Condition

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.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026

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A milium is a tiny sealed pocket of keratin under intact skin. There is no pore and no opening, which is why cleansers, scrubs, patches and pore strips do nothing, and why the actual fix takes about ten seconds per bump: a nick with a sterile blade and a gentle press, and the white pearl comes out whole. If your baby has them, do nothing — newborn milia clear themselves within a few weeks. In adults they are cosmetic and nothing more, so treat them if they bother you and ignore them if they do not.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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How commonVery common - roughly half of newborns have them, and they appear in adults at any age
Who gets itNewborns most of all, then adults of any age, particularly on the eyelids and cheeks
Curable or managedCurable - baby milia clear on their own, and adult milia go for good once they are extracted
Prescription neededUsually not. A prescription retinoid sometimes helps when there are many of them
Time to improveNewborn milia clear in a few weeks. Adult milia can sit for months or years, then go in seconds when extracted

What It Is

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A milium is a tiny cyst filled with keratin, the tough protein skin cells make — usually 1 to 2 millimeters across, firm, dome-shaped, white or slightly yellow. There is no opening, so nothing comes out, and it never turns red or sore. The plural is milia.

They turn up most often on the eyelids, under the eyes, and on the cheeks, nose and forehead, but can appear anywhere, including the trunk and genitals. A milium stays at a fixed size; it does not enlarge into anything else.

Primary milia arise without an obvious cause, from the base of a fine hair follicle or a sweat duct — the version newborns get and most adults have. Secondary milia follow damage that severs or blocks a duct: blistering conditions, burns, long-running sun damage, a scrape, radiation, laser resurfacing, dermabrasion, deep peels, or long-term strong steroid cream on thin skin. They follow the shape of the injury and appear weeks to months later.

Two named patterns matter. Milia en plaque is an uncommon variant where many milia sit on a raised, reddish patch, usually behind the ear or on the jaw or eyelid, and it needs medical treatment rather than extraction alone. Multiple eruptive milia is a crop of dozens over weeks, which is unusual and worth having looked at.

Milia get confused with a closed comedone, or whitehead. A whitehead is a blocked pore holding oil and cells behind an opening; it belongs to acne and can inflame. A milium is sealed, has no pore, is not acne, and never inflames.

Symptoms

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Tiny white bumps

Around the Eyes

Firm, white, pinhead-sized bumps under the surface, most often on the eyelids and cheeks. They contain trapped keratin, not pus, so they cannot be squeezed out. They are harmless and often need a small procedure to remove.
Newborn spots

In Babies

Small white bumps on the nose, cheeks and chin in the first weeks of life, present in about half of newborns. They clear on their own within a few weeks. No treatment is needed.
Bumps that follow something

After Damage or Heavy Creams

Milia appearing where the skin has been burned, blistered, lasered or covered with heavy occlusive products for a long time. They tend to sit in a group in one area. They often settle once the skin has fully recovered.

Where It Shows Up

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Front view of a head with red marks on both eyelids, under both eyes, on both upper cheeks, on the nose, on the forehead and on the chin.
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.

Causes

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The mechanism is simple. The lining of a very small structure — usually the base of a fine vellus hair follicle, sometimes a sweat duct — keeps producing keratin and shedding it. Normally that keratin travels up a duct and leaves at the surface. If the route out is blocked or never formed, it has nowhere to go.

It collects in a closed sac instead. The sac is lined with the same cells as the skin surface, so it keeps producing keratin inward and packs it into a firm ball. It is completely sealed: no channel to the outside, no bacteria, no inflammation.

In newborns the reason is developmental. Sweat and oil glands are still maturing and some ducts are not yet connected to the surface. As they open over the following weeks, the trapped keratin clears itself.

In secondary milia an injury is the reason. A blister, burn, deep scrape, radiation or resurfacing procedure can shear a duct in two. The deeper fragment heals over as a closed pocket lined with surface cells and behaves like a primary milium. Long-term potent steroid cream thins the skin and does the same.

Risk Factors

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Most people who get milia have no particular risk factor. These make them more likely.

Age
Being a newborn
The most common setting by far. Around half of babies have them in the first weeks, usually across the nose, chin and cheeks.
Skin damage & procedures
Skin that has blistered
Any blistering condition is followed by milia as it heals.
Skin damage & procedures
Burns, scrapes and other injury
Milia appear weeks to months later, in the area that was damaged.
Skin damage & procedures
Resurfacing procedures
Laser resurfacing, dermabrasion and deep chemical peels are recognized triggers, usually one to two months later.
Skin damage & procedures
Years of sun damage
Sun-damaged skin around the eyes and cheeks develops milia more readily.
Habits & products
Long-term potent steroid cream
Months of use thins already thin eyelid skin further. Never stop a prescribed cream on your own - ask your doctor.
Habits & products
Heavy occlusive products around the eyes
Often blamed, though the evidence is weak. Something lighter is harmless to try.
Inherited
Rare inherited conditions
A few genetic syndromes produce many milia from an early age. Widespread milia in a child is worth assessing.

Course

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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.

Newborn, first monthWeeks 1 to 4
Small white bumps appear

The baby is not bothered by them.

NoseChinCheeksGumsRoof of the mouth
Newborn, second monthWeeks 4 to 8
They disappear on their own

The ducts finish maturing and the bumps go. No cream, no cleaning routine, no treatment.

Adult, at firstThe first weeks
One or a few firm white bumps show up

They rarely appear all at once.

Around the eyesCheeks
Adult, laterMonths to years
An adult milium is stable

It does not grow, does not inflame, and shows little tendency to clear. Some resolve eventually; many do not.

After extractionPermanent
Gone from that spot for good

An emptied milium does not return there. New ones can form nearby — a new bump, not a recurrence.

What Makes It Better & Worse

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A milium is four problems — a duct lining producing keratin, no open route to the surface, keratin packed into a sealed sac, and injury that creates new blocked pockets. Almost everything people try acts on the surface; the problem is behind a sealed roof.

1The duct lining producing keratin

What helps

  • A topical retinoid at night Speeds up how the duct lining sheds — ask the doctor managing your pregnancy first.
  • Daily sunscreen Keeps any mark after extraction from darkening.

What makes it worse

  • Potent steroid cream on thin skin A recognized cause around the eyes — ask the prescriber.

2No open route to the surface

What helps

  • A gentle chemical exfoliant Salicylic or low-strength glycolic acid keeps ducts clearer.
  • A lighter product around the eyes Low cost, low risk, uncertain benefit.

What makes it worse

  • Scrubs, brushes and grainy exfoliants Abrading the surface cannot reach the sac.
  • Pore strips and extraction tools Nothing to grip — there is no opening.
  • Heavy occlusive balms in one spot Worth changing if milia keep forming there.
  • Waiting for cleansers to fix it Cleansing cannot reach a sealed sac.

3Keratin packed into a sealed sac

What helps

  • Professional extraction A tiny nick lifts the pearl out whole.
  • Doing nothing for a newborn Baby milia clear themselves within weeks.
  • Waiting a few months after a procedure Milia after a laser or peel often settle.

4Injury that creates new blocked pockets

What helps

  • Treating the cause in secondary milia Stops new ones forming; extraction alone does not.
  • An experienced practitioner Going only as deep as needed lowers risk.

What makes it worse

  • Squeezing them No opening — pressure only bruises and marks the skin.
  • Picking with fingernails Risks infection, a scar or a dark mark.
  • Using a needle on yourself at home Unsterile and hard to aim near the eye.
  • Repeated injury to the same area Each healing episode can seal off another fragment.
  • Aggressive resurfacing Deep peels, dermabrasion and ablative lasers are triggers.

Over-the-Counter Products

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Everything here you can buy without seeing anyone.

Five adapalene gel 0.1% tubes and boxes lined up on white, including Differin, Effaclar, PanOxyl and NeutrogenaLabeled cutaway diagram of a single skin pore, headed Adapalene. The epidermis is a brick-textured band across the top and the dermis is pink below it, with a yellow oil gland at the base of the pore and a small cluster of bacteria inside it. Three callout lines point in: decreases dead cells in pore and decreases oil production are drawn in dark navy as main effects, and decreases inflammation is drawn in gray as a lesser one.
Limited evidence
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.
Paula's Choice 2% BHA exfoliant, La Roche-Posay Effaclar cleanser and a CeraVe psoriasis cream pumpLabeled cutaway diagram of a single skin pore, headed Salicylic Acid. The epidermis is a brick-textured band across the top and the dermis is pink below it, with a yellow oil gland at the base of the pore and a small cluster of bacteria inside it. A single dark navy callout line points into the top of the pore: decreases dead cells in pore. There are no other callouts, so the drawing shows one effect where the other ingredient diagrams show two or three.
Limited evidence
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.
Four glycolic acid toner and liquid bottles lined up on white, one with its box16:9 hero for Glycolic Acid. Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
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.
A daily sunscreen
A daily sunscreen
Limited evidence
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.
A white cream tube lying on its side on a white background, with a plain white label reading Eye Cream and a yellow swoosh beneath it.
A lighter cream around the eyes
Weak evidence
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.
Scrubs, brushes and pore strips
Scrubs, brushes and pore strips
Weak evidence
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.

Prescriptions

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These need a prescription.

A plain white medicine tube lying at an angle on a white background, capped, labeled Tretinoin in black with a navy blue swoosh curving along its length.Diagram: how Tretinoin works in the skin
Limited evidence
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.

Procedures

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These are done in the office, usually over several visits.

A double-ended stainless steel comedone extractor lying horizontally on a white background: a slim polished rod with a small open wire loop at each end.Diagram: how Comedone Extraction works in the skin
Strong evidence
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 gloved clinician treating a small dark spot on a patient's shoulder with a fine handheld instrument16:9 hero for Electrodesiccation and Curettage. Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
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.
16:9 hero for Cryotherapy (Liquid Nitrogen). Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Cryotherapy (Liquid Nitrogen) works in the skin
Weak evidence
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.

When to See a Dermatologist

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Milia are harmless, so most visits are about convenience rather than concern — a good reason to come, since a short appointment removes them properly and beats another month of trying at home. Book for a medical reason if dozens appear over a short period, if milia sit on a raised red patch, or if a child has widespread milia, especially with fragile or blistering skin. Book too if you are not sure the bump is a milium, since anything that grows, changes color, bleeds, crusts or becomes sore should be identified rather than watched, and come in if they keep forming after a procedure, because working out why stops the next batch. No test is needed in a typical case — a firm white dome with no opening is recognizable by eye, and the extraction itself confirms it, since a small nick releases a firm white pearl and no other bump does that.

— Dr. Schwarz, Board Certified Dermatologist

Complications

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Lookalikes

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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.

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.

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.

Myths

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  • "Milia are whiteheads." They are unrelated. A whitehead is a blocked pore with oil and cells behind an opening; it belongs to acne and can inflame. A milium is sealed keratin with no opening, is not acne, and does not inflame. Acne treatments do almost nothing for them.
  • "They mean your skin is dirty or you are not washing properly." Washing has no bearing on them. Half of all newborns get them, which settles the hygiene question.
  • "You can squeeze them out." There is no opening for anything to come out of. Pressure bruises the skin and can push the sac deeper. The keratin comes out once the roof is opened with a sterile blade.
  • "A good scrub or exfoliating brush will get rid of them." Abrasion works on the surface; the sac sits under it. Scrubbing irritates the skin and can block more ducts.
  • "Your eye cream definitely caused them." Heavy eye products get blamed, but the evidence is weak and plenty of people get milia using nothing. Switching to something lighter is harmless - just do not expect it to clear the ones already there.
  • "Babies with milia need treatment." They need nothing. Newborn milia clear within a few weeks, and rubbing or applying products only irritates the skin.
  • "They are a sign of high cholesterol." That comes from confusing milia with xanthelasma - soft yellow plaques on the eyelids that can be linked to cholesterol. Milia carry no such link.
  • "Once you have them, they are permanent." Each milium is gone for good once extracted. New ones can appear elsewhere, but the one removed does not come back.

Questions Patients Ask

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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.

References

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