Milia are tiny, firm white bumps that sit just under the surface of the skin, most often around the eyes. Each one is a small pocket of trapped keratin with no opening, which is why squeezing does nothing and why a professional can remove one in seconds. Molluscum contagiosum is a common viral skin infection that causes small, firm, dome-shaped bumps with a dimple in the middle. It is harmless, it spreads easily among children, and it clears on its own - though that can take a year or more.
The same eight facts on every condition comparison.
They are tiny cysts.
Milia contain keratin just beneath the skin surface.
They look like white bumps.
They are firm and pearly, often on the eyelids or cheeks.
They are harmless.
Milia are different from acne whiteheads.
Unusual bumps need a check.
Inflamed, widespread or persistent bumps may need assessment.
It is a poxvirus infection.
It produces small firm bumps, often with a central dip.
It is common in children.
In healthy people it usually clears without treatment.
It spreads by contact.
Skin contact, shared objects and scratching can spread it.
Some cases need review.
Genital lesions, or many large lesions in an adult, warrant assessment.
Primary milia Form on their own, often around the eyes.
Newborn milia Tiny white bumps cluster across the nose and cheeks.
Secondary milia Form after burns, blisters or heavy creams.
Milia en plaque Many milia on a raised patch; rare.
Pearly bumps with a central dimple Smooth, shiny and dome-shaped, with a tiny dip in the center.
Clusters Groups in skin folds.
Milia are tiny cysts that trap keratin, a normal skin protein, just beneath the surface. The enclosed keratin makes a firm pale bump rather than an inflamed acne spot.
The molluscum virus infects surface skin cells and causes them to enlarge. A small smooth bump develops, often with a characteristic central dimple.
Milia. Can occur at any age and are especially common in newborns.
Molluscum Contagiosum. Most common in young children; adults can also acquire it, including through sexual contact.
Milia form when keratin, a skin protein, gets trapped in a tiny pocket just under the surface. They can appear on their own or after skin damage.
Molluscum contagiosum is caused by a poxvirus that infects the top layer of skin.
Evidence labels come from each condition’s own treatment list.
These are what most people try first, and they cannot work. A scrub abrades the surface, and the sac sits under an intact surface. A pore strip needs an opening to grip, and a milium has none. What scrubbing does achieve is irritation, which is not neutral here, because repeated injury to one area can seal off new ducts.
Thick eye creams and balms get blamed for milia constantly. The evidence is weak and plenty of people get milia while using nothing at all, so this is not a reliable fix and it will not clear the bumps already there. If you keep getting them in the exact spot where a heavy product sits, switching to something lighter costs nothing and is worth trying.
The over-the-counter retinoid, used at night. It speeds up how the duct lining sheds, which over two to three months lowers how many new milia form. It will not open or empty the ones you already have, because nothing applied to intact skin can reach a sealed sac. Start a few nights a week, and keep it off the eyelids themselves. Ask your doctor about it if you are pregnant or trying to become pregnant.
A gentle leave-on exfoliant that helps keep small ducts clear, which is prevention rather than treatment. It does nothing to a milium that has already sealed over. Low strength, a few times a week, and not on eyelid skin, which is thin and irritates easily.
Keeps the surface layer shedding evenly, on the same prevention logic as salicylic acid. Low strength only. Strong glycolic peels are the opposite of helpful here — deep peeling is one of the recognized causes of milia in the first place.
The wart products in the pharmacy are the wrong tool here. Molluscum is a poxvirus, not the wart virus, and the bumps are soft domes rather than thickened skin for an acid to dissolve. On thin skin, on a child, and on thirty bumps at once, it mostly buys irritation and dark marks. If a bump is going to be treated, the clinic options are more reliable and better controlled.
For the dry itchy eczema-like patch that develops around the bumps in about a third of children — not for the bumps themselves. Treating it properly matters, because the itch drives the scratching and the scratching is what spreads the infection. Use it on the skin between and around the bumps, thinly and for a short course. Strong steroid creams applied over the bumps calm the redness and can help the virus stay longer.
A common suggestion, usually combined with iodine, and the evidence behind it is a small number of low-quality studies. Against an infection that clears by itself, that is very hard to read. The real drawback is that it stings and it commonly causes an allergic rash on children's skin, which then itches, which then gets scratched.
The prescription-strength version of the same idea as adapalene, used at night when there are many milia or they keep coming back. Over two to three months it reduces how many new ones form. It does not clear the existing bumps, and it is used carefully near the eyes. Ask your doctor about it if you are pregnant or trying to become pregnant.
A retinoid dabbed onto individual bumps to irritate them into clearing. It is sometimes chosen for bumps on the face, where blistering or scraping is less appealing. The evidence for it in molluscum is thin, it is slow, and it makes the skin around the bumps red and flaky, which is its own reason to scratch.
Berdazimer gel. A newer prescription gel mixed and applied at home once a day, designed specifically for molluscum. In its trials about a third of children had all their bumps clear at twelve weeks, against roughly one in five given the placebo gel — a real effect, but a modest one. Redness and irritation where it is applied are common, and cost and availability are the practical limits.
A dilute alkaline solution dabbed on individual bumps at home, usually once or twice a day until each bump becomes inflamed and then clears. It is cheap and it can be done without appointments. It stings, it works by irritating the skin, and it can leave dark or pale marks if it is overdone — so it goes on the bumps only, and starting with a few is sensible.
This one was studied properly in children, in two large trials, and it did not work any better than the placebo cream — while causing more skin reactions, and in some children pain and swelling. It is still prescribed for molluscum out of habit. On the evidence there is, it should not be.
An old stomach-acid tablet, taken by mouth for several weeks in the hope of nudging the immune system into recognizing the virus. It appeals because it is painless and needs no procedure, which matters for a frightened child with many bumps. The trials do not support it, and it interacts with a number of other medicines, so it is a long shot rather than a plan.
The definitive treatment, and the only thing that actually empties a milium. The roof is nicked with a sterile blade or needle and light pressure lifts the keratin pearl out whole, in about ten seconds a bump. The one that is removed does not come back in that spot. Done once, properly, it heals in a few days; repeated digging at the same place is what leaves marks.
A fine heated needle used to destroy the sac, usually kept for milia that are numerous, very small, or sitting somewhere awkward for a blade. It works. It is also more likely than a simple nick to leave a small mark, so it is not the first choice for one or two bumps on an eyelid.
Freezing is sometimes offered for milia. It is less precise than extraction, more uncomfortable, and on deeper skin tones it carries a real risk of leaving a pale or dark mark where the bump was. There is little reason to choose it over opening the sac and lifting the contents out.
Each bump is frozen for a few seconds, and it usually takes several visits a few weeks apart. It works, and it is quick. It also stings sharply at the time, which most young children will not sit through twice, and it leaves dark or pale marks more readily than the other options — a real consideration on deeper skin tones, where those marks can last longer than the infection would have.
A blistering liquid painted onto each bump in the clinic and washed off a few hours later at home. A small blister forms over the next day and the bump lifts off with it. It is painless to apply, which is why it suits children, and it usually takes two or three visits. It is not used on the face or the genitals, and it can leave a dark or pale mark, so a few bumps are treated first to see how the skin reacts.
The bumps are scraped off with a small looped instrument, usually after numbing cream has been left on for an hour. It is the fastest option — most of a crop can be dealt with in one visit — and it is the one that gives an immediate result. It is uncomfortable even with numbing, small children often find it distressing, and it can leave small marks or pitted scars where bumps were deep.
The course depends almost entirely on age: in a newborn the bumps clear themselves, and in an adult they sit still. Milia that follow an injury or procedure appear one to two months after the skin healed and often clear over several months, though they can be extracted sooner.
Molluscum is self-limiting and usually clears within six to eighteen months, occasionally two years or more in children with eczema. The shape of the course catches people out, because the bumps do not all appear at the start and fade together.
Gone from that spot for good
An emptied milium does not return there. New ones can form nearby — a new bump, not a recurrence.
Bacterial infection
A bump that has been scratched or torn open can let ordinary skin bacteria in, and it can turn into impetigo. This is the one thing that looks like the harmless red flare of a bump clearing, so the difference is worth knowing: redness that spreads outward into the skin around the bump, warmth, pus, or fever means it needs checking that week. A single angry bump with normal skin around it is usually good news. Keeping nails short and covering broken bumps is most of the prevention.
Marks and scars from picking
Molluscum itself does not scar. Small round pitted scars come from picking, deep scratching and treatments that burn or blister the skin harder than they needed to. Flat dark or pale marks are far more common and are not scars — they fade over months, more slowly on deeper skin tones. Leaving the bumps alone, treating the itchy skin around them, and starting with a few bumps rather than thirty is how most of this is avoided.
Bumps on the eyelid
A bump on the eyelid margin or very close to the eye can rub the surface of the eye and cause a red, watery, irritated eye that does not settle. It is uncommon, and it is one of the few molluscum situations that should not simply be waited out. The bumps here are treated carefully rather than frozen or scraped, and an eye assessment is sometimes needed as well.
Ask a clinician about persistent or troublesome bumps, especially near the eyes. Avoid trying to pierce or extract them yourself.
Seek advice for uncertain lesions, extensive disease, eyelid involvement or weakened immunity. Adults with genital bumps should be assessed for other possible causes.
Because there is no pore. A milium is a sealed sac of keratin under intact skin, so nothing has a route out. Pressure sends the contents sideways into the tissue, which is how bruising and dark marks happen. Open the roof first and it comes out.
You can reduce how many new ones form, with a retinoid at night over two to three months. You cannot reliably remove the ones you have, and please do not try with a needle - eyelid skin is thin, the aim is difficult, and the usual result is a mark that outlasts the bump.
A brief scratch rather than real pain; most people need no anesthetic. One small nick and light pressure heals in a few days without a scar. Repeated digging at the same spot is what leaves marks.
The one removed does not return. New ones can form elsewhere, especially if you are prone to them or something is triggering them — a blistering condition, a resurfacing procedure, steroid cream. That is a new bump, not a recurrence.
Nothing. Newborn milia are common and clear within a few weeks as the ducts finish maturing. No creams, no rubbing, no special washing. If they are still there after a couple of months, or the baby has widespread bumps with fragile or blistering skin, have them looked at.
Yes. Milia are a recognized consequence of laser resurfacing, dermabrasion and deep peels, usually a month or two after the skin heals. They often settle over several months, and can be extracted any time if they bother you.
Usually six to eighteen months, sometimes longer, with new bumps appearing while older ones clear. That is the normal course, not a sign something is wrong. Children with eczema are at the longer end.
Most often it is clearing. As the immune system recognizes the virus, bumps become red, swollen and tender, sometimes crusted, then disappear — the beginning-of-the-end sign. Genuine bacterial infection is possible, so redness spreading outward with warmth, pus or fever should be checked the same week.
No. Molluscum is not a reason to miss school, nursery or swimming. Cover the bumps where practical, use your own towel, and do not share kickboards and floats.
Not for medical reasons - it clears on its own and leaves nothing behind if left alone. Treating is reasonable when the bumps are in an awkward place, being scratched raw, very numerous, keeping eczema stirred up, or when the family has had enough.
The infection itself does not scar. Scars come from picking, deep scratching or aggressive treatment. Flat dark or pale marks where bumps sat are not scars - they fade over several months, more slowly on deeper skin tones.
In adults, molluscum in the groin, genitals and inner thighs is usually passed through sexual contact, so it is worth being seen and worth testing for other sexually transmitted infections. It can also arrive by ordinary skin contact or shared towels, including from a child in the house, so it is not proof of anything.
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