The skin under the eyes is delicate, which is why it sometimes appears sunken and has darker coloring than elsewhere on the face.
Age plays a role in sunken eyes but other factors can contribute, so it may affect younger people as well.
Most people notice sunken eyes when they look in the mirror. The exact appearance will differ from person-to-person.
- The medical term for sunken eyes is tear trough hollows.
- Sunken eyes can be prevalent in older adults.
- Cosmetic surgery and dermal fillers are options for sunken eyes caused by aging or genetics.
- A doctor will ask for a medical history and examine the face and eyes to decide if treatment is necessary.
Causes of sunken eyes
Sunken eyes may not cause any adverse symptoms, apart from the skin around the eyes appearing darker and ‘hollow’.
Most cases of sunken eyes relate to the quality of an individual’s nutrition and healthy living.
When these causes are corrected, sunken eyes can resolve without further treatment. This means that causes can be avoided or treated in good time to prevent the recurrence of sunken eyes.
Below are some examples of health and lifestyle issues affecting the skin under the eyes:
The most common cause of sunken eyes is dehydration, or not having enough water in the body.
Consuming too much coffee, soda, and prepackaged drinks may cause diuretic effects, including increased production of urine, which may lead to dehydration.
Deficiencies of vitamin C, vitamin K, and iron can cause eyes to become sunken. In fact, “hollow” eyes is one of the symptoms of undernutrition, as reported in the SM Journal of Nutrition and Metabolism.
Vitamin C helps with absorbing iron and decreasing bruising, whereas vitamin K is responsible for blood clotting.
Deficiencies in one or both of these vitamins can lead to easy bruising, unhealthy skin, and sunken eyes.
Disrupted sleep, or a lack of sleep, may cause sunken eyes. Establishing a good sleep pattern may help to treat the condition.
Not enough sleep or poor quality sleep can cause sunken eyes and discoloration of the delicate skin just below the eyes.
According to a 2017 report from the National Sleep Foundation, good quality sleep has the following necessary elements:
- sleeping for much of the time in bed
- taking no more than 30 minutes to fall asleep
- waking no more than once per night
- not being awake for more than 20 minutes during the night
Collagen is the most abundant protein in the human body and gives the skin its strength and flexibility.
As the body ages, it tends to lose collagen. The first place where collagen loss is most noticeable is the skin under the eyes. The loss of collagen causes the eyes to settle back into the eye sockets, making the eyes appear sunken.
Most people tend to lose weight in their face first. Sometimes, the weight loss is dramatic enough to cause blood vessels below the eyes to become prominent, and the skin to be transparent, producing the appearance of sunken eyes.
Dramatic weight loss may also cause nutritional deficiencies, which can lead to sunken eyes.
It is possible for sunken eyes to be caused by a person’s genetics or DNA. As an example of the effect of DNA, the position of the eyes in the sockets is due largely to genetics.
Smoking causes collagen and skin elasticity degradation. These losses can cause the skin in the face to sag and the eyes to appear sunken.
Allergies can cause the eyes to sink and dark circles to form under them. These effects are attributable to inflammation in the tiny blood vessels below the eyes or blocked nasal passages, which can be associated with allergies.
Inflamed sinuses are another culprit of sunken eyes. Nasal congestion and pressure are symptoms of a sinus infection and should be brought to the attention of a doctor.
Any injury to the face or the bones around the eyes can cause the eyes to appear sunken. Most orbital fractures heal within a few weeks or months. However, many fractures are orbital blowout fractures, where the bony rim of the eye is intact, but the thin floor of the eye socket has ruptured or cracked.
A 2015 report in Clinical Ophthalmology finds that injury to the eye is common in 29 percent of orbital fractures.
Sunken eyes resulting from medical conditions, such as allergies and sinus problems, can be treated with medications. These may include antibiotics for sinus infections and antihistamines and eye drops for allergies.
Cosmetic surgery and dermal fillers may be a consideration for sunken eyes resulting from aging or genetics. However, surgery is never without risks.
Dermal fillers involve an injection of hyaluronic acid into the sensitive tissue just below the eyes, so these may cause side effects.
Surgical treatment is the best way to treat eye fractures, restore eye regularity, and balance the volume of the injured orbit in the case of eye injuries.
Lifestyle changes and home remedies can help to reduce sunken eyes.
For the following remedies involving application of substances to the area, a person should ensure they keep their eyes closed and avoid getting them into their eyes.
Home remedies include:
Dehydration may cause sunken eyes, so drinking water may help.
Water is the most necessary thing the body needs to stay healthy. It affects every organ in the body, included the largest of them all – the skin.
Usually, people who have sunken eyes experience improvement by increasing water intake and limiting diuretic beverages.
Drinking 8 to 10 glasses of water per day can help people avoid sunken eyes.
Good quality sleep
Sunken eyes are often an indicator that someone is not getting enough good quality sleep. According to the National Sleep Foundation, adults need about 7 to 9 hours of sleep per night, while infants, children, teens, and older adults may need more.
Sunken eyes indicate that the skin below the eyes has lost nutrients. The space below the eyes can be nourished with almond oil, which is rich in vitamin E, a vital skin vitamin. Vitamin E oil is also another skin-nourishing option.
Potatoes contain vitamin C, enzymes, and starch to nourish the thin skin below the eyes. And the coolness of the raw potato reduces inflammation of blood vessels to minimize swelling and a dark appearance. Potatoes can be applied below the eyes while lying down for about 20 minutes.
Tea contains antioxidants and flavonoids. Using tea bags improves sunken eyes by promoting circulation and relaxing the eye nerves and muscles.
Steep two tea bags for at least 5 minutes. Squeeze the liquid from them and make sure they are not too hot for the thin, sensitive area below the eyes. Place under each eye for at least 10 minutes.
Cucumber is a popular home remedy for dark circles and sunken eyes. Cucumber slices can be placed under the eyes for a cooling effect and to reduce swelling and skin discoloration.
Fish oil is rich in fatty acids, making it an anti-inflammatory that promotes healing of damaged cells.
Fish oil can be applied by breaking open a fish oil capsule and putting the oil on the skin under the eyes. This should be done before going to bed for up to 4 weeks.
Lemon juice is nature’s bleach, and when applied to the skin below the eyes it aids dead skin removal and discoloration. It is essential to dilute lemon juice with water to reduce skin irritation, and to keep it away from the eyes themselves.
When to see a doctor
If sunken eyes appear to worsen with time, despite getting more sleep and staying hydrated, and if they are accompanied by other symptoms, a person should go and see their doctor.
Additional symptoms signaling another problem include:
- congestion of the nasal passages
- itchy, dry, or red eyes
- fatigue that is ongoing
- extreme or unusual weight loss or appetite problems
- nausea and other digestive issues
Based on a physical exam or symptoms, a doctor may request further tests to determine the cause of sunken eyes.
Most of the time, sunken eyes are not related to life-threatening conditions. If they are linked to aging or genetics, they do not usually cause other problems.