Hooded eyes – What is it, causes, and treatment
Our eyes are one of the most prominent features of our face, now more than ever as we connect with people virtually and don a mandatory face mask. Caused by various factors, our eyelids may undergo changes, one of which are, hooded eyes. In this article, we will learn more about the definition, causes, and treatment options for hooded eyes.
What are hooded eyes?
Hooded eyes occur when excess skin and soft tissue below the eyebrow line folds downwards and touches or comes close to the eyelashes, but not the eye itself. The term hooded was adopted as the skin forms a “hood” over the eyelid. It is usually more noticeable around the outer corner of the eye, where the eyebrow tapers around the temple. Hooded eyes typically affect both eyes and rarely, only one eye is affected.
What causes hooded eyes?
Here are some causes:
Genetics
Genetics play a role in determining eye shapes. If a parent has hooded eyes, the likelihood of that individual developing likewise, increases. Individuals born with it may find that they become more prominent with age.
Aging
As we age, the muscles that support the eyebrows tend to lose tone and begin to sag. Coupled with a loss of collagen as we age, when the eyebrows droop, they push down on soft tissue and cover the eye socket, thus creating a ‘hooded’ effect over the eyelid.
Trauma
Sustaining trauma to the side of the head may also cause hooded eyes [1].
Medical treatments
Chemotherapy and radiation therapy used for cancer treatment can hasten ageing in the skin and soft tissues, causing the eyebrows to droop, giving rise to the appearance of hooded eyes [1].
Treatment for hooded eyes
It can obscure part of the affected person’s vision, in which treatment would be necessary as it can affect functionality. Most people with it do not require treatment, however, some may wish to alter their appearance as hooded eyes can make one look older and more tired. This section covers non-surgical and surgical options for hooded eyes.
Non-surgical options for treating hooded eyes
Dermal fillers
Dermal fillers are skin plumping injections that smooth out wrinkles. These can help tighten the skin around the eye and lift the eyebrow. The doctor will administer a local anaesthetic before injecting the filler.
Botox injections
Botox injections for hooded eyes (Source: NY Facial Plastic Surgery Center)
Botox is injected into the outer edge of the eyebrow and can lift it slightly. If badly positioned, the botox injection can cause the brows to droop further, especially if they affect the nerves controlling the eyebrow muscles.
Radiofrequency treatments
In this treatment type, an electromagnetic current is delivered into the skin and soft tissue around the eyes. They tighten the skin and help lift the eyebrows.
Laser therapy
Laser therapy reduces the appearance of wrinkles by removing the top layer of skin.
The above non-surgical treatment options for it are temporary and usually need to be repeated every 6 months.
Makeup techniques can reduce the appearance of hooded eyes, but the effect is temporary and disappears when the makeup is removed.
Surgical options for hooded eyes
Eyelid or brow surgery improves the appearance of aging and restores a fresh, rested, and youthful look. Changes will be noticeable immediately after the procedure, however, after the swelling subsides within 12 weeks, the final result will be visible.
Brow lift
A brow lift is suited for it when there is a low eyebrow position, moderate droopiness, and, not too much excess skin.
In this procedure, the brow is lifted slightly, creating more space between the eyebrow bone and the eyelashes.
For heavy eyelids or more significant hooded eyes, however, a brow lift might not be sufficient and instead, a blepharoplasty is recommended.
Eyelid lift or blepharoplasty
Blepharoplasty (Source: Dr Walid Balti)
An eyelid lift or blepharoplasty is a procedure where the surgeon readjusts the fat around the eye area and tightens the muscle and skin to restore a smooth appearance. Blepharoplasty is performed by an oculoplastic surgeon (an eye surgeon or ophthalmologist that has undergone specialised training in reconstruction of the functioning of the eye and the facial regions around the eye). The surgery is performed on an outpatient basis.
References:
[1] Russell D.J and Hohman M.H, “Brow Ptosis”, StatPearls Publishing, May 2022.
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