Sunken Eyes? How To Treat Tear Trough Deformity: Causes And Possible Remedies

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Sunken Eyes? How To Treat Tear Trough Deformity: Causes And Possible Remedies

Under-eye hollows, sunken eyes, skeleton eyes - no matter what you call it, a tear trough deformity is one of the earliest and most striking signs of ageing. Here’s how you can treat it 

Sunken Eyes? How To Treat Tear Trough Deformity: Causes And Possible Remedies

Image Source: Dinodia

Everyone wants to delay premature ageing as much as possible, but there’s very little awareness of its symptoms and treatment methods. The under-eye area is the first to fall prey to ageing, stress, and unhealthy lifestyles. 

The tear trough area - space between the lower eyelid and upper cheek - starts to lose weight making you look tired and aged before time. The thinning skin makes the under-eye area look puffy and the shadows created by the hollowness start to resemble dark circles. This tear-trough deformity is what many refer to as sunken eyes or under-eye hollows. Other names include tear trough hollows, deepened upper eyelid sulcus and skeletonised eyes. 

Although a tear trough deformity is not a fatal flaw, it can affect your overall aesthetics and create a gloomy first impression. Fortunately, there’s a lot of extensive research on the subject including non-surgical treatment methods to under-eye hollows. But before we jump into treatment options, let’s take a look at what under-eye hollows really mean and their potential causes. 

What Is Tear Trough Deformity?

A tear trough deformity occurs when you lose the fatty tissue in the facial area between the lower eyelid and the upper cheek. This gives a hollowed-out look to the eyes with sagging skin under the lower eyelid.

Depending on whether or not they have under-eye bags, doctors classify the tear trough deformity into three groups: 

  • Class I: Patients who have excessive skin on the lower eyelid, but no bulging orbital fat in the tear trough area 
  • Class II: Patients who don’t have excessive skin on the lower eyelid, but mild to moderate orbital fat bulging
  • Class III: Patients who have both excessive skin on the lower eyelid skin as well as severe orbital fat bulging 

Many people confuse the shadow created by the under-eye hollows for dark circles, but they are not the same. Hence, the treatment methods vary accordingly.

What Causes Tears Trough Deformity? 

There are various reasons why people suffer from under-eye hollows. The contributing factors can range from ageing and genetics to lifestyle and health issues. Some key examples of contributing factors for under-eye hollows include:

  • Dehydration caused by excess consumption of coffee, soda and pre-packaged drinks
  • Deficiencies of vitamin C, vitamin K, and iron
  • Poor sleep quality or insomnia
  • Loss of collagen caused by ageing 
  • Dramatic weight loss 
  • Smoking
  • Inflammation in the tiny blood vessels below the eyes or blocked nasal passages due to allergies 
  • Sinus infections
  • Injury 

Anyone can have a tear-trough deformity, regardless of their gender or race. Similarly, while it’s more common in aged people, people from any age group can have under-eye hollows.

What Are The Treatment Options?

In cases where tear trough deformity results due to genetics or facial trauma, the patient may require medical management or cosmetic surgery. But for under-eye hollows caused by unhealthy living and lack of proper nutrition, patients can seek the following treatment methods: 

  • Dermal fillers, require an injection of hyaluronic acid into under-eye tissue
  • Surgical treatment in the case of eye fractures
  • Antibiotics for sinus infections 
  • Antihistamines and eye drops for allergies

“A lateral filler injection which uses high G prime fillers such as Juvéderm Volumafor, can be more effective for sunken eye treatment, as compared to dermal fillers,” says Dr Debraj Shome. This novel technique helps tighten the under-eye muscles and offers several other advantages such as: 

  • Lower filler volume injected into eye tissue 
  • Reduced unevenness in the under-eye hollows
  • Lightening the under-eye dark circles
  • The treatment procedure has little or no downtime 

Lastly, for those who seek at-home remedies for sunken eyes such as adequate hydration, good quality sleep, almond oil or vitamin E oil, applying raw potatoes and/or placing tea bags below the eyes, it may just do the trick. 

Post-Treatment Care: Activities To Avoid After Tear Trough Hollows Treatment 

According to Dr Debraj Shome, as the treatment for tear trough hollows is a non-surgical intervention, good rest and avoiding strenuous activities post-treatment for 48 hours is enough. Patients are also advised to take the following precautions after tear-trough surgery. These include: 

  • Avoid using make-up or other skincare products for at least the first four hours post-treatment
  • Avoid drinking alcoholic beverages for two days
  • Avoid saunas, sun beds, and tanning treatments for two weeks 
  • Avoid exposure of skin to extremely cold temperatures 


Under eye hollows, medically referred to as tear trough deformity, is typically caused by loss of fatty tissue in the space between the lower eyelid and upper cheek with ageing. However, unhealthy lifestyle habits like smoking, excess consumption of coffee, and pre-packaged drinks can also speed up the process. 

People can usually manage the effects with adequate hydration, good sleep, and by regularly applying almond or vitamin E oil. However, if at-home remedies produce no results, one can look into non-surgical treatment options like dermal fillers as well as lateral injection fillers to rejuvenate the under-eye area. 

Disclaimer: The above content is for informational purposes only and should not be used as a substitute for the advice of a qualified physician or doctor. The Company does not vouch for or endorse any of the above content, and disclaims any and all warranties, express or implied, relating to the same.