Hooded eyelids are when excess skin folds down from the brow line. People often associate hooded eyes with aging, but this may also be due to genetics.

People with hooded eyes, or dermatochalasis, may find that the skin below the eyebrow touches or comes close to their eyelashes. While this does not usually cause medical issues, some people may find it obscures their vision. It may also affect a person’s quality of life if they find the appearance aesthetically displeasing.

With hooded eyes, the drooping skin may cover all or part of the eyelid, leaving a crease. Carefully applying makeup can help open up the appearance of the eyes, but if this does not achieve the desired effect, doctors may recommend a procedure called blepharoplasty.

The American Society of Plastic Surgeons (ASPS) says this procedure can improve the appearance of the eyelids.

This article will explain what causes hooded eyes and look at different treatment options. It will also explain the difference between this and other eye conditions, including droopy eyes, or ptosis.

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Hooded eyes are an eye shape where excess skin and soft tissue around the eyebrow covers the eyelid, but not the eye itself. The condition is so-called because the skin forms a “hood” over the eyelid, leaving a visible crease.

Some people have this eye shape at birth, but others develop hooded eyes as they grow older. Even individuals born with hooded eyes may find that the “hoods” become more prominent as they age.

Occasionally, only one eye is hooded, but the condition more typically affects both eyes.

Genetics determines eye shapes, so if a parent of a person has hooded eyes, the likelihood of that individual having them increases. But for other people, hooded eyes have an association with aging.

As individuals grow older, the muscles that support the eyebrows may lose tone and start to sag. As the eyebrows droop, they push down on the soft tissue and fat that covers the eye socket, creating a hooded effect over the eyelid.

In a 2021 article, researchers stated that trauma to the side of the head may also cause hooded eyes. They also noted that some medical treatments, including chemotherapy and radiation therapy, can speed up aging in the skin and soft tissues and cause the eyebrows to droop.

Most people do not need medical treatment for hooded eyes. However, some may feel that their eyes make them look older and more tired than usual, so they may wish to alter their appearance.

Makeup techniques can open up the eyes and help make a person appear more awake, but the effect disappears when they remove the makeup.

Other nonsurgical treatments include:

  • Botox injections: These injections go into the outer edge of the eyebrow and can lift it slightly. However, badly positioned injections can cause the brows to droop further, especially if they interfere with the nerves controlling the brow muscles, according to the 2021 article.
  • Dermal fillers: These are skin-plumping injections that smooth out wrinkles. They can help lift the eyebrow and tighten the skin around the eye.
  • Laser therapy: This technique removes the top layers of skin, reducing the appearance of wrinkles.
  • Radiofrequency treatments: These deliver an electromagnetic current into the skin and soft tissue around the eyes. They tighten the skin and help lift the eyebrows.
  • Thread lifts: A process where temporary sutures, or stitches, pull the eyebrows back into place. However, the ASPS cautions that this treatment is more suitable for people with mild to moderate hooding, as the stitches usually only lift the eyebrows by a few millimeters.
  • Eye drops: Eye drops, such as Upneeq, which the Food and Drug Administration (FDA) has approved for sale, can help lift droopy eyelids.

Some people with hooded eyes may consider having a brow lift, or blepharoplasty. The American Academy of Cosmetic Surgery explains that while this procedure can improve the appearance of baggy skin around the eye and help reposition the eyebrow higher on the brow bone, it is not advisable for everyone.

If the droopy eyelids obscure part of a person’s vision, medical insurers may consider this a functional change and not cosmetic, and therefore the individual’s insurance may cover the procedure.

Additionally, some people may look startled or constantly surprised due to having elevated eyebrows after an eyebrow lift, so they may prefer other techniques to achieve their desired outcome.

Surgeons perform most brow lifts while a person is under general anesthesia. They usually hide the incisions under the eyebrow hair and then remove the soft tissue and excess skin causing the hooding.

Sometimes, hooded eyes push down on the upper eyelid itself, causing dermatochalasis. If the eyelid droops over the eye, it can interfere with a person’s vision, and doctors may recommend surgery to lift the eyelid.

While people with hooded eyes may also have dermatochalasis, it can occur by itself. A 2017 article states that some individuals have a genetic predisposition to it, while others may develop it as they grow older.

Ptosis, or droopy eyelids, is another condition that causes the eyelids to sag. Most people with ptosis do not need surgery, but doctors may recommend it if the condition compromises a person’s vision.

Researchers are looking at new ways to treat ptosis, or blepharoptosis. There is encouraging evidence that drug treatments may be effective, making treatment available to a wider group of people.

Most people with hooded eyes do not need medical attention unless they cannot see clearly or find the appearance of their hooded eyes distressing.

Individuals can use makeup to enhance their eyes and make them seem wider and more open.

Other treatment options include dermal fillers, laser therapy, and surgery to lift the eyebrow and remove excess skin, fat, and soft tissue. Doctors perform these procedures under either local or general anesthesia and will discuss the risks with suitable candidates before getting their consent.

Hooded eyes are when the eyebrow and soft tissue surrounding the eyes start to sag, causing a bulge that can hide the upper eyelid.

Some people have hooded eyes at birth, but for most individuals, the condition has an association with aging.