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Sunken (Hollow) Eyes: Causes, Symptoms, Treatment

Kristina Cadwell  
November 6, 2024  

In most cases, sunken eyes are an aesthetic, not a medical concern. They give a tired, fatigued look, causing people to feel self-conscious about their appearance.

This article explains what causes sunken eyes and gives tips on how to get rid of them through lifestyle changes, cosmetic treatments, or surgery.

Sunken eyes and ways to eliminate them

What Are Sunken (Hollow) Eyes?

Sunken eyes (also called tear trough hollows) are a genetic or acquired condition characterized by dark circles and hollowness in the under-eye area. It gives an unattractive, fatigued look affecting people’s social and psychological wellbeing.

Symptoms of Sunken Eyes

Sunken eyes are characterized by one or a combination of these symptoms:

  • Dark under-eye circles
  • Shadows under the lower lids
  • Hollowness in the under-eye area
  • Deep-set eye sockets
  • Sagging lower lids
  • Thin, transparent skin and visible blood vessels under the eyes

Note: Check out our recommendation of best eye creams for dark circles.


What Causes Sunken Eyes?

Common causes of sunken eyes are medically harmless and include:

  • Genetics – Genes determine the position of our eyes in the sockets, so the sunken-eye look can run in families.
  • Aging – As we age, we lose collagen and elastin, the proteins that keep the skin plump and firm. The loss of collagen and elastin is the main reason our skin gets thinner, sags, and the eye socket bones recede, appearing hollow.
  • Nutritional deficiencies – Undernourishment and a poor diet cause vitamin and mineral deficiencies, contributing to collagen loss and the appearance of sunken eyes. This is especially true for people who lack vitamins C, K, E, B12, and iron.
  • Dehydration – Low water intake causes collagen loss, thin and dry skin, and potentially sunken eyes.
  • Sun exposure – UV rays accelerate collagen degradation, contributing to many premature aging signs, including sunken eyes.
  • Sleep issues – Insufficient and interrupted sleep often causes dark circles and hollowness under the eyes.
  • Weight loss – The face is one of the first areas to lose volume when we lose weight. This can emphasize the hollowness in the under-eye area, especially when weight loss happens quickly.
  • Smoking – Nicotine degrades collagen and elastin, causing sagging skin, dark circles, and a hollow under-eye area.
  • Allergies – Seasonal and other allergies cause nasal congestion, leading to dark under-eye shadows and hollowing.
  • Sinus infection – Like allergies, sinus infections can affect the skin under the eyes, making them appear sunken.
  • Horner’s disease – This rare neurological syndrome affects one or both eyes. It is often accompanied by other symptoms, such as eyelid drooping (ptosis) and constricted pupils.
  • Thyroid conditions – Both hyperthyroidism and hypothyroidism can cause symptoms of sunken eyes, including dark circles and eyeballs sinking into the socket.   

How to Get Rid of Sunken Eyes Naturally

Hydration for sunken eyes

There are several ways to eliminate or reduce sunken eyes naturally, depending on what caused them.

Change Your Lifestyle

Dedicated skin care shows the best results when combined with lifestyle changes. Try to eliminate or reduce harmful habits and introduce healthy ones to see an improvement in your skin and overall health.

  • Stay hydrated - Health experts agree that drinking about eight glasses of water daily is optimal. Hydration from within combined with a moisturizing eye cream rejuvenates the skin around the eyes and relieves the tired, sunken-eye look.
  • Eat nutritionally rich foods - Nutritionally rich foods promote collagen production, help remove toxins, and improve skin tone and texture. Have at least four portions of vegetables every day, especially leafy greens such as broccoli, cabbage, celery, and lettuce.
  • Get enough sleep - During sleep, the body gets rid of toxins, reduces inflammation, and heals itself. Scientists recommend getting between seven and nine hours of uninterrupted sleep every night for general wellbeing and a rested look.
  • Quit smoking - Tobacco smoke causes collagen and elastin degradation. When you stop smoking, you will quickly see an improvement in your skin tone. Eliminating this harmful habit helps reduce sunken eyes, besides decreasing your chances of lung cancer and other serious illnesses.

Use Home Remedies

User experience shows that some home remedies can refresh the under-eye area and reduce the sunken appearance.

  • Tea bags – Boil two tea bags for five minutes and place them under your eyes once they’ve cooled. Tea contains antioxidants and flavonoids, which improve blood circulation and can briefly refresh the under-eye area.
  • Cucumber slices – Place a cucumber slice under each eye to cool the area and minimize the appearance of dark, puffy eye bags.

Treatments for Sunken Eyes

In addition to improving your lifestyle habits, you may need a more effective cosmetic solution. The following products and treatments are an excellent aid in correcting sunken eyes.

Skincare Products

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. Use ingredients that hydrate and reduce dark circles, puffiness, and wrinkles:

  • Hyaluronic acid
  • Vitamin C
  • Vitamin E
  • Retinol
  • Caffeine

Alastin Restorative Eye Treatment is an excellent product for the delicate under-eye area that targets the cosmetic issues associated with sunken eyes.

Sunscreen is the best preventative measure for all skin concerns related to sun damage, including sunken eyes. Use a broad-spectrum SPF 30+ sunscreen as the last step of your morning skincare routine. Elta MD UV Daily is on many beauty magazines’ “best sunscreen” lists because it provides powerful protection and hydration.


Note: Read our guide to choosing the best sunscreen.


Non-Surgical Cosmetic Treatments

If targeted skin care and lifestyle changes don’t improve your condition, consult a medical cosmetic professional about non-surgical options for sunken eyes. The Vibrant Skin Bar team recommends the following treatments.

  • Dermal fillers - Dermal fillers are injectables that fill sunken facial features with a gel-like substance to restore lost volume. Under-eye fillers typically contain hyaluronic acid, which hydrates, plumps, and rejuvenates the under-eye area. The treatment is minimally invasive, quick, and requires no downtime.
  • Laser treatment - A laser delivers light energy to the skin, stimulating collagen production, regenerating cells, and improving various skin conditions. Laser treatment for sunken eyes helps replace lost volume in the under-eye region and smooth out the area.
  • 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. Microneedling effectively reduces under-eye shadows, puffiness, and other aging signs.
  • 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. They are excellent tear trough correction treatments.
  • Massage – Facial massage and lymphatic drainage effectively increase circulation, remove toxins, and improve facial skin issues, including dehydration and dark circles. People who want to avoid invasive treatments can try this holistic approach.

Cosmetic Surgery

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. The types of surgery used for sunken eyes include:

  • Eyelid surgery (blepharoplasty) – removes excess skin and fat around the eyelids.
  • Fat transfer injection – involves harvesting fat from a different body part and injecting it into the under-eye area.
  • Tear trough implant – involves inserting silicone implants into the tear trough hollows.

Medications

If allergies or a sinus infection are giving you dark circles and a tired look, your condition will improve with medication such as antihistamines or antibiotics, which treat the underlying cause. Consult your medical provider for the best solution.   

When Should You See a Doctor?

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. They will assess your general health and perform lab tests to discover the cause of your condition.

Sunken Eyes: FAQ

The following questions and answers can help you assess your condition and choose the best solution for your hollow under-eye area.

What Causes Eyes to Look Sunken?

The sunken appearance under the eyes can be the result of harmless genetic or lifestyle factors (such as bone structure, aging, or lack of sleep) or a sign of a medical condition (sinus infection, thyroid disorder, etc.).

What Deficiency Causes Sunken Eyes

Vitamin and mineral deficiencies can cause the sunken eye look. Deficient nutrients include vitamins C, E, K, B12, and iron.


Note: Learn which vitamins and minerals are the best antioxidants in skin care and how they help improve the complexion.


Do Sunken Eyes Mean Dehydration?

In some cases, sunken eyes result from dehydration. If that is causing your tear trough hollows, drinking more water and applying artificial tears can improve your condition.

What Is the Difference Between Ptosis and Enophthalmos?

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. Ptosis is a medical term for a condition manifested as upper eyelid drooping, caused by muscle atrophy due to aging, eye injury, or disease.

Conclusion

Sunken eyes often lower self-esteem and occasionally lead to anxiety and depression. There are many ways to improve the condition on your own, but if you don’t get results, we can help.

Our fantastic team at Vibrant Skin Bar is always happy to discuss quick, safe, and effective solutions for your aesthetic concerns. Contact us today to get started on a journey to younger, glowing skin!

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About the Author:
Kristina Cadwell
PA Kristina Cadwell graduated from Arizona State University with a Bachelor of Science degree in Biology. She then completed the Physician Assistant program at A.T. Still University graduating with a Masters of Medical Science degree. Kristina has been working in the Aesthetic Medical field for over 10 years. She is certified in neurotoxin cosmetic injection, dermal fillers, Plasma Pen skin tightening, chemical peels, and laser therapy. She is known for producing natural results and has extensive knowledge in diet and exercise allowing her to help you achieve vibrant skin from the inside out.
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