Sunken Eyes: Causes and Treatment

“Sunken eyes” is another way of saying you have bags under your eyes.

Officially known as enophthalmos, sunken eyes make your eyes appear to have sunk into your face, making your face appear somewhat hollow.

Causes include a family history, dehydration and a lack of sleep.

What Are Sunken Eyes?

Sunken eyes is the colloquial expression of a medical condition call enophthalmos. Both are a way of saying that you have bags under your eyes.

Also known as tear troughs, sunken eyes are when hollows appear under the eyes. The soft skin under the eyes seems to move inwards, leaving a hollow.

This hollow usually looks darker than the rest of the skin. While this may not cause any vision problems, it can cause cosmetic concerns. Fortunately, there are several ways that doctors can rectify sunken eyes. 

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Symptoms

The exact symptoms of sunken eyes may differ from one person to another. The most common symptoms are:

• A hollow below the eyes
• A shadow or darker appearance below the eyes
• Thin skin under the eyes, sometimes with visible blood vessels 
• Redness around the eye due to skin thinness 
• A sagging appearance on the lower eyelid 
• A fatigue appearance on the face 

Causes

Sunken eyes show up for various reason. Among them

• Aging
• Genetics
• Weight loss
• Dehydration
• Lack of sleep
• Medical conditions

Aging

As we age, we tend to lose collagen protein, which protein gives the body flexibility and strength. When protein levels decrease, skin thins and loosens.

Skin changes are most noticeable around the eyes because the skin is so soft in the face. When the skin lacks support, it moves inwards, creating a hollow.  

Genetics

There is such a thing as a young, healthy people with sunken eyes. But that is not the norm for this condition. Hollow eyes of young people typically stem from a family history of sunken eyes. 

Weight Loss

When you lose a lot of weight, fat reduces in all parts of your body. Your eyes will lose fat, too, and this can cause the skin around the eyes to become thin and move inwards. 

Dehydration 

Low levels of water in the body, or dehydration, makes your body cells lose their plumpness. Consequently, your skin becomes thin and loose. This change is noticeable under your eyes as sunken eyes. Children are more susceptible to bacteria and diseases that cause dehydration. Therefore, this trigger is more prevalent among children. 

Lack of Sleep

When you do not get enough sleep, you tend to wake up with dark circles under your eyes. If this is the reason for your appearance, the condition usually disappears after a few hours and after you have replenished your body with water and food.

Medical Conditions 

Certain medical conditions can cause sunken eyes. Among them are sinus infection, some types of cancer, HIV and thyroid disease. You can also develop sunken eyes as a result of an eye injury or eye surgery. 

Other causes of sunken eyes include trauma, lack of sleep, poor diet, smoking, exposure to the sun and allergies. 

Treatment

You can get rid of sunken eyes through treatment. Several options are available, including medical procedures and home remedies. Among them are:

• Dermal fillers
• Cosmetic surgery

Dermal Fillers 

Doctors use dermal fillers to restore lost volume under the skin and remove wrinkles. Many people prefer this treatment since it doesn’t involve surgery. Treatment involves injection below the eye to fill the hollow. Doctors use different types of fillers, but make sure the filler you get is FDA-approved.   

Cosmetic Surgery 

Cosmetic surgery involves using implants to fill up the hollow. This method provides a long-term solution, but it may require a longer recovery time. It’s a bit invasive but quite effective. 

Home Remedies

Home remedies you can try on sunken eyes are:

• Oils
• Hyaluronic serums and creams

Oils

Some types of oils can help keep your skin healthy. These include coconut oil, avocado oil, castor oil, olive oil, fish oil, and almond oil. Every night before you go to bed, apply the oil below your eyes and wash them off in the morning. 

Hyaluronic Serums and Creams 

Hyaluronic acid helps the skin stay hydrated. You can apply a cream that has this acid in the hollow areas. It acts like a sponge that holds water and keeps body cells plump. 

Complications of Sunken Eyes

Sunken eyes should not be a cause for medical concern. If you get them because of a family history or age, the hollow eyes will not indicate any health issue. However, you may get sunken eyes as a symptom of an underlying medical condition. In such a case, it’s best to seek medical attention to identify the specific cause. 

Prevention

Sunken eyes are preventable in some cases. You try to minimize the issue in a few ways:

• Drink a lot of water to stay hydrated and keep your cells plump.
• Get enough sleep. Adults generally need around eight hours of sleep a night.
• Maintain a healthy diet with a lot of vegetables to promote collagen production 
• Take vitamins, such as vitamin C or collagen supplements.
• Establish a skincare routine to minimize the dark shades under the eyes.
• Use almond oil to rejuvenate your skin and improve its appearance. 

When to See a Doctor

Having a sunken eye is reason enough to schedule a trip to the doctor. Any other symptoms are important and can help the doctor gain a clear understanding of what may be happening.

You should also see your doctor if:

• Your feel pain from an injury to the eye
• You have tried several home remedies, but your sunken eyes get worse with time
• Hollow eyes give you depression and anxiety

In the absence of acute trauma, doctors are likely to investigate the sunken eye carefully. A medical history, especially a recent one, is central to a potential diagnosis (and treatment).

References

1. Injectable Fillers Guide. American Board of Cosmetic Surgery.

2. Sudden Sunken Eye: A case of sudden onset unilateral enophthalmos in the absence of trauma. Abby Tang.

3. Enophthalmos. (November 2021). StatPearls.

4. Enophthalmos Clinical Presentation. (September 2018). MedScape.

5. Bags under eyes. (March 2021). Mayo Clinic.

6. Enophthalmos Clinical Presentation. (September 2018). Medscape.

7. Chapter 51 – Secondary Management of Posttraumatic Craniofacial Deformities. (2010). Plastic Surgery Secrets Plus (Second Edition).