By LIV Clinic · Medically reviewed by Dr. Narathai Vichienkalayarut, M.D. · Published September 30, 2026

“You look tired” usually comes down to one of four things — and only one of them is sleep.

Which treatment is best for tired looking eyes? It depends on the cause — hollowing under the eye suits tear trough filler, a heavy or dropped brow suits Botox, crepey texture suits skin boosters or resurfacing, and true puffiness or excess skin may need surgical assessment rather than injectables.

Why eyes look tired

Four separate causes

A tired eye area usually comes from hollowing beneath the eye, a heavy or descending brow, crepey thin skin, or genuine puffiness — and each needs a different treatment.

Why the distinction matters

Treating hollowing when the problem is puffiness makes things worse, which is why assessment comes before any injection here.

If the cause is hollowing

Tear trough filler

A groove under the eye casts a shadow that reads as tiredness. Soft filler placed carefully softens the hollow — see tear trough filler on Koh Samui.

A delicate area

Thin skin and important blood vessels mean this needs an experienced injector and a soft, appropriate product.

If the cause is a heavy brow

Botox for a subtle lift

As the brow descends, the upper lid looks heavier. The American Academy of Ophthalmology notes botulinum toxin relaxes targeted muscles — relaxing the muscles that pull the brow down can create a subtle lift.

Precision matters

Over-treating the forehead causes brow heaviness rather than fixing it, so conservative, balanced dosing is essential.

If the cause is skin quality

Crepey, thin skin

Fine crinkling around the eye reflects light unevenly and reads as tired. Skin boosters, polynucleotides and gentle resurfacing improve this — see treating crepey skin.

Sun damage is usually involved

The eye area is thin and highly sun-exposed, so daily protection makes a real difference here.

Matching cause to treatment

Many people have two or three of these together.

When injectables are not the answer

Genuine eye bags

Prominent fat pads or excess eyelid skin are structural, and filler can make puffiness look worse rather than better.

An honest clinic will say so

Being told that a surgical opinion would serve you better is a good sign, not a lost sale.

The unglamorous contributors

Worth addressing alongside treatment:

• Sleep quality and quantity
• Hydration, especially in island heat
• Allergies causing puffiness and rubbing
• Sun exposure without protection
• Smoking and alcohol

How to approach tired looking eyes

A practical sequence:

1. Have a consultation to identify which cause applies to you.
2. Address sleep, hydration and allergies alongside any treatment.
3. Treat the dominant cause first rather than everything at once.
4. Start conservatively in this delicate area.
5. Use daily sun protection around the eyes.
6. Seek a surgical opinion if the issue is excess skin or fat pads.

Eye area treatment at LIV Clinic Koh Samui

At LIV Clinic, Dr. Narathai assesses the cause before recommending filler, Botox or skin treatment. Book a consultation.

Frequently asked questions

Safety and consultation

Eye area treatment is a medical procedure and, like any injectable treatment, carries some risk — common temporary effects can include redness, swelling, bruising or tenderness, and less common reactions are possible. Results vary from person to person, and no specific outcome can be promised. This article is general information, not medical advice.

At LIV Clinic, every treatment begins with an in-person assessment by Dr. Narathai Vichienkalayarut, M.D., who reviews your skin, medical history and goals before recommending a personalized plan. Book a consultation to find out whether this treatment suits you.