A: If the swelling under your eyes is due to hereditary fat pads, you probably have them all the time (not just during allergy season or when you wake up in the morning). In that case, the fat can be dissolved with phosphatidylcholine injections (instead of extracting it through surgery), says Cheryl M. Burgess, MD, medical director at the Center for Dermatology and Dermatologic Surgery in Washington, D.C. Do allergies bring on your puffiness? Try an antihistamine to reduce inflammation. Inadequate lymphatic drainage can also cause puffiness, most noticeable when you wake up, says Burgess. Try sleeping with your head elevated to discourage fluid pooling under your eyes. Never use a concealer lighter than your skin tone on undereye bags; you'll accentuate them, says Renato Almeida, makeup artist for Shiseido. Instead, try a concealer as close as possible to your skin tone, and dab a little highlighter on the inner corners of your eyes to brighten them and draw attention to your irises rather than your puffiness.
Bottom line: In order to treat undereye bags effectively, you first have to figure out what's causing them.