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What Is Dermatochalasis and How Can It Be Treated?

What Is Dermatochalasis?

Dermatochalasis is a condition that affects a significant portion of the population, and, while it most commonly affects middle-aged adults and the elderly, it can sometimes develop as early as 20 years old. Dermatochalasis is colloquially known as “baggy eyes,” and while the tired appearance caused by droopy eyelids can be cosmetically undesirable, the excess eyelid skin that causes the condition is potentially more problematic than a cosmetic concern.

A common misconception about Dermatochalasis is that it is the same condition as Ptosis, yet this is not the case. It is especially important to differentiate between the two when making a medical diagnosis, as treatment options vary. Ptosis is caused by a weakening of muscle that results in the upper eyelid drooping over the eye. Whereas, Dermatochalasis is caused by excess skin, fat, or muscle in the eyelid area. Both conditions cause a similar appearance, yet each requires a specific procedure to correct and therefore should only be diagnosed by an ophthalmologist or oculoplastic surgeon.

Dermatochalasis can affect both the upper and lower eyelids, but the upper eyelid is usually most significantly affected. The excess eyelid tissue can impair vision and diminish the quality of life for those with the condition, as it droops over the eyeball and causes discomfort. The overlap of skin can cause other related conditions as well, including ocular irritation, eyelash interference, and inflammation of the eyelids and surrounding skin.

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Who Does It Affect?

The majority of patients who develop Dermatochalasis acquire it due to the natural aging process. Symptoms usually develop at around 40 years of age and progressively worsen with time. As individuals age, their skin and eyelids naturally begin to sag due to weakening muscles that cause a loss of elasticity. Once the skin and/or muscles have reached the point where they no longer retain elasticity, excess fat and skin accumulate around the eyes — causing facial changes such as sagging eyebrows, droopy eyelids, and puffy under-eye bags.

While Dermatochalasis most commonly develops as part of the natural aging process, it can also be congenital (acquired at birth). Symptoms of Congenital Dermatochalasis often begin to appear as early as 20 years of age.

According to scientific research, it does not appear that race or sex play a role in the onset of Dermatochalasis. However, preliminary studies suggest that smoking is a contributing factor in the onset of Dermatochalasis. Findings show smokers undergo blepharoplasty treatment almost four years earlier than those who don’t smoke or even those who are ex-smokers! Thankfully, whether the onset of Dermatochalasis is congenital, part of the natural aging process, or sped up by behavioral factors, there is sufficient research done on Dermatochalasis to ensure a specialist will be able to efficiently diagnose and treat the condition.

What Are My Treatment Options?

While there are many temporary solutions to improving the appearance of those with the condition — including, oddly enough, transparent eyelid tape — these are neither cost-efficient nor practical. A permanent solution to Dermatochalasis is a procedure called blepharoplasty (commonly referred to as an “eye lift”).  Over hundreds of thousands of patients undergo this procedure annually. Blepharoplasty removes the excess skin surrounding the eye before then attaching the remaining skin to healthy connective tissue.

dermatochalasis patient
Figure 5, International Journal of Ophthalmology (2016) An SH,Jin SW,Kwon YH,Ryu WY,Jeong WJ,Ahn HB. Effects of upper lid blepharoplasty on visual quality in patients with lash ptosis and dermatochalasis

According to a visual field test study conducted by the UK Department of Ophthalmology, the blepharoplasty procedure is a significant solution for those with Dermatochalasis. Results show that, “for those who had blepharoplasty alone, 90.9% recorded an improvement in points seen in the modified visual field test and 80.6% had improvement in visual field height.” That is, undergoing blepharoplasty significantly improves visual quality and, therefore, quality of life, for those with this condition.

While recovery time may vary, full recovery often takes two weeks to a month, depending on age and overall health of the patient. Yet, the surgery itself is often quite short, lasting about one to three hours with most patients returning home the same day.

If your Dermatochalasis has progressed to the degree of impairing your vision, then your health insurance company will likely cover the costs since it is deemed medically necessary. However, keep in mind that if you seek to undergo the procedure for cosmetic reasons, your insurance company may require you pay out-of-pocket, either in part or in whole. Despite this consideration, it is worthwhile to consider Blepharoplasty, as it is proven to significantly improve the quality of life for those who suffer from Dermatochalasis.