Diseases

Dermatochalasis – Causes, Symptoms & Treatment

Dermatochalasis

Sagging eye skin or eyelids filled with fat are not only an optical problem, but can also impede vision. We are talking about dermatochalasis , which can occur as a result of an illness or can also be family-related. In almost all cases, the affected person must be treated surgically.

What is dermatochalasis?

Dermatochalasis is what doctors call a change in the connective tissue. The change is age-related, although familial clusters have sometimes been observed. The term dermatochalasis occurs not only in ophthalmology, but also in the field of dermatology.

Flabby, large and inelastic wrinkles are characteristic, which are nothing more than “hanging skin” that can appear on different parts of the body. Above all, those affected complain about the sagging skin on the eyes or patients are often affected by bags under the eyes or droopy eyelids . Strictly speaking, dermatochalasis is an age-related misalignment of the eyelid.

causes

Due to the fact that the connective tissue slackens with age, the process of fat depositing in the tissue layers occurs. As a result, the skin bulges forward and the skin begins to sag. Possible causes are hereditary (so-called hereditary) diseases of the connective tissue, whereby doctors also speak of a cutis laxa syndrome .

However, idiopathic recurrent swellings of the upper eyelids (blepharochalasis) and age-related reasons (cutis laxa senilis) can also trigger dermatochalasis. Sometimes inflammatory skin diseases ( dermatitis ) can also promote dermatochalasis. Dermatochalasis can also occur during pregnancy; especially if the pregnant woman is taking penicillamine (cutis laxa acquisita).

Symptoms, Ailments & Signs

The relaxation of the connective tissue primarily ensures that the skin of the upper eyelid is no longer taut and sometimes the excess skin, which has formed due to fat storage, protrudes over the edge of the eyelid. The affected person not only complains about aesthetic problems, but can sometimes also – if he wants to open the eye – feel a stronger resistance.

As a further consequence, those affected are plagued by headaches ; that condition is triggered, for example, by the fact that a significantly higher level of physical exertion is required if the patient wants to open the eye. Sometimes, however, there can also be an enormous restriction of the field of vision if the eyelid is “ever getting bigger”. If that happens, the cosmetic problem turns into a medical problem, with the ophthalmologist usually being responsible for such treatments and diagnoses.

At the latest when the restricted view is perceived as disturbing, a doctor should be consulted immediately to look at or treat the dermatochalasis.

Diagnose

The ophthalmologist can – as part of an ophthalmological examination – make the diagnosis of dermatochalasis. However, it is important that a differential diagnosis is made so that the suspicion of dermatochalasis can also be confirmed.

Importantly, diseases such as Williams-Beuren Syndrome , Ehlers-Danlos Syndrome , Progeria (also known as Hutchinson-Gilford Syndrome ), Barber-Say Syndrome , Costello Syndrome , Kabuki Syndrome , Pseudoxanthoma elasticum or the cardiofaciocutaneous syndrome can be ruled out.

As part of the diagnosis, the eyelids must therefore be carefully observed, so that the position of the edge of the eyelid is particularly relevant. However, if the patient’s eyelid edge is unchanged or is merely covered by the skin, it is a case of dermatochalasis; ptosis can thus be ruled out . The doctor also performs a visual field measurement so that any visual field defects can be assessed.

The doctor can often already suspect dermatochalasis based on the optical examination. The course is based on its cause. As a rule, if the dermatochalasis causes not only aesthetic but also medical problems, the affected person must be treated surgically over time.

complications

In most cases, dermatochalasis has both cosmetic and physical complications. In addition to reduced aesthetics, the patient’s vision is also prevented due to the enlarged eyelids. The patient has to make an increased effort to open the eye. Due to the increased strength, headaches often occur.

These can spread to the neighboring regions, so that teeth or ears are also affected by pain, although there is no causal complaint in these regions. Likewise, the view is severely limited, which can lead to significant limitations in the everyday life of the person concerned. Dermatochalasis can be diagnosed and usually needs to be treated immediately.

If the condition is acute and serious, surgery can be performed. This usually proceeds without complications. If no intervention is required, the underlying disease can also be treated with physiological methods. Here, too, there are no further complications and the disease progresses positively. Small scars often remain on the eye after the operation. Life expectancy is not reduced by dermatochalasis.

When should you go to the doctor?

Whether and what the patient can do himself to improve his condition depends on what the dermatochalasis is due to and how severe the condition is.

In the early stages, the patient can try to combat the disorder with the help of special gymnastic exercises for the face and eyes. Connective tissue massages can also have a positive effect.

If the drooping eyelids are caused by dermatitis or other inflammatory skin diseases, eye showers with alternating temperatures or cold compresses can help. If the upper eyelids are severely swollen, applying ice cubes wrapped in a paper handkerchief will help. Dabbing with eyebright tea that has been placed in the freezer for some time is also helpful. The laying on of ice-cold cucumber slices often causes the songs to subside.

If the disorder is due to an allergy, the allergen must be identified and avoided. In the case of various food intolerances, a general change in diet can be useful. In naturopathy, this is usually recommended as a therapy method for chronically swollen eyelids.

In severe cases, especially if the dermatochalasis is genetic or due to old age, only surgery will help. Since the procedure is only associated with manageable risks, patients who suffer from the disorder physically or mentally should inform themselves promptly about the possibility of surgical treatment.

Treatment & Therapy

As part of the treatment, the doctor must consider the cause. Depending on the cause, there are different therapeutic approaches; on the one hand there are conservative options, which include gymnastics, connective tissue massages or cold/warm showers , but also surgical treatments. This includes, for example, blepharoplasty . It is advisable that – if there is an underlying disease that has caused dermatochalasis – primarily only the symptoms or the cause – in terms of the underlying disease – are treated.

If the doctor decides on the most common variant – i.e. for the surgical procedure – he removes the excess skin. The patient is treated with local anesthesia; the correction takes about 45 minutes (for both eyes). The doctor first removes the excess skin and then the excess fatty tissue that has formed. After five to six days, the doctor then removes the stitches. Bruises , which can very well occur, heal after about one to two weeks.

The procedure leaves a very fine and gentle scar, which lies directly in the crease of the eyelid and is not visible. Before the procedure, of course, a detailed explanation must take place, in which the patient not only expresses his or her wishes, but at the same time the doctor also reports on the risks and other side effects that are – at least theoretically – possible in the context of a surgical procedure.

Outlook & Forecast

Dermatochalasis usually does not heal itself and the symptoms do not improve if the disease is not treated. For this reason, those affected are always dependent on medical treatment to treat this disease.

If dermatochalasis is left untreated, sufferers will suffer from excessive fatty deposits on the eyelids and continue to have difficulty opening and closing the eyes. These complaints have a negative effect on the patient’s quality of life and can reduce it. Likewise, there are limitations in the field of vision and thus also in everyday life. Those affected often also suffer from headaches and visual problems due to dermatochalasis.

Dermatochalasis can usually be treated relatively easily. The deposits are removed by a surgical procedure so that the symptoms are completely resolved. Special complications do not occur, so that the course of the disease is positive. However, a small scar remains. A surgical procedure is not always necessary, so that in some cases the dermatochalasis can also be treated with massages or cold/warm showers. This can also lead to a positive course of the disease.

prevention

As a rule, dermatochalasis cannot be prevented. This is because in most cases other diseases are responsible for the dermatochalasis. Even if dermatochalasis has run in the family, there are no preventive measures.

aftercare

In the case of dermatochalasis, the affected person is usually entitled to very few or even no measures or options for aftercare. Since the disease cannot be treated completely in many cases, the person affected is primarily dependent on early and rapid detection and subsequent treatment of the disease.

The dermatochalasis cannot heal on its own, so treatment is necessary in any case. The earlier the dermatochalasis is detected, the better the further course of this disease is in most cases. The treatment is usually carried out with the help of surgical interventions.

This should be done as early as possible. After such an operation, the affected person should usually always rest and continue to take care of their body. Bed rest should always be observed. Efforts or stressful activities should also be avoided.

The procedure for dermatochalasis is usually carried out without complications and leads to an almost complete healing of the symptoms. The life expectancy of the affected person is not reduced as a result. Since the disease can often lead to mental upsets or depression, an accompanying psychological treatment is recommended.

You can do that yourself

Dermatochalasis does not always require medical treatment. Depending on the cause, there are various therapies that can sometimes be carried out without medical support. In mild cases, the skin changes can be treated with gymnastics or connective tissue massage . Cold/warm showers are particularly helpful for swelling of the upper eyelids and skin changes as a result of inflammatory skin diseases such as dermatitis.

In general, classic face masks with quark or cucumber are also said to have a preventive effect. Homeopathic remedies such as healing earth or the Schuessler salts No. 6 and No. 9 help with allergy-related dermatochalasis. Dermatochalasis during pregnancy can be treated by changing the medication (usually the drug penicillamine is the cause).

If the sagging of the eyelids is due to age, the dermatochalasis usually has to be surgically removed. A change in diet or changes in lifestyle (e.g. more sleep or fewer stimulants) prevent new skin changes. However, dermatochalasis is partly genetic, which is why the relaxation cannot always be prevented. In severe cases, a [psychologist|psychological consultation]] can therefore also be useful. Those affected should discuss which measures are possible in detail with the doctor responsible.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.