This is What Will Get Rid Your Your Eye Bags | Dr. Sam Ellis

Key wellness / self-care strategies + productivity-style takeaways (what to do for under-eye bags)

1) Start by identifying the type of under-eye issue (most important “strategy”)

Dr. Sam Ellis emphasizes that the #1 mistake is treating the wrong problem—so diagnose which “bag type” you have first, because treatments differ.

• Type 1: Puffiness (fluid retention / poor lymphatic drainage)

  • Worse in the morning; improves as the day goes on
  • Can fluctuate with diet (especially salt)

• Type 2: True eye bags (fat bulging / herniation)

  • Size/structure doesn’t change throughout the day
  • Often genetic; can worsen with age
  • Self-assessment: gently press on the eyeball (ideally with someone watching or via video recording); bulging suggests fat herniation

• Type 3: Hollowing / volume loss

  • Looks like “bags” via indentation/shadowing
  • Often genetic; can become more noticeable with weight loss/aging and possibly with GLP-1 use

• Type 4: Dark circles

  • Pigment-type: remains when you pinch skin
  • Vascular-type: skin color doesn’t change when pinched; vessels/muscle show through

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Home / at-home routine for puffy (Type 1) under-eye bags

A) Use caffeine-based under-eye products

• Caffeine can cause mild vasoconstriction, helping with dark circles and making puffiness less obvious.
• Examples mentioned:
  • The Ordinary 5% caffeine under-eye solution
  • The Inkey List caffeine under-eye cream

B) Look for peptides that support fluid drainage

• Acetyl tetrapeptide-5 (used in some eye creams) to help with fluid retention/drainage.

C) Cold + gentle lymphatic massage

• Cold therapies:
  • Frozen spoons (classic method)
  • Cold facial plunge or cold roller
• With rollers or fingertips:
  • Press up and out gently
  • Goal: lymphatic drainage
• Framing: “cold + massage” is extra helpful.

D) Evening/morning lifestyle habits to reduce fluid retention

• Reduce at night:
  • Alcohol
  • Salty foods
• Sleep positioning:
  • Sleep with head slightly elevated (about 10° using an extra pillow)

E) If allergies contribute, use consistent antihistamine use

• If you have seasonal allergies (itchy/watery eyes, stuffy nose, sinus pressure), allergies may worsen under-eye appearance.
• Key strategy: consistency
  • Auto-treatment “only when puffy” may be insufficient—you typically need chronic histamine suppression.
• Example discussed:
  • Zyrtec (cetirizine) 10 mg right before bed for at least a month, then evaluate whether it helps.

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Office / in-clinic options for puffy (Type 1) under-eye bags

A) Focus on skin tightening if there’s loose skin

• If puffiness comes with looseness, tightening can make puffiness look less noticeable.
• Resurfacing options mentioned:
  • Microneedling
  • Fraxel laser (collagen stimulation / smoothing / tightening)

B) Be cautious with Botox around the eyes for puffiness

• Botox that relaxes periocular muscles can reduce “muscle squeezing” that may help drainage.
• Dr. Ellis reports under-eye bags worsening in some cases after Botox for crows feet.
• If pursuing Botox:
  • Discuss conservatively with the injector
  • Start with a lower dose and monitor effects

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What to avoid / treat differently for true fat bulging (Type 2)

A) Avoid expecting eye creams or minimally invasive options to “fix” fat pads

For fat pad herniation, Dr. Ellis states:

• “No eye cream” and no minimally invasive office procedure will make an exciting difference.
• Recommended next step:
  • Consult a plastic surgeon for lower blepharoplasty (surgical repositioning/removal).

B) Filler to camouflage fat pads may backfire—especially with skin laxity

• Filler may be reasonable if you have very tight skin (often ~40 or under).
• With skin laxity, filler can make bulging look worse.
• Dr. Ellis describes patients later requesting dissolution because results weren’t good.

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Home / in-clinic strategies for hollowing / volume loss (Type 3)

A) Add retinoids to improve texture + collagen + thickness

• Use retinol/retinaldehyde/retinoid around the eyes if tolerated.
• Benefits:
  • Smooth fine lines/wrinkles
  • Stimulate collagen to thicken skin
• Example mentioned:
  • Medik8 “retinel” eye cream (Level 3 mentioned)
• Alternative:
  • Use a retinoid you already tolerate on your face near the eyes if sensitivity is manageable.

B) Consider “volume” strategies (trial mindset, not instant)

• Mentioned option:
  • Volufiline (example given: a new Ordinary offering)
• How to use (per video):
  • Don’t apply directly on dry skin; mix with moisturizer or apply on top
  • Suggested method: apply normal eye cream first, then a small drop of volufiline on top
• Time horizon:
  • Try for 6–9 months to judge benefit
  • Trials were described as “not super impressive,” but perceived risk may be low.

C) For faster/more predictable volume: under-eye filler (tear trough)

• Hyaluronic acid gel injected under the eye for support.
• Dr. Ellis emphasizes:
  • Under-eye filler’s reputation is often tied to wrong candidates or poor technique.
  • Results can be subtle and natural.
  • It is not permanent and is dissolvable if needed.

D) Restore volume globally first (balance matters)

• If hollowing exists elsewhere (temples/cheeks), tear trough is often the last area addressed.
• Approach:
  • Restore other volume first (temples/cheeks)
  • Reassess under-eyes after—this may reduce needed tear trough filler or skip it.

E) Other volume-adjacent options

• PRP/PRF (platelet-rich plasma / platelet-rich fibrin)
  • Derived from your own blood; offers subtle volume stimulation
• Fat transfer
  • Typically discussed with plastic surgeons
  • More unpredictable than filler
  • Sometimes better aligned if doing other facial surgeries (e.g., facelift)

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Dark circles (Type 4)

• Dr. Ellis calls dark circles a “different beast” and indicates there’s a separate video.
• Guidance:
  • If you have dark circle questions, comment them for a dedicated video.

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Bottom-line “system” for best results (Dr. Ellis’s combined strategy)

• Combine:
  • Good at-home skincare
  • Good lifestyle habits
  • Appropriate office treatments
• Best outcomes come from matching the treatment to the under-eye type (puffiness vs fat vs hollowing vs pigment/vascular causes).

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Presenters / sources

• Presenter: Dr. Sam Ellis (board-certified dermatologist)
• Brands/products mentioned:
  • The Ordinary (5% caffeine under-eye solution; also a volufiline product mentioned)
  • The Inkey List (caffeine under-eye cream)
  • In Beauty (extreme eye firming/contouring cream mentioned)
  • Medik8 “retinel” eye cream (Level 3 mentioned)
• Medication mentioned:
  • Zyrtec (cetirizine) 10 mg (spelled as “Zerek” in subtitles)