Milia
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.
Key facts
Milia at a glance.
Typical signs
Tiny, firm white bumps
Common locations
Around eyes and cheeks
Expected course
Newborn cases clear; adult bumps persist
Treatment options
Observation or professional extraction
What is it?
Top things to know about Milia
- 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.
What it looks like
What Milia looks like
Milia are tiny, firm white or yellowish bumps, about 1 to 2 millimeters wide. They form when keratin, a skin protein, gets trapped just under the surface. They are most common around the eyes, on the cheeks and nose, and in newborns. Milia don't hurt or itch, and they can't be squeezed out like a whitehead because they have no opening to the surface.
Milia are grouped by how they form. Most are harmless and need no treatment.
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.
Where it shows up
Milia commonly occur on the face, particularly around the eyelids and cheeks.
Face
Facial locations.
On different skin tones
Milia on different skin tones
Milia look similar across skin tones as small white or yellow bumps, and they stand out more against darker skin. On brown and Black skin, they can be confused with dermatosis papulosa nigra, small dark bumps that are a different, harmless condition.
What happens in Milia?
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.
- A pale bump becomes visible: The firm bump sits just below the surface.
- A tiny cyst forms: A thin lining encloses a small space.
- Keratin collects inside: Trapped skin protein fills the cyst.
Causes and triggers
What causes Milia
Causes
Why it happens
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.
Risk factors
Raise the odds
- Newborns
- Sun-damaged skin
- Blistering skin conditions
Triggers
Bring it on or make it worse
- Burns or blisters (Strong link)
- Heavy creams around the eyes (Possible)
- Laser or peel treatments (Possible)
- Long-term steroid creams (Possible)
When it usually starts
When it usually starts
Milia
Can occur at any age and are especially common in newborns.
Daily care
Daily care for Milia
A lighter product around the eyes
Low cost, low risk, uncertain benefit.
Daily sunscreen
Keeps any mark after extraction from darkening.
Professional extraction
A tiny nick lifts the pearl out whole.
A gentle chemical exfoliant
Salicylic or low-strength glycolic acid keeps ducts clearer.
Treating the cause in secondary milia
Stops new ones forming; extraction alone does not.
Avoid: Squeezing them
No opening — pressure only bruises and marks the skin.
Avoid: Picking with fingernails
Risks infection, a scar or a dark mark.
Avoid: Using a needle on yourself at home
Unsterile and hard to aim near the eye.
Avoid: Scrubs, brushes and grainy exfoliants
Abrading the surface cannot reach the sac.
Avoid: Pore strips and extraction tools
Nothing to grip — there is no opening.
Avoid: Repeated injury to the same area
Each healing episode can seal off another fragment.
Avoid: Aggressive resurfacing
Deep peels, dermabrasion and ablative lasers are triggers.
Avoid: Heavy occlusive balms in one spot
Worth changing if milia keep forming there.
Avoid: Waiting for cleansers to fix it
Cleansing cannot reach a sealed sac.
Treatments
Treatments for Milia
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.
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.
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.
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.
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.
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.
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.
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.
Cryotherapy
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.
Outlook
What to expect with Milia
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.
- 1
Newborn, first month · Weeks 1 to 4
The baby is not bothered by them.
- 2
Newborn, second month · Weeks 4 to 8
The ducts finish maturing and the bumps go. No cream, no cleaning routine, no treatment.
- 3
Adult, at first · The first weeks
They rarely appear all at once.
- 4
Adult, later · Months to years
It does not grow, does not inflame, and shows little tendency to clear. Some resolve eventually; many do not.
- 5
After extraction · Permanent
An emptied milium does not return there. New ones can form nearby — a new bump, not a recurrence.
Complications
Complications to know about
Gone from that spot for good
An emptied milium does not return there. New ones can form nearby — a new bump, not a recurrence.
When to get help
When to get help
When to seek care
Ask a clinician about persistent or troublesome bumps, especially near the eyes. Avoid trying to pierce or extract them yourself.
Lookalikes
What else could it be?
Acne
Acne whiteheads may become inflamed and change over time. Milia are firm, sealed white bumps that often stay unchanged for months.
Molluscum Contagiosum
Molluscum bumps often have a small central dip and multiply in clusters. Milia lack that dip and do not spread from person to person.
Basal Cell Carcinoma
Milia usually stay tiny and unchanged. A pearly bump that grows, bleeds or repeatedly crusts needs checking for basal cell cancer.
Questions
Questions you might be asking.
Why will they not pop?
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.
Can I get rid of them at home?
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.
Does extraction hurt or leave a scar?
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.
Will they come back?
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.
My newborn has white bumps on the nose. What should I do?
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.
I got them after a laser treatment. Is that normal?
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.
Sources
Sources and further reading
Related
Keep exploring.
Molluscum Contagiosum
Comedone Extraction
Acne
Basal Cell Carcinoma
Salicylic Acid
Adapalene
Tretinoin
Electrodesiccation and Curettage
Glycolic Acid
Cryotherapy
Acne vs Milia