Red, swollen skin under the eye

A red swollen area under the eye may come from allergy, irritation, or infection; pain, fever, or vision change requires prompt care. Whether one or both sides are affected, and whether swelling is itchy or tender, can help distinguish likely causes.

Allergic conjunctivitis often causes itching, watering, and puffiness around both eyes, sometimes after pollen, dust, or another trigger. Conjunctivitis can make the eyelids crusty and the surrounding skin sore from wiping. Irritation from cosmetics, skin products, or rubbing may stay close to the lower lid. A tender, hot, rapidly enlarging area may be a skin infection, while deeper infection can cause fever, marked illness, or pain when moving the eye.

Stop any new cosmetic or skin product near the area and avoid rubbing. Use a cool clean compress for itchy puffiness; gentle cleansing can remove crusts without scraping the skin. Wash hands often and do not share towels or eye products. Do not put steroid or antibiotic creams close to the eye unless a clinician has prescribed them for that location.

Seek urgent medical care for reduced vision, severe eye pain, pain with eye movement, double vision, fever, a rapidly spreading red area, marked tenderness, or difficulty opening the eye. Emergency help is needed for breathing difficulty or swelling of the lips and tongue. Arrange review when symptoms follow an injury, persist despite removing an irritant, or affect a young child who seems unwell.

Ask whether the pattern fits allergy, conjunctivitis, or a skin infection; which compress is suitable; whether you need treatment; and what change in swelling or vision should trigger immediate help.