There isn't a day goes by that I do not get questioned about a patient's facial appearance that includes puffy eyelids, dark circles as well as wrinkles. We let's face it; our looks are of great interest and concern. I recently had a chat with dermatologist Dr. Bobby Buka, section chief in the Dept. of Dermatology at Mount Sinai School of Medicine in New York City about this.

"Puffy eyes are progressive," he said. "As we age, we all lose fat pads (called subcutaneous tissue) that rest below our eyes. These dark circles that may appear underneath your eyelids and can be visible as a discoloration or bluish color with puffiness of the eyelids is actually blood coursing through veins beneath."

Buka also mentioned that getting enough water and fluids optimize "hydration", and this is very critical. Doing this can replenish the deeper layers of the skin with water delaying drooping of skin, and improve the appearance of dark circles. Avoiding dehydration can help to decrease the effect of gravity as adequately hydrated skin tends to sag less with advancing age! Buka also recommends a well-balanced, high-vitamin diet.

Those affected by allergies, particularly children and young adults, may have the presence of a horizontal crease on the middle part of the nose. This may reflect persistent upward "rubbing" of the nose from itchiness and explain the appearance of a nasal "crease" associated with allergies, especially if your allergies are not adequately controlled or treated. In other words, get proper therapy for your allergies so you can feel better and look better!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.