Puffy Eyes

A few years ago, I went on a second course of Accutane to help combat my mild-moderate acne which had plagued me for years.

Although the medication worked wonders at changing my skin - to the extent that (touch wood) I have never broken out so badly since then - I have found that the bags under my eyes are considerably more noticeable now, possibly due to the skin being so thin and delicate.

When I look close up in the mirror, it's almost like I have two black eyes - there are distinct dark circles under my eyes, but the puffiness isn't so much as you'd see in a tired person; it's more sagging/hollow bags, which when I squint or lift them with my finger instantly disappear.

I have tried a whole load of different eye creams, including cold compresses, face masks, glycolic peels and so on, but nothing seems to help.

I drink a lot of coffee and realise this apparently doesn't help. But I have even given that up for a week to see if it made any difference, alas no.

I hear people in a similar position saying the only solution is to have cosmetic surgery. Yes, in my case it was always partly hereditory. But for a 26 year old to be constantly told "dude you need to get more sleep" or "stop drinking so much coffee", I'm wondering whether there is an underlying cause which I can change too.

Any advice would be most welcome!

[Bhupinder Kaur, MD]

Hello,
There are many possibilities for puffy eyes and the chief causes include oversleeping/lack of sleep, diet, fluid retention, alcohol and tobacco use, allergies, skin disorders, crying, mononucleosis, thyroid disease, kidney disease and periorbital cellulitis. Treatment is diagnosis specific and for this you need to get all these causes ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.