Everything You Need To Know About Milia

If you’ve ever looked in the mirror to discover tiny white bumps under your eyes, then you’ve probably had milia. Here’s how to treat and prevent them.
Written by Sara Spruch-Feiner
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Everything You Need To Know About Miliavchal/Shutterstock

If you’ve ever looked in the mirror to discover tiny, whitehead-esque bumps under your eyes, then you’ve probably had milia. But, while these yellow and white dots may look like acne, they are actually small cysts that require different care and attention than the pustules, papules, and, yes, even whiteheads you may also find on your face and body. Here’s what you need to know about milia.

What Are Milia?

Milia (the plural of milium) are “small, firm whitish cysts that occur primarily on the face,” says Samer Jaber, MD, a board certified dermatologist and founder of Washington Square Dermatology in New York City. They are most common in newborns (some 50 percent of infants develop milia, he notes), but they can affect anyone, regardless of age or ethnicity.

These cysts are usually found in groups and are especially common around the eyes — though they can also be found on the lips, cheeks, and even the torso and genitals. Generally speaking, milia are not itchy or painful and don’t necessarily need to be treated. Depending on where they are on the body, however, they can become red and irritated due to friction.

There are two types of milia: primary and secondary. Primary milia occur spontaneously — most often on the eyelids, forehead, cheeks, or genitals — and usually clear up on their own. They pop up when “keratin or dead skin cells get trapped under the skin, essentially clogging it,” explains Lily Talakoub, MD, a board certified dermatologist in McLean, VA.

Secondary milia, meanwhile, are the result of skin damage (think: injury, irritation, rash, burn, abrasion, etc.) and may be permanent. For example, it is possible to experience milia after skin resurfacing procedures, such as dermabrasion and laser treatments. In these cases, the milia occur in the location where the skin is compromised. Milia can also develop if the skin loses its natural ability to exfoliate, which is common of the aging process.

How to Treat Milia

As we mentioned, milia doesn’t do any harm and, in time, can often resolve on their own. With that said, they may pose an aesthetic concern — especially on the face. Due to their resemblance to whiteheads, it can be tempting to pick at or even try to pop milia, but dermatologists advise you to avoid this at all costs or else you risk damaging your skin.

While we don’t recommend DIY extractions of any kind, removing a milium is nothing like popping a pimple. Unlike a pustule, a milium does not feature a soft core of dead skin cells, sebum, and pus that flow out of a pore. Instead, it’s composed of hardened dead skin cells that have become trapped just below the surface of the skin. As such, squeezing a milium is not going to get you very far.

To avoid scarring and infection, you should visit a board certified dermatologist to diagnose and remove the milium. The extraction process involves “sterilizing the area, puncturing it with a sterile needle first, and then applying pressure to the area,” Dr. Jaber explains.

How to Prevent Milia

The best way to address milia at home and to potentially prevent them from developing in the first place is to use chemical exfoliants. Alpha hydroxy acids (AHAs), like glycolic acid, slough away dead skin cells, while skincare’s ultimate multitasker, retinol, increases cell turnover. While at-home exfoliants (check out our favorites) may do the trick, more potent professional chemical peels can also be used for a deeper exfoliation.

If you are prone to milia, you will want to avoid skincare ingredients that can potentially clog the skin. These include mineral oil, lanolin, and petroleum oil to name a few.

The Takeaway

Milia are generally harmless in both newborns and adults, but that doesn’t mean they aren’t annoying. Consulting with a board certified dermatologist will ensure, first and foremost, that the bumps you are concerned about are, in fact, milia. From there, they will be able to develop a treatment protocol to help clear up your skin.

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SARA SPRUCH-FEINERis a contributing writer for AEDIT.

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