Milia
A tiny cyst full of keratin Keratin is the protein that makes up the surface of your skin. A small amount gets trapped in a closed pocket under the skin, and there is no opening for it to come out of.
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Milia vs Skin Tag
Milia are tiny keratin cysts trapped just under the surface of the skin. They are firm, white or pale yellow, and they do not move when you push them. Skin tags are soft flaps of skin growing on a thin stalk. They are flesh-coloured, and they wobble when you touch them. White and hard means milia. Soft and dangling means a skin tag.
At a glance
| The difference | Milia | Skin Tags |
|---|---|---|
| What it is | A tiny cyst full of keratin | A small flap of skin on a stalk |
| What it looks like | A firm white or yellow dot | A soft flesh-coloured tag |
| Does it itch or hurt | No | Only when something catches it |
| What it does over time | Often clears on its own | Stays, and more appear |
| Treatment | A pinpoint nick and gentle pressure | Snipped, frozen or burned off |
Skin Tags
Side by side
The differences that matter
What it is
Milia
A tiny cyst full of keratin
Keratin is the protein that makes up the surface of your skin. A small amount gets trapped in a closed pocket under the skin, and there is no opening for it to come out of.
Skin Tags
A small flap of skin on a stalk
A loose bundle of collagen and blood vessels wrapped in skin. It grows outward on a narrow neck, usually where skin rubs against skin.
What it looks like
Milia
A firm white or yellow dot
Smooth, round and dome-shaped. There is no opening on top and no redness around it. It looks like a grain of sand sitting under the skin.
Skin Tags
A soft flesh-coloured tag
Skin-coloured or a shade darker. The surface can be smooth or slightly wrinkled. It hangs off the skin, so it moves when you brush past it.
More photographs
Skin Tags
Size
Milia
One to two millimetres
About the size of a pinhead. Milia stay the size they started at.
Skin Tags
One to five millimetres
Usually the size of a grain of rice. A few keep growing over years and reach a centimetre or more.
Does it itch or hurt
Milia
No
Milia are painless and do not itch. People notice them by sight, usually in the mirror in good light.
Skin Tags
Only when something catches it
A tag is painless on its own. It can sting or bleed if a necklace, a collar, a seatbelt or a razor catches it.
Where it shows up
Milia
Around the eyes
Eyelids and under the eyes most of all, then the nose, cheeks and forehead. Newborns get them across the nose and chin.
Skin Tags
In skin folds
Neck, armpits, groin, under the breasts, and the eyelids. Anywhere skin rubs on skin or on clothing.
Where it appears
Milia
Eyelids, under the eyes, cheeks and nose
Milia turn up most often on the eyelids, under the eyes, and on the cheeks, nose and forehead. In newborns they sit across the nose, chin and cheeks, and sometimes on the gums or the roof of the mouth. They are firm and white, and they do not come to a head.
Skin Tags
Neck, armpits, under the breasts and the groin
They form where skin rubs against skin or clothing. A line of them often follows a collar, a bra strap or a waistband. They do not appear on the palms or the soles.
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Eyelids and the sides of the neck
The eyelids are the other common spot, and the sides of the neck are where most people notice their first one. A tag that is painful, bleeding, growing or changing color is worth having looked at, because those are not things a tag does.
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Does it spread
Milia
No
Not contagious. Several can appear in one small area, but one does not seed the next.
Skin Tags
No
Not contagious either. People who get one usually get more in the same folds, because the cause is friction rather than a germ.
What it does over time
Milia
Often clears on its own
Milia in babies clear within a few weeks. In adults they often sit quietly for months, and some stay for years.
Skin Tags
Stays, and more appear
A skin tag does not go away by itself. Occasionally one twists on its stalk, turns dark and drops off, but that is uncommon.
Treatment
Milia
A pinpoint nick and gentle pressure
A clinician opens the surface with a sterile needle and lifts the keratin out. It takes seconds per bump, usually needs no anaesthetic, and the skin heals over within about a week. A retinoid cream can clear a crop slowly instead.
Skin Tags
Snipped, frozen or burned off
The area is numbed, then the tag is cut at the base with sterile scissors, frozen with liquid nitrogen, or removed with heat. It is over in a minute or two.
Milia
Adapalene
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.
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Salicylic Acid
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.
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Glycolic Acid
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.
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A daily sunscreen
Not a milia treatment, and it will not stop new ones forming. It is here for what is left behind: a mark from an extraction or from picking darkens and lasts longer with sun on it, and that matters more on deeper skin tones. The useful window is the few weeks after a bump has been removed.
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A lighter cream around the eyes
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.
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Scrubs, brushes and pore strips
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.
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Comedone Extraction
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.
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Electrodesiccation and Curettage
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.
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Cryotherapy (Liquid Nitrogen)
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.
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Tretinoin
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.
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Skin Tags
Petrolatum
This is aftercare rather than treatment. A dab of plain petroleum jelly and a small dressing over the spot left after a tag is removed keeps the scab soft and gives the neatest healing. It does nothing to a tag that is still there, and it will not shrink one.
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Zinc Oxide
Daily mineral sunscreen over a healed spot on the neck or eyelid stops the temporary mark from deepening and helps it fade faster. It matters most on deeper skin tones, where a dark mark can otherwise last many months. It has no effect on whether new tags form.
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Tea Tree Oil
Tea tree oil, apple cider vinegar and garlic are the usual home remedies, and where they appear to work at all it is by burning the skin. That is a poor trade on a growth that was never dangerous, particularly on a neck or a face, and the mark left behind is often more noticeable than the tag. There is no evidence any of them dissolves a tag.
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Home removal bands and kits
Ligation bands, freezing sprays and removal creams sold online all kill the tissue and let it drop off. Done at home they are unclean, slow and painful, and they are the source of most of the scarring seen from something harmless. They are also applied to growths nobody has examined, which is how a skin cancer gets destroyed without ever being identified.
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Shave Removal
The usual method: the base is numbed and the tag is snipped or shaved off at the stalk with sterile scissors or a blade in a couple of seconds. It gives the most control over the mark left behind, which is why it is preferred on the face and neck and on deeper skin tones. It also leaves tissue that can be sent to the laboratory if there is any doubt about the growth.
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Electrodesiccation and Curettage
A fine electric tip burns through the stalk and seals it at the same time, so there is no bleeding. It suits several small tags in one session and very small ones on the eyelids. It destroys the growth, so it is not used on anything that needs examining first.
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Skin Biopsy
When a growth is firm, broad-based, ulcerated, bleeding on its own or simply different from your others, it is removed and sent for examination under a microscope rather than discarded. When it is being taken off anyway, that costs almost nothing, and it is the only way to be certain a growth was what it looked like.
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Cryotherapy (Liquid Nitrogen)
A few seconds of liquid nitrogen freezes the tag so it drops off over a week or so, and it is quick when there are many. It is less predictable with pigment, because the pigment-producing cells are sensitive to cold, so it is used more cautiously on deeper skin tones and near the eyes. It destroys the tag, so nothing can be examined afterward.
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Mupirocin
An antibiotic ointment for the small number of tags that get infected after being nicked or snagged — hot, swollen, oozing. It treats the infection on the surface and does nothing to the tag itself. If the redness is spreading into the surrounding skin, antibiotic tablets are needed instead.
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Cost
Milia
Low, priced per visit
A short cosmetic appointment. Several milia are usually done in one sitting.
Skin Tags
Low
Quick to remove, and usually counted as cosmetic, so it is often paid out of pocket.
See a doctor if
Milia
- The bump has changed colour, size or shape
- It bleeds without being knocked
- A skin tag has turned dark, painful or swollen
- White bumps have appeared in a patch on scarred or blistered skin
- Milia are still there after three months
- You are not certain which one you have
Related topic illustrations
Milia
Acne
The closed comedone — a whitehead — is what milia get mistaken for most. Both are small pale bumps in the same places. A whitehead is a blocked pore, so it has an opening you can find, it holds oil and skin cells rather than a firm pearl, it can turn red and sore, and it comes and goes over days. A milium is sealed, has no opening, sits unchanged for months and never becomes inflamed. That is also why acne treatments do very little for milia.
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Molluscum Contagiosum
Both are small, firm, dome-shaped and pale. Molluscum bumps are usually a little larger, most have a tiny dimple in the middle, they turn up in clusters that spread over weeks, and they are common in children and in skin folds. Milia do not spread, do not dimple and cannot be passed on. Molluscum is a virus and clears on its own eventually; a milium sits still until someone removes it.
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Basal Cell Carcinoma
Worth knowing about, because an early basal cell skin cancer can look like a small pearly bump on the face, which is exactly what a milium looks like. The difference is behavior. A basal cell grows slowly month by month, often has fine blood vessels visible over its surface, and may crust, bleed or refuse to heal. A milium is one to two millimetres, stays that size and never bleeds. A single bump that is growing or bleeding should be looked at.
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Skin Tags
Basal Cell Carcinoma
This is rare in this company but it is the reason not to remove anything at home. An early basal cell carcinoma on the neck or under an arm can look like a small raised bump and get dismissed as a tag for a year. It is firm rather than soft, has a broad base rather than a stalk, is often shiny with fine vessels running across it, and it slowly grows, crusts or bleeds without being caught. Anything that fits that description gets looked at, not snipped off.
Common questions
Questions Patients Ask
How can I tell if it is milia or a skin tag?
Push it gently sideways. A skin tag moves, because it hangs off a thin stalk. Milia sit inside the skin and do not move at all. Milia are also white or pale yellow, while skin tags are flesh-coloured.
Can I pop milia at home?
No. A milium has no opening, so squeezing it only bruises the skin over the top. On the eyelid, where most milia appear, the skin is thin enough that picking often leaves a brown mark or a small dent.
Do milia go away on their own?
Often, yes. In babies they clear within a few weeks. In adults they can sit for months or years, which is why people ask about removing them.
Can a skin tag turn into cancer?
A skin tag itself is harmless and does not become cancer. The reason to have a changing growth looked at is that a few other things can look like a skin tag, including moles and rare skin cancers.
Why do I keep getting skin tags in the same places?
Skin tags form where skin rubs on skin, so the same folds keep producing them — neck, armpits, groin and under the breasts. Removing one does not stop new ones forming nearby.
Does a dermatologist charge to remove either one?
Usually yes, because both are treated as cosmetic. Both are quick, and several can normally be removed in a single visit.