Are you often told that you look tired, even after a full night’s sleep? Do you notice dark shadows or a hollow appearance under your eyes when you look in the mirror? Sunken eyes, also known as “hollow eyes,” refer to the appearance where your eyes seem to sit deeper within their sockets. While aging, dehydration, and lack of sleep are common causes, other factors can also contribute, meaning even younger people can experience them too.
This comprehensive guide will help you understand everything about sunken eyes, from what they are and how to recognize them to their various causes and potential solutions.
Identifying Sunken Eyes
Sunken eyes, often called “tear trough hollows” or “under eye hollows,” are typically noticeable when you look in the mirror. Their exact appearance can vary from person to person. Sunken eyes describe the appearance of dark, hollowed-out skin directly under your lower eyelids, making your eyes look like they’re sitting deeper in their sockets and giving a tired or fatigued impression.
Common symptoms of sunken eyes include:
- Dark circles under the eyes
- Tired-looking eyes
- A deep groove or hollow under the eye
- Dry eyes
- Droopy or pulled back upper eyelids
- Asymmetrical eye positioning
- Double vision (if caused by an eye fracture)
Common Causes of Sunken Eyes
Now that you’re familiar with what sunken eyes look like, you might be wondering, “what causes sunken eyes?” There are actually many reasons why someone might develop sunken eyes. This can be caused by various factors, most commonly aging (due to loss of collagen, fat, and bone density), dehydration, lack of sleep, and genetics.
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1. Aging
As we get older, our faces naturally undergo changes. We lose fat and bone density, including around the eyes. The supportive structures that keep our skin firm also weaken, and the skin itself loses collagen, becoming thinner and more translucent. Age plays a role in sunken eyes, but other factors can contribute, so it may also affect younger people. As the body ages, it tends to lose collagen. One of the earliest places to see age-related changes 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.
2. Lack of Sleep
In today’s busy world, many of us struggle to get enough restful sleep. Consistently getting less than seven hours of quality sleep can really show on your face. Chronic fatigue and lack of sleep can accentuate hollows under the eyes, making them appear more pronounced and deep-set.
3. Dehydration
What deficiency causes sunken eyes? The answer is “water.” When your body is dehydrated, your skin loses its plumpness and elasticity. People with dehydration can present with sunken eyes. Severe dehydration can lead to sunken eyes, particularly in children, though adults can also experience this effect when fluid levels drop significantly. Dehydration can take a toll on your health and your skin. Additionally, dehydration could cause the appearance of sunken eyes. When dehydrated, your skin tissue loses moisture and becomes less plump. The skin around your eyes is already thinner, so any reduction in plumpness is visible relatively quickly.
4. Allergies and Sinus Infections
If you suffer from allergies like hay fever (allergic rhinitis), you might notice “allergic shiners”-dark circles under your eyes that can make deep eyes look. This happens because allergies cause inflammation and can affect blood flow around your eyes. Allergies can cause sudden swelling of the face, which may affect the eyes. When allergies cause swelling in the face, the skin around the eyes can become inflamed and puffy, causing the appearance of sunken eyes. A temporary condition like allergies or a sinus infection can make your eyes appear sunken and hollow.
5. Weight Loss
Weight loss can cause sunken eyes too. When you experience dramatic weight loss, you lose fat from all over your body, including your face. This significant reduction in facial fat can make the area around your eyes look more hollow. Rapid weight fluctuations can shift facial fat distribution, leading to hollow or sunken areas beneath the eyes. Sometimes, weight loss is dramatic enough to cause sunken eyes. Extreme weight loss may cause blood vessels below the eyes to become prominent and the skin to be transparent, producing the appearance of sunken eyes. Your weight loss journey might come with an unintended consequence-sunken eyes! When you shed weight, you lose it everywhere, including the fat paddings in your face. As a result, your face becomes slimmer. However, if you lose a lot of weight rapidly or too much at once, your orbital fatty tissue might atrophy.
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Rapid weight loss lowers your levels of two proteins in the skin: elastin, which helps keep skin stretchy, and collagen, which provides support and structure. The faster you lose weight, the more likely you are to experience Ozempic face.
6. Genetics
Sometimes, sunken eyes are simply in your DNA. Just like eye color or hair type, the way your eyes sit in their sockets can be inherited. A person’s genetics or DNA can cause deep set or sunken eyes. As an example of the effect of DNA, the position of the eyes in the sockets is due largely to genetics. If under-eye hollows run in your family, you may be genetically predisposed to developing them, regardless of age or lifestyle. If you’re wondering where your under-eye hollows came from, your parents might be to blame. The position of the eyes in the sockets is due largely to genetics. The eyes’ position in the eye socket is genetic.
7. Smoking
A 2019 cross-sectional survey of women ages 18-75 years associated smoking with tear-trough hollowing, among other signs of premature aging. Smoking causes collagen and skin elasticity degradation. These losses can cause the skin on the face to sag and the eyes to appear sunken. Tobacco smoke causes collagen and elastin degradation. When you stop smoking, you will quickly see an improvement in your skin tone.
8. Trauma
Any injury to the face or the bones around the eyes, including surgery, can cause the eyes to appear sunken. For example, classic orbital blowout fractures can cause soft tissue changes in adults, giving the appearance of a sunken eye. Enophthalmos, characterised by one or both sunken eyes, may result from trauma, bone loss, weight loss, autoimmune diseases, or conditions like metastatic breast cancer. Inflammation and swelling from eye trauma can be one of many sunken eyes causes.
9. Anti-glaucoma eye drops
Certain eye drops to treat glaucoma may cause skin darkening around the eyes as a side effect. This can give the appearance of sunken eyes. People can discuss side effects with a doctor if they are using eye drops to treat glaucoma. A healthcare professional may be able to prescribe medication for sunken eyes due to medical conditions, such as allergies and sinus problems. These may include antibiotics for sinus infections or antihistamines and eye drops for allergies.
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10. Nutritional deficiencies
Undernourishment and a poor diet cause vitamin and mineral deficiencies, contributing to collagen loss and the appearance of sunken eyes. Vitamin and mineral deficiencies can cause the sunken eye look.
11. Medical Conditions
On occasion, sunken eyes are a sign of a serious medical condition that needs attention. If dark circles and under-eye hollowness don’t disappear after months of applying the tips above, or if they are accompanied by other symptoms, such as nasal congestion, pain, fatigue, and sudden weight loss, visit your doctor. Enophthalmos is a medical term for sunken eyes caused by conditions that require medical attention, such as bone fracture, sinus diseases, vascular problems, and more.
How to Address Sunken Eyes
How to get rid of sunken eyes? When sunken eyes are more pronounced or persistent, especially due to aging, medical treatments can offer effective solutions. After getting dermal fillers to correct sunken eyes, integrating healthy habits into your routine is crucial for extending the longevity of your results and promoting overall eye health. Think of it as a partnership: the filler provides the immediate correction, and your self-care ensures those beautiful results last.
Medical Treatments
Dermal Fillers (Hyaluronic Acid Injections): This is a highly effective and popular option. While some surgical options exist, a popular and less invasive approach involves under eye filler. Dermal fillers are injectables that fill sunken facial features with a gel-like substance to restore lost volume. A naturally occurring substance called hyaluronic acid is carefully injected into the tissue under your eye. This helps to restore lost volume, plumping up the hollow area and making your eyes look less sunken and more refreshed. Under-eye fillers typically contain hyaluronic acid, which hydrates, plumps, and rejuvenates the under-eye area. The procedure is typically quick and often painless.Eyelid filler procedure is painless and uses hyaluronic acid to fill sunken areas around the eyes. Results are immediate right after the treatment with minimal downtime. Temple fillers offer immediate improvement with minimal downtime. A hyaluronic acid-based filler is injected into the temple hollow using a needle or cannula. Tear trough fillers provide a quick, painless procedure with long-lasting results. The area is numbed, filler is precisely injected, and expert skincare advice ensures lasting effects.
Cosmetic Surgery: For more long-term and dramatic results, surgical options are available. Cosmetic surgery is the best option for patients who want long-term results for their sunken eyes. It involves more risk and recovery time than non-invasive cosmetic treatments, but the results are more dramatic. One option people turn to is Blepharoplasty, or eyelid lift. It’s important to understand that blepharoplasty does come with some degree of risk. That’s why we recommend getting hyaluronic acid fillers instead. This treatment option will offer fantastic results with minimal downside.
Lifestyle Adjustments and Home Remedies
Lifestyle changes and home remedies may also help to reduce sunken eyes in some cases. However, further research is necessary to understand if certain home remedies are actually effective at improving the appearance of sunken eyes.
Stay Hydrated: Water is essential for every part of your body, especially your skin. If your sunken eyes are due to dehydration, simply drinking enough water can make a big difference. Water is the most necessary thing the body needs to stay healthy. It affects every organ in the body, including the largest of them all - the skin. People with sunken eyes due to dehydration may notice improvement by drinking enough water. People may need to increase their water consumption in the following circumstances: they are experiencing vomiting or diarrhea, they have a fever, they are in a hot climate, they are exercising.Health experts agree that drinking about eight glasses of water daily is optimal. Drinking enough water is crucial for keeping your skin and eyes fresh. Dehydration can cause your eyes to look tired and sunken. Try to drink water throughout the day and reduce alcohol, as it can dehydrate you quickly.
Get Enough Quality Sleep: Consistently getting 7-9 hours of restful sleep each night can make a significant difference. During sleep, the body gets rid of toxins, reduces inflammation, and heals itself. Your eyes can look tired and hollow if you do not get enough sleep. Try to get between 7 and 9 hours of sleep every night to allow your body to heal and rejuvenate. As you rest, your skin takes the time to rebuild itself. So when you cut corners on sleep, you’re robbing your skin out of much-needed recharge.
Avoid Rubbing Your Eyes: Frequently rubbing or scratching your eyes can irritate the delicate skin underneath and contribute to a more tired or sunken appearance.
Use Under Eye Cream: Applying a good under eye cream is an easy way to nourish the delicate skin. Daily skin care is necessary to ward off aging signs and keep your skin supple. If you have sunken eyes, introduce a moisturizing eye cream into your skin care. This is particularly helpful if you’re someone who works hard, gets little sleep, or is often exposed to pollution, dust, and sun. A proper eye care routine can help improve the look of sunken eyes. Using the right products, like eye serum, eye creams, and LED under-eye patches, can make a noticeable difference. These products deeply hydrate, brighten, and stimulate collagen production.
Under Eye Masks: Whether you use homemade masks with ingredients like cucumber or tomato, chilled tea bags, or convenient store-bought eye masks, this method offers relaxation and a boost of moisture to the skin around your eyes. Cold compresses can also help reduce puffiness.
Almond oil: Anecdotal evidence may suggest that almond oil can lighten discoloration underneath the eyes, reduce puffiness, and lock in moisture. People may apply almond oil underneath the eyes or may use cosmetics and skin care products containing almond oil. However, almond oil can cause skin and eye irritation. If this occurs, people should stop using the oil and may need to wash the eye out with water.
Raw potatoes: Some people may suggest that laying a slice of raw potato on the eyes for a short period may reduce puffiness and lighten dark circles below the eyes. Potatoes contain vitamin C, enzymes, and starch, which may nourish the thin skin below the eyes. The coolness of raw potatoes may also help reduce blood vessel inflammation to minimize swelling and a dark appearance.
Tea bags: Tea contains antioxidants and flavonoids. Applying damp, warm teabags may help improve the appearance of sunken eyes by promoting circulation and relaxing the eye nerves and muscles. Boil two tea bags for five minutes and place them under your eyes once they’ve cooled. Before application, people should squeeze out excess water and ensure the tea bag is not too hot.
Cucumber slices: Cucumber is a popular home remedy for dark circles and sunken, inflamed eyes. A person can place cucumber slices under the eyes for a cooling effect and to reduce swelling.
Fish oil: Fish oil is rich in fatty acids, making it an anti-inflammatory that promotes the healing of damaged cells. People may choose to include fish oil in their diet or apply it topically to the skin.
Lemon juice: Lemon polyphenols may have an anti-aging effect. For some people, including lemons in the diet may help to improve the appearance of sunken eyes.
Nutrient-rich foods: Nutritionally rich foods promote collagen production, help remove toxins, and improve skin tone and texture. A nutrient-rich diet is key for maintaining vibrant skin. Foods packed with vitamins A, C, and E support healthy cell regeneration, keeping your skin firm and reducing the appearance of sunken eyes. You can try eating more leafy, dark green vegetables like spinach, broccoli, sprouts, and kale because they have a lot of antioxidants. It’s also a good idea to cut back on caffeinated drinks such as tea and coffee.
Quit smoking: Tobacco smoke causes collagen and elastin degradation. When you stop smoking, you will quickly see an improvement in your skin tone. If you smoke, quit! At first glance, it might not seem like smoking has much to do with your sunken eyes. But it does! Smoking destroys collagen. As we’ve already mentioned, collagen is the protein that gives your skin shape and resilience. It provides the structure that keeps your skin from sagging.
Sunscreen: Sunscreen is the best preventative measure for all skin concerns related to sun damage, including sunken eyes. UV rays from the sun can damage the delicate skin around your eyes, leading to wrinkles, droopiness, and dark shadows.
Microneedling: Microneedling is another popular cosmetic treatment for the under-eye area. It uses tiny needles to create micro-wounds on the skin, increasing collagen production.
PRF and EZGel injections: A new generation of anti-aging injectables, PRF and EZGel are made from your own blood and contain a high concentration of platelets and growth factors that are slowly released in the tissue to rejuvenate the skin.
Massage: Facial massage and lymphatic drainage effectively increase circulation, remove toxins, and improve facial skin issues, including dehydration and dark circles. You can also gently massage around your eyes to improve blood flow and reduce puffiness.
Addressing "Ozempic Face"
When you start taking Ozempic®, you may feel hopeful about the results to come. But it’s always important to know about all the possible side effects, including a harmless but sometimes unwelcome effect sometimes called “Ozempic face.”
“The term ‘Ozempic face’ refers to the changes in the face that can happen with rapid weight loss,” explains endocrinologist Vinni Makin, MD. “It’s characterized by gauntness, sunken cheeks, new wrinkles and loose skin on the face and neck.”
‘Ozempic face’ isn’t a side effect of the medication itself. Rather, it’s a side effect of the rapid weight loss the medication can bring. Facial changes can also occur after having bariatric surgery or adopting lifestyle changes that cause very rapid weight loss.
Losing facial fat can change the way your face looks, of course. But instead of just looking thinner, you may be surprised to find that you look older, too. Rapid weight loss causes you to lose subcutaneous fat from your face and neck, which causes facial hollowing and sagging skin. We all lose subcutaneous fat in the face as we get older, but rapid weight loss can cause these processes to occur more rapidly, which can mimic the natural aging process. Rapid weight loss lowers your levels of two proteins in the skin: elastin, which helps keep skin stretchy, and collagen, which provides support and structure.
When rapid weight loss affects your face, you may see signs of aging in your face that seem to come out of nowhere. Some hallmarks include wrinkles, sunken eyes, thin lips, sagging skin, and more prominent bone structure.
To try to prevent facial changes associated with rapid weight loss, consider a more gradual approach instead. Focus on slower weight loss - about one to two pounds per week. You can also minimize these side effects by using your medication in combination with a healthy diet and exercise regimen.
Ozempic face won’t fade with time. If you regain the weight you lost, your face may start looking fuller again, too. But that doesn’t mean there’s nothing to be done about it. Cosmetic fillers or skin tightening procedures can help minimize the appearance of wrinkles or sagging skin. Options include noninvasive procedures like microneedling, platelet-rich plasma (PRP injections) and radio frequency (RF) skin tightening, injectables like Botox® and dermal fillers, and cosmetic procedures.
When to Seek Medical Advice
Sunken eyes are not always due to an underlying health condition and can happen as a person ages. However, if sunken eyes appear to worsen despite getting enough sleep and staying hydrated, or if a person experiences other symptoms, they can speak with a healthcare professional about treatment options.
Additional symptoms that may indicate another problem include:
- congestion of the nasal passages
- itchy, dry, or red eyes
- ongoing fatigue
- extreme or unusual weight loss or appetite problems
- nausea and other digestive issues
- headaches
- feelings of depression or anxiety due to sunken eye appearance
A doctor may use a physical exam and other tests to diagnose the underlying cause of sunken eyes and administer the most appropriate treatment.