Understanding dermatochalasis: Causes, symptoms, and treatment options for droopy eyelids

If you've ever looked in the mirror and thought your eyelids could double as carry-on bags, you may have a condition known as dermatochalasis. Although many people believe that dermatochalasis is nothing more than a cosmetic problem, it can interfere with your vision, making it less safe to drive or perform other tasks. Sit back, relax, and find out what you can do if dermatochalasis is damaging your self-esteem or impairing your vision.

Overview of dermatochalasis

What is dermatochalasis?

Although it sounds scary, dermatochalasis is a common condition characterized by an excessive amount of skin on the upper eyelid. When the extra skin sags, it makes you look like you have bags under your eyes. You may even have coworkers or family members ask why you always look so tired. To quote Stephanie Tanner, "How rude!"

In addition to changing the appearance of your eyes, dermatochalasis may interfere with the function of your eyelids. For example, sagging skin may reduce your visual field, impairing your peripheral vision. This is just a fancy term for what you can see up, down, and off to the sides without moving your head.

Causes of droopy eyelids

Two proteins — collagen and elastin — provide structure for your skin. They also allow the skin to stretch and snap back into place. When you're young, you have plenty of these proteins. Don't believe us? Just pinch a baby's cheek (be gentle!) and see how long it takes for the skin to return to its normal position. It happens in the blink of an eye.

As you age, hormonal changes reduce the amount of collagen and elastin in your body. The main cause of droopy eyelids is the resulting loss of skin elasticity. Aging also makes it more difficult for the skin to heal, which may cause excess eyelid skin to droop after an eye injury.

Chronic eye rubbing and certain genetic variations also contribute to dermatochalasis. If you rub your eyes frequently, you may damage the muscles in charge of lifting the eyelids, causing them to droop. Some genetic variations affect elastin and collagen production, accelerating the effects of aging on the skin. You may have droopy eyelids if one of your parents had a genetic variation and passed it on to you.

Symptoms and impact of dermatochalasis

Common symptoms of dermatochalasis

The most obvious symptom of dermatochalasis is hooding of the upper eyelids. If you have severe eyelid drooping, the excess skin may sag right to the lash line. Drooping also gives your eyes a tired appearance, even if you get plenty of sleep each night. Additional symptoms include obstruction of the visual field, eye irritation, and fullness of the upper eyelids.

Because dermatochalasis affects your appearance, it can cause poor self-esteem, reducing your overall quality of life. Depending on how severe the condition is, dermatochalasis may also make it more difficult to perform tasks requiring stellar peripheral vision.

Impact of vision and function

Droopy eyelids aren't just a cosmetic issue. Excess skin can block your visual field, impairing your peripheral vision. When you have poor peripheral vision, you can only see what's right in front of you. This makes it incredibly difficult to drive safely, as you can't see the cars on either side of your vehicle unless you turn your head.

If you're playing hockey, you may not be able to see a puck flying toward your face until the last second, making it difficult to avoid injury. Poor peripheral vision even makes it more difficult to navigate familiar environments. For example, you may find yourself bumping into doorknobs as you walk down the hallway of your home. It's important to address droopy eyelids to improve your vision and avoid these complications.

Treatment options for dermatochalasis

Nonsurgical treatments

Nonsurgical treatments have fewer risks, so they're usually the first line of defense against droopy eyelids. Eye creams, eye exercises, and skin-tightening treatments are all potential options. Many creams contain collagen and elastin, making it a little easier to fight the battle against premature aging.

Eye exercises may help you strengthen the muscles that hold up your eyelids, making them droop a little less. Many dermatologists offer laser treatments, radiofrequency therapy, and other minimally invasive procedures designed to tighten the skin. These procedures may improve the appearance of droopy eyelids.

These treatments don't cure dermatochalasis, so you may need to repeat them to maintain the desired effect. There's also a chance you're not a good candidate for certain procedures. Schedule an appointment with a board-certified dermatologist to find out which option is likely to produce the best results with the lowest risk of side effects.

Surgical treatments

If nonsurgical treatments don't have the intended effect, you may want to try blepharoplasty. During this procedure, a surgeon removes excess skin and fat deposits from the eyelids. This prevents drooping, making you look refreshed instead of exhausted. In addition to restoring your appearance, blepharoplasty widens your visual field, making it easier to see things that aren't right in front of you.

This procedure typically causes bruising, swelling, and discomfort for a few weeks. These side effects go away once the surgical site heals. Like all surgeries, blepharoplasty has some potential risks. For example, some people experience bleeding behind the eyes.

It's also possible to remove too much tissue, leaving the eyelids in an abnormal position. While you're recovering, it's important to wear sunscreen and sunglasses every time you go outside, as sun exposure can make surgical scars worse.

The eyes have it 

Whether you decide to use temporary treatments or undergo blepharoplasty, it's important to treat your eyes right. Getting regular exams is a good start, as is protecting your eyes against the sun's harmful ultraviolet rays. If you wear contacts, use 1-800 Contacts to find your preferred brand of lenses.

FAQs

Can dermatochalasis cause vision problems?

Yes. Droopy eyelids may make your peripheral vision worse, making it more difficult to see things that aren't right in front of your face. You may also have difficulty reading or performing other close-up tasks.

Can dermatochalasis be prevented?

You can't prevent dermatochalasis, but there are two things you can do to prevent it from getting worse. First, avoid rubbing your eyes, as it can damage the muscles responsible for supporting your eyelids. Second, use products containing collagen and elastin. Your eyelid skin needs these proteins to maintain its structure.

What is the recovery time after blepharoplasty surgery?

It may take a few months to heal fully from blepharoplasty surgery. However, the bruising and swelling usually go away after just a few weeks.

Can insurance cover the cost of blepharoplasty for functional purposes?

Health insurance doesn't cover blepharoplasty when it's done for cosmetic reasons. However, your plan should cover a functional blepharoplasty, which is blepharoplasty performed for medical reasons. Before your insurance pays for the surgery, you'll need a thorough eye exam, along with documentation to support your claim that you need the procedure for medical reasons instead of cosmetic ones.