Everything from a lack of sleep, allergies, hormonal issues, Thyroid conditions to Graves' disease may cause puffiness under the eyes. Identifying the reasons and deal with them can help you wipe out the tired look for good. However, there is one aspect that is inescapable: the aging process.

As we age, the muscles and ligaments under the eyes become thinner, which allows fat under the eyes to slide forward. The excess fat tissue form fat pads (eye bags) under the eyes and bulges in the tear trough areas. These types of fat pads are diet and exercise resistant, fortunately, there are many approaches that help.

Ask anybody and the first thing that he or she will recommend is an eye cream. An good anti-aging eye cream can do wonders in eliminating tiredness and puffiness of the eyes. According to Mayo Clinic, the efficiency of a product depends on the amount and type of the active ingredients. Some active ingredients, such as Peptides and Epidermal Growth Factor (EGF) help strengthen the skin and tighten eye bags. The best-known anti-aging eye creams to improve firmness around the eyes are Skin Doctor's Instant Eyelift and Perfective Ceuticals' Anti-imperfection Eye Therapy Cream with Growth Factor.

Another common way to reduce under eye bags and tauter contours around the eyes is a skin tightening treatment. The most popular skin tightening procedures are Thermage Eye, Refirme, Polaris, TriPollar and Accent. Skin tightening treatment (radiofrequency) is based on stimulating the collagen and elastin production under the skin with a burst of radiofrequency waves. Radiofrequency procedures do not require skin incision. After the treatment, you can apply make-up and return to routine activities.

Although the science behind radiofrequency treatment is theoretically sound, a number of people report side effects, especially when treated by inexperienced providers therefore finding a board certified provider experienced with the particular radiofrequency procedure is very important.

Dermal fillers, such as Restylane, Radiesse and Sculptra, injected into deep tear troughs will plump up the cheeks and can immediately revitalize the hollow appearance under eyes. The injection is not into the eye sockets, which is potentially dangerous and the filler manufacturers do not recommend it. The treatment takes minutes to perform and the results are immediate.

According to American Society for Aesthetic Plastic Surgery, risk may occur when dermal fillers are injected by someone who is not properly qualified to perform injections. Risks include hematoma or blood pooling beneath the skin, and though rare, infection and necrosis (tissue death) or skin loss is possible.

An unsatisfactory outcome is also a risk. Semi-permanent and permanent fillers may clump: the particles form a granuloma or lump that can be felt or seen beneath the skin. Particles may also migrate or displace from the injection site. Injection of an anti-inflammatory may improve minor clumps or swelling. More significant clumping or granuloma may require surgery.

If the methods described above can not deliver the results you crave, a more aggressive treatment, such as Blepharoplasty, to remove the excess fat and skin from the area to cure the condition may be considered. Consult a board certified surgeon.