Dermatochalasis: Causes, Symptoms & Excess Eyelid Skin Treatment

When individuals discuss extra skin on the upper eyelids, they often mean dermatochalasis.

It’s a common problem, especially as we age, and although it may appear to be merely a cosmetic annoyance at first glance, it can have effects on vision, eye comfort, and daily life. In this blog, we’ll lay out everything you need to know about dermatochalasis in plain human language.

What Is Dermatochalasis?

When you have dermatochalasis, there is an excess of skin on the eyelids that most often appears above the eyes (though it can also show up beneath your lower lids). It occurs when the skin loses elasticity, resulting in excess folds over the eyelids. The degree of the condition can be subtle for some people and dramatic for others, hanging low enough to bat eyelashes or even partially obscure the eye itself. neilmodi.

When both upper eyelids are affected, the condition is referred to as dermatochalasis and can cause someone to appear consistently tired or older. neilmodi.

Dermatochalasis does not describe drooping of the muscle that opens the eyelid; that’s something else called ptosis, but it can still make the upper lids look droopy or heavy. 

Why Dermatochalasis Occurs

Understanding how and why dermatochalasis occurs can help put symptoms and treatment into context. There are a few things that can lend a hand:

1. Natural Ageing and Loss of Elasticity

Collagen and skin elasticity are depleted with age. The eyelid skin is very thin, so it’s easily affected by this, resulting in redundant or extra folds of skin. neilmodi.

2. Genetics and Family History

Some people naturally have more skin around their eyelids. If your parents or siblings have excess eyelid skin, you may also be at increased risk of developing dermatochalasis.

3. Repeated Eyelid Swelling or Inflammation

Chronic swelling, repeated bouts of inflammation, or prior trauma to the eyelid skin can cause the eyelid skin to become permanently stretched and sag. 

4. Other Health Conditions

Some medical conditions, such as thyroid eye disease, cutis laxa, or connective tissue disorders, may also affect the collagen and strength of the skin, resulting in increased eyelid skin. Healthline

Common Signs and Symptoms

You may not readily recognise dermatochalasis, particularly when it is mild. But as the disease advances, here are some common signs:

1. Heavy, Sagging Eyelids

Loose skin can be heavy, and some patients complain of a persistent weight on the eyelids. This tends to be most pronounced later in the day. 

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2. Obstructed Vision

If that excess of skin dips low enough, it can begin to encroach on your visual space, especially at the top of your visual field. This is one of the primary reasons people seek treatment. 

3. A “Tired” Appearance

Droopy eyelid skin, also known as extra skin on the eyes or extra eyelid skin, can give the face a terminally tired appearance and an older look.

4. Eye Irritation and Lash Problems

Excess skin can become caught on eyelashes and cause discomfort, irritation, or interference with makeup application. neilmodi. 

5. Compensatory Brow Raising

Some people may also unconsciously raise their eyebrows throughout the day to see beyond excess eyelid skin, which can lead to forehead fatigue or headaches.

How Is Dermatochalasis Diagnosed?

Dermatochalasis can be diagnosed by a physical examination performed by an ophthalmologist or an oculoplastic surgeon. They could also conduct tests of your peripheral vision to determine whether the field of vision is affected. Photographs can be used to assess the extent of excess skin, including whether it affects the line of sight.

It can occur independently, but it’s not unusual for dermatochalasis to accompany other conditions, such as blepharitis or ptosis. Your ophthalmologist can examine it closely and determine the precise cause of your eyelid problems. 

Dermatochalasis vs Ptosis: What’s the Difference?

It’s a question on many people’s minds, as both can contribute to the appearance of droopiness in the eye area. However:

• Dermatochalasis is caused by excess skin and tissue on the eyelid, not by weakness of the eyelid muscle. It’s primarily about loose skin, not muscle function. 
• Ptosis refers to the levator muscle, which raises the eyelid. When this muscle is weak, the eyelid margin itself is lower than it should be. 

They can also occur in combination, and in this case, both problems must be addressed. An ophthalmologist (Eye MD) will determine if you have ptosis, dermatochalasis, or both.

What Treatment Options Are Available?

If you don’t like the appearance or feel of loose skin on your eyelids, or if the sagging is affecting your vision (really), there are safe and effective solutions.

1. Surgical Correction: Blepharoplasty

The best cure for this condition is surgery and a procedure referred to as blepharoplasty. It’s known as an eyelid lift. This means excess skin (and sometimes fat) is removed from the upper or lower eyelids, so that the eyelids no longer appear droopy and vision is improved. 

• During this procedure:
• The redundant upper eyelid skin is meticulously excised
• There may also be some fat repositioned or reduced
• The incision is placed in a natural crease to keep scar formation to a minimum
• Recovery is typically a week to two weeks of swelling and bruising easing. clinic

A healing means that many patients see better and feel less fatigued. A minority of people may have eyelid surgery covered by insurance if the excess skin impairs vision. 

2. Non-Surgical Options

No medical treatment is effective in reversing or completely curing dermatochalasis. Some will consider options: skin-tightening treatments are available, but they are less effective for  excess eyelid skin. If appearance is your primary concern, rather than vision, consult a specialist.

3. Recovering After Surgery

Postoperatively, there is usually swelling and bruising of the periocular region that may take 1–2 weeks to resolve. For most, it’s safe to return to your routine after this period. Complete healing , when the final results are evident in the skin, may take a few months.

Carefully follow your surgeon’s aftercare instructions, especially regarding eye protection, avoiding heavy lifting, and using the ointments or drops prescribed.

When to see a doctor. What you can do. It’s typically safe to treat the digestive discomfort caused by binge eating at home.

When Should You Consider Seeing a Specialist?

You should see an eye doctor if:

• Loose eyelid skin is interfering with your vision
• You feel a sensation of heaviness or tiredness in the eye all the time
• You cannot put on makeup because you have too many eyelid folds
• Your upper eyelid skin obstructs your vision.

A thorough evaluation can reveal the presence and the preferred method to address dermatochalasis.

Ready to achieve your aesthetic goals?

• CQC-Registered Clinic with Nationally Recognised Leadership
• Over a Decade of Surgical & Aesthetic Expertise
• Personalised treatment plans tailored to your needs

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Summary

Dermatochalasis is a common condition characterised by excess eyelid skin that results in a hooded or droopy appearance. While age-related loss of skin elasticity is the most frequent cause, genetics and prior eye swelling can contribute. The main treatment is surgical correction, which can significantly improve both the function and appearance of the eyelids.

If you notice that your upper eyelids are hanging lower than they used to, or you’re experiencing obstructed vision or discomfort, it’s worth discussing dermatochalasis with a qualified ophthalmologist. With proper diagnosis and care, you can find the right solution for healthier, more comfortable eyes.

FAQs

1. What is dermatochalasis?

Dermatochalasis is a condition characterised by excess eyelid skin, typically on the upper eyelids. This extra skin can make the eyes look heavy and, in some cases, interfere with vision.

2. Can dermatochalasis affect vision?

Yes, when excess upper eyelid skin hangs low enough, it can block part of the visual field, especially peripheral vision. This is common in dermatochalasis of both upper eyelids.

3. Is dermatochalasis the same as ptosis?

No, dermatochalasis involves excess skin on the eyelids, while a weakened eyelid muscle causes ptosis. However, both conditions can occur together.

4. What causes dermatochalasis to develop?

Dermatochalasis can result from natural ageing, loss of skin elasticity, genetics, and repeated eyelid swelling or inflammation.

5. What is the most effective dermatochalasis treatment?

The most effective treatment for dermatochalasis is eyelid surgery (blepharoplasty), which removes excess eyelid skin and improves both appearance and vision when indicated.