Causes, Prevention, and Treatment
Under-eye contour depression, also known as sunken eyes, is one of the most common aging signs along with dehydration and lack of sleep. The condition can affect younger people too.
Figure 1 – Large eye sockets (orbital openings) can create regions of sunken contour typically below the lower eyelid as they lack the skeletal support to prop it up.
Why Does Under-Eye Contour Depression Affect Facial Aesthetic?
People who have under-eye contour depression do not like looking in mirrors to avoid noticing their sunken eyes. The symptoms of sunken eyes include grooves, dark circles, and skin thinning under the eyes associated with dark shadows over the lower eyelid. The entire face looks exhausted all the time.
Aging is the main cause of under-eye contour depressions. It is an indicator of age starting from the late 30s.
What Causes Under-Eye Contour Depression?
Under-eye contour depression is usually not a worrying sign. However, in some cases, it can indicate a health issue.
Ageing
As we age, our bodies start losing fat density and bone strength. Our faces lose their youthful support. The collagen in our faces breaks down and the production of new collagen deteriorates. Our skin becomes thinner and loses its elasticity.
The formation of grooves and depressions under the eyes is a direct result of all of these changes. (1)
Rapid Weight Loss
Rapid weight loss means that you lose fat from all over your body, including your face. The area under your eyes loses fat rapidly leaving a depression. The blood vessels in this area may also be more visible and transparent than before.
It is better to consult your doctor if the weight loss is rapid and unexplained. (2)
Genetic Predisposition
If under-eye depression runs in your family, you may have it throughout your life. The shape and position of your eyes in their orbits depends on your genes in the first place. (3, 4)
Poor Sleep
Not getting enough sleep is a common cause of under-eye contour depression. People who get less than 7 hours of sleep per day usually develop dark circles and sunken eyes. (5, 6)
Dehydration
Dehydration leads to under-eye contour depression in children. Diarrhea, vomiting, dry mouth, low urine output, and thirst are associated with sunken eyes in children. (7
Sun Exposure
Prolonged sun exposure enhances the production of melanin, which makes your skin darker. Sun exposure can make sunken eyes worse in people with darker skin. (8, 9)
Allergies
Seasonal allergies worsen dark circles and sunken eyes. It is called allergic shiners. Allergies irritate the areas under the eyes and can make the condition worse. (10)
Sinus Infections
Dark circles and sunken eyes are common symptoms of sinus infections along with nasal congestion and pressure on the eyes. (11)
Smoking
Smoking breaks down the collagen in your face and inhibits the production of elastin making the face lose its elasticity and structure. Heavy smokers usually have sagging skin, facial wrinkles, dark circles, and sunken eyes. (12, 13
How To Prevent Under-Eye Contour Depression?
Hydration
Water is necessary for our bodies including our skin. Hydration improves under-eye contour depression and tightens skin. (14)
Sleep Well
7 to 9 hours of good, night sleep can prevent the appearance of sunken eyes and other facial aging features.
Almond Oil
Almond oil is rich in vitamin E, which can nourish the skin under the eyes and prevent the appearance of sunken eyes and dark circles. (15)
Raw Potatoes
Potatoes are rich in enzymes and vitamin C, which can improve the texture of the skin under the eyes. In addition, potatoes can soothe skin inflammations, which reduce the appearance of dark circles and sunken eyes. (16)
Tea Bags
Applying tea bags under the eyes can improve the appearance of under-eye grooves since they contain antioxidants and flavonoids, which can promote blood circulation and tightens facial skin. (17)
Cucumber Slices
Cucumber slices can be applied under the eyes to reduce dark circles and under-eye grooves. It is a common traditional home remedy. (18)
Fish Oil
Fish oil contains high amounts of fatty acids, which are known for promoting healing and replacing damaged cells. You can take fish oil capsules or apply fish oil directly under the eyes. (19)
Lemon Juice
Lemon juice can remove dead skin cells and reduces dark circles. Apply diluted lemon juice to reduce skin irritation and improve sunken eyes appearance. (20)
Facial Exercises
Doing facial exercises improves the texture and structure of the entire face including the areas under the eyes. The exercises are called Facial Yoga and they can tighten the skin of the face. There is little evidence about the efficacy of facial yoga, but people who do these exercises report that they can enhance the production of collagen and improve the overall appearance of the face.
Figure 2 – Image on the left shows pre-operative aging signs while the image on the right shows post-operative corrections of aging signs including under-eye contour depression.
How to Treat Under-Eye Contour Depression?
Antibiotics and Other Medications
Antibiotics and medications are recommended for sunken eyes caused by health issues. For example, when sinus infections and allergies are treated, the under-eye contour depression improves. Sinus infections are usually treated with antibiotics while allergies are treated with antihistamines and eye drops.
Dermal Fillers
Dermal fillers such as Perlane, Restylane, and Juvederm depend on injecting certain substances such as hyaluronic acid into the skin under the eyes. Hyaluronic acid is made naturally in the skin. Dermal filler injections are painless and the entire procedure takes a few minutes. Dermal fillers do not last forever and must be redone from time to time. Injectable fillers fill the depressions and provide your face with more volume. (21)
Blepharoplasty
Blepharoplasty can remove all signs of aging from your face including sunken eyes. Blepharoplasty balances the tissue distribution in the face. The procedure depends on removing the excess fat from certain areas and tightens the facial skin. After the procedure, your face will be more youthful and awake. (22)
Face-Lift
A facelift is one of the best procedures to fight the facial signs of aging such as skin relaxation, fine lines, folds, grooves, and cheeks and jaw problems. The face-lift procedure can correct your facial problems no matter the cause. Whether your under-eye contour depression is caused by sun damage, smoking, skin thinning, loss of facial fat, chronic stress, or genetic predisposition, a facelift can be the best solution. (23
Figure 3 – (A) Injection around the orbital rim by linear threading, using the
droplet technique. (B) Entry point for an injection to treat a groove
when using a cannula. (C) Entry point for an injection to treat hollowness when using a cannula. IOF, infraorbital foramen.
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