchiness due to allergy or foreign object in the eyes
  • Side-effects of medications, especially sleep medications
  • Viral and bacterial infection of the eyes
  • Swelling and itchiness caused due to inappropriate use of OTC eye drops.
  • Red bumps beneath the eyes caused due to excessive body heat

It is highly recommended that these eye drops be used only after consultation with doctor.

Artificial Tear Drops

treatments-for-puffy-itchy-under-eyesAlso known as lubricating eye drops, it provides temporary and short term relief from itchiness and subsequent swelling caused by itchiness. Although the artificial eye drops is used to tread dryness of eyes, it also reduces eye irritation. Especially, if you have strained eyes due to lack of sleep, too much work, etc. artificial tear drops may be helpful.

Anti-histamine Drops

Histamine is a fluid that your immune system secrets to protect the eyes when any external object comes into contact. However, histamine irritates the eyes and causes under eye bags. If you are sure that exposure to any foreign object or extreme climate change causes the itchy puffy under eyes, just put the OTC antihistamine drops.

Remember, if you are unsure about the cause of puffy itchy under eyes, don’t take any chances with antihistamine drops. Consult a doctor and get appropriate eye drops.

Oral Antibiotics and Analgesics

Generally, physicians examine the puffiness of the eyes and prescribe the antibiotics in addition to eye drops. If the pain and itchiness is intolerable along with swelling, you may also consider taking analgesics for one or two days.

Too much antibiotics may affect the immunity and weaken the immune system, making it dependent on antibiotics. When you use generalized eye drops you may take oral antibiotics to reduce the swelling and treat the infection. When you put antibiotic eye drops, just go for mild painkillers like Paracetamol. Don’t take oral antibiotics or painkillers for more than 3 days without prescription. Again, before taking all these, it is recommended to consult your doctor or an ophthalmologist.

When the antibiotic drops and antibiotics medicines don’t improve the condition, surgery is mostly recommended as the treatment for puffy itchy under eyes.

Lymphatic drainage massage with Vitamin E Oil

In many cases, a lymphatic drainage massage reduces the puffiness of the eyes. Massage with vitamin E oil to rejuvenate the eyes, which also reduces eye itching. Remember, this treatment is recommended only when the cause of puffy itchy under eyes is due to unhealthy lifestyle or poor sleep! You cannot go for an eye massage when you developed the puffy itchy eyes due to allergy, infection or trauma. In such case, read, puffy itchy eyes allergies- what to do?

Tear Trough – A Non Surgical Procedure (Cosmetic Procedure to reduce puffy itchy under eyes caused due to aging)

Tear Trough is one of the latest advances in the aesthetic medicine that treats swollen under eyes! It is an advanced form of hyaluronic fillers. It is one of the exciting procedures that provide quick and long lasting results.

Until a few years, surgery was the only resort to treat the under eye bags. Tear trough is not a common procedure. Being one of the biggest specialty treatments for puffy itchy under eyes, tear trough procedure undoubtedly creates a ‘Wow’ factor immediately after the treatment.

What is a tear trough?

Tear trough refers to the depressions of under the eyes that runs around the eyes and connects with nose. These depressions tend to droop and swell under the eyes for many reasons from aging, sagged skin, fluid retention, etc.  When they swell, it causes puffiness and accumulation of fluids causes irritation.

Tear trough procedure benefits all ages. Those who developed huge bags under the eyes with or without frequent itchiness due to aging and laxity of skin can gain from this procedure. If the puffy itchy under eyes make you look aged and sad, choose tear trough procedure.

Tear trough procedure

It is a simple procedure that lasts for no more than 10 minutes. The aesthetician injects the dermal filler through a thin needle and manipulate the skin to get the fillings appropriately. This is not a painful treatment. You may experience mild bruising after the treatment, which will subside on its own in a couple of days. The effects last from more than a year to two years. However, it varies with every individual.

The procedure brings a magical result that is quite instantaneous. It is performed with inserting needles and the puffiness literally disappears in a moment.

Who can benefit from tear trough procedure?

Tear trough procedure is one of the many anti-aging treatments but it is not for everyone. Being a form of cosmetic treatment, there are many restrictions regarding choosing the right one for this procedure. Besides, it may not be very effective to treat puffy itchy under eyes caused by other factors. However, you can make the most of tear trough procedure subject to following circumstances:

  • When the fat that surrounds the eyeballs puff out and creates a bag under the eyes
  • When you develop a hollow under the eyes, immediately followed by puffiness bordering the hollow. The puffiness is often caused due to fluid retention and unhealthy lifestyle.
  • Eye muscles and nose muscles are connected through tiny channels. This is the reason that makes your eyes swell and turn itchy when you suffer from sinus or cold. These channels lose the elasticity as you age and leads to puffy itchy under eyes.
  • When the muscles and tissues of the facial skin sag, the volume loss of cheeks leads to puffiness. Accumulation of fat and / or fluids under the eyes also irritate your eyes.

Choosing the right patients for this procedure needs a lot of expertise. No cosmetic procedure is recommended when the puffy itchy under eyes are caused by allergies or eye infections.

It is apparent that tear trough procedure works best for those who developed itchy under eye bags due to aging and lifestyle.

Surgical Treatment Options for Puffy Itchy Under Eyes

Blepharoplasty – An Eyelid Procedure

Blepharoplasty is the surgical reconstruction of the eyelids. It is performed to reconstruct the deformed upper lid and puffy itchy lower lids. Most commonly, this surgical procedure is recommended in most cases to remove the under eye bags. Removal of baggy eyes automatically treats the itchiness of the eyes. Let us see briefly know about surgical removal of under eye bags.

Eyelid procedure is often recommended to those who found no improvement in treating under eye bags. Blepharoplasty can be a rejuvenation procedure to get rid of puffy itchy under eyes, almost similar to a cosmetic treatment because, puffy itchy under eyes make you look aged. Besides, it is also performed as a treatment to address eye related ailments. It helps improving the functions of the eyes, tiny eye glands, tissues and muscles.

Blepharoplasty also treats the following conditions with respect to puffy itchy under eyes:

  • Sagged skin that manifests itself into wrinkles, folds and bags under the eyes
  • Fluid retention that makes itchy and red eyes (performed when other treatments doesn’t show any promising improvement)
  • Under eye bags caused due to poor lifestyle
  • Dropping under eyes that affect the iris

Remember, unless the under eye bags affect the vision or leads to other complications, this surgical procedure is neither recommended nor performed.

The surgical procedure removes the excessive fat, accumulated fluids, skin and muscles that cause the baggy eyes.

If you have gone through Botox treatment to reduce wrinkles under eyes, you must know how to manage itchy puffy eyes after Botox

How to prepare for the surgery

  • Stop taking any medicines without the prescription or consent from the physician 3 to 4 days before the surgery
  • Quit smoking and don’t consume alcohol
  • Follow a healthy diet and eat easily digestible foods
  • Avoid too much salt, caffeine and sugar

These were only general guidelines. If you are considering opting for this surgical treatment for your puffy itchy under eyes, talk to your doctor.

Surgical Procedure

This is a very simple surgical procedure. You can get the surgical intervention as an outpatient itself. The surgeon injects numbing medicine to the eyelids which makes your eyes groggy. In rare cases, general anesthesia is administered to the patients to perform the surgery.


The surgeon cuts a line just below lower lashes across the lower lid. The accumulation of fluid, excessive fat and muscles stored under the eyes are either removed or redistributed. Soon after removing the excess tissues, the cut is closed. This procedure takes around 2 hours to complete. However, patients are monitored for 2 or 3 hours after the procedure to prevent the risk of any complications.

For a few hours to a couple of days, patients may experience double, irritated and blurred vision. Besides, the patient may also develop redness, itchiness and swelling around the eyes. Most of these indications ease off in a maximum of two days. However, it is essential to follow the post procedure care as recommended by the physician.

Risks involved in Blepharoplasty:

The eyelid surgery involves the following risks and complications:

  • Infection, bleeding and irritation of the eyes
  • May lead to dryness of eyes (dry eyes obviously leads to puffy itchy under eyes)
  • Discoloration of the skin around the eyes
  • Injury to nerves and muscles
  • Unavoidable scarring
  • Poor vision for a few days (blurred vision, dull vision, sensitivity to light, etc)

You need to discuss with the physician to weigh and rule out the potential risks and complications of eyelids surgery.

Post surgery care:

  • Gently apply the prescribed ointments or eyedrops without fail
  • Don’t take any analgesic without discussing with your physician. Pain killers may cause internal bleeding and bruise your eyes.
  • Stay relaxed for a few days and avoid doing any strenuous activities
  • Try to spend most time indoors and avoid exposure to extreme climate
  • Don’t rub your eyes
  • Wear sun glasses and avoid sun exposure
  • You should not wear any contact lens at least for two months after surgery
  • Avoid wearing eye makeup at least for a month
  • You may apply cold compress (no longer than 2 or 3 minutes) to reduce the irritation

If you experience any serious vision problems or difficulty in breathing, immediately notify your physician and get appropriate treatment.

Treatment of Cellulitis of the eyes that cause puffy itchy under eyes

As mentioned earlier, infection of the eyes is one of the serious conditions that causes puffy itchy under eyes. Cellulitis is classified into two types:

Peri-orbital Cellulitis

It is a bacterial infection that causes inflammation of the eye lids and eye surface. It is an acute condition and in most cases antibiotics prescribed by physicians reduces the puffiness and itchy eyes. When the condition doesn’t improve in three to four days, a deep diagnosis is required to identify whether the infection spreads into the eye orbit.

Orbital Cellulitis

It is a bacterial infection that affects the internal tissues of the eyes behind the orbit. This condition not only causes puffy itchy under eyes, but inflames both upper lid and lower eyes. The infection spread through blood and sinuses. In simple terms, the eyes get inflamed which affects the vision and eye movement.

This is one of the serious conditions that call for immediate hospitalization. Initially, antibiotics are injected through IV and the patient is monitored for up to 6 hours. Upon notable improvement, oral antibiotics are prescribed for a minimum of 2 weeks. The antibiotics aim at treating infection, reducing inflammation and soothing the irritation of the eyes.

When the IV antibiotics do not show any improvement in 2 days, a surgical intervention is recommended. Surgical procedure involves draining the sinuses.

Cellulitis is often ignored by many due to lack of knowledge about the severity of the condition. When proper medication and treatment is not administered before the symptoms aggravate, it may lead to chronic infection and permanent blindness.

How to identify the right treatment for puffy itchy under eyes?

When you cannot identify a trigger or the real cause of the puffy itchy under eyes, you may need further tests and examinations to find the root cause. For instance, if you don’t have any eye infection or viral infection, the cause of the puffy itchy eyes could be a medical condition.

Lipid Profile – Check out the cholesterol levels. Excessive cholesterol, fat and triglycerides may lead to fat deposits under the eyes, causing puffiness, blocks of tear ducts, malfunction of the oil glands, etc.

Blood and Urine Test – It generally depicts the following results which help in diagnosing the actual cause of puffy itchy under eyes.

  • Complete blood profile
  • Blood sugar levels before and after fasting
  • Albumin in the blood – it will be very low in blood if you have nephrotic syndrome (a cause of puffy itchy under eyes)
  • Thyroid level – Low level indicates hypothyroidism
  • Elevated protein level in the urine is a sign of nephrotic syndrome

Food intolerance – You may not know that eating berries or almonds may cause you allergy, and leads to puffy itchy under eyes and a swollen face. Food allergy or intolerance is one of the major causes of this condition. Until you identify the allergic foods, no medicine or procedure could treat or prevent the recurrence of puffy itchy eyes.

Food intolerance could be lactose intolerance, allergy to nuts and seeds, fructose intolerance, food additives intolerance, etc. Generally, food intolerance is diagnosed through hydrogen breathing test, glucose tolerance test, professionally supervised diet, immune response to specific foods, etc.

Biopsy – In case of lumps or cysts, a skin biopsy is performed. Biopsy is also recommended to identify the cause of skin disorders like eczema, which causes puffy eyes.

Face X-Ray – When you have any trauma or developed black eye with under eye bags (internal rupture) a face X-ray could diagnose the underlying cause.

CT scan – When you cannot identify the trigger of the puffy under eyes with X-ray, a CT scan is recommended. Besides, CT scan is generally performed to study the condition or fracture in detail.

Treatment Options for Puffy Itchy under Eyes caused by an Underlying Ailment

When the over the counter medications or eye drops doesn’t show any improvement in reducing the puffiness and itchy under eyes, you should look for the other causes. When the underlying condition improves, it automatically reduces the swelling and itchiness of the eyes.

List of medical conditions that do not need any special treatment for puffy itchy under eyes.

Hypothyroidism – It causes swelling of eyes, face, neck, hands, etc. Check the thyroid levels through a blood test taken on an empty stomach. When the thyroid levels are low, it indicates hypothyroidism. The only treatment available to manage hypothyroidism is administering thyroid hormone through medicine. You can go for synthetic thyroid or nature thyroid. Get the right dosage prescribed by a doctor. Once the thyroid level increases, the swelling of the eyes also get reduced subsequently.

Edema – It refers to swelling due to fluid retention in various parts of the body including the lower eyelids. The major reason of swelling is excessive salt intake. Reducing salt consumption together with increasing potassium rich  foods helps reducing the inflammation.

Skin disorders – Appropriate treatment for the skin disorders treats the puffiness of the eyes. These treatments can be either home based or prescribed by physician.

Get some tips on how to get rid of puffy eye bags

Trauma, fracture, and other health condition need proper treatment and regular intake of drugs. Until the real cause is addressed, puffy eyes cannot be treated.

Instances where puffy itchy under eyes automatically subsides without any treatment or home remedies.

Pregnancy: One of the major causes of puffy itchy under eyes is pregnancy. Due to raging hormones and rapid changes in the body, pregnant women often develop swelling and irritation in the eyes. You can try some simple home remedies like warm compress or cold compress often, whenever you feel uncomfortable. During pregnancy you shouldn’t try taking any medicine or drugs without consulting your physician.

Crying:  Yes, crying cause puffy itchy under eyes. But you don’t need any treatment. Get some rest and give a warm or cold compress, the puffiness and itchiness will subside in a few hours.

Lack of sleep: If you work too much sacrificing your sleep, get adequate sleep and rest your eyes to reduce itchy and puffy eyes. This scenario doesn’t require any extra treatment. However, if you feel the puffiness and itchiness doesn’t decrease even after adequate sleep, you may consult with a physician and get some prescription drugs.

Follow health lifestyle, eat nutritious food, and have quality sleep. This is the mantra to prevent and treat puffy itchy undereyes naturally. If, however, your puffy itchy under eye bags indicate some serious issue inside your body, go to your doctor and talk about the treatment options available for your case of puffy itchy under eyes.

Disclaimer: This article is a general information based write up to make the readers aware of various treatment options for puffy itchy under eyes. Readers are strictly recommended to visit and follow the instructions of their doctor for actual treatment of puffy itchy under eyes.

One Response

  1. PARUL February 8, 2016

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