Milia: Causes and Treatment for those Tiny White Bumps

Milia are tiny white bumps that form on the skin, usually around the eyes, nose, cheeks, or genitals. Milia that occur without a known cause (primary milia) tend to disappear on their own within a few months. Milia that occur as a result of skin damage (called secondary milia) may be permanent. Let’s take a closer look at the two types of milia and what can be done about them.

What are Milia?

Unlike pimples, those small white bumps are actually cysts that form from dead skin cells being trapped beneath your skin.

  • Primary Milia. Primary milia develop spontaneously, without a known cause. These most often occur on the eyelids, cheeks, forehead, or genitals. Primary milia generally clear up on their own within a few months.
  • Secondary Milia. Secondary milia are milia that develop after skin trauma. Secondary milia may result from injury or irritation to the skin, rashes, burns, inflammatory skin conditions, abrasive skin treatments, strong skincare products, or too much sun exposure. This type of milia may be permanent.

Should Milia Be Treated?

Milia are a cosmetic problem, not a medical one. Babies often develop milia, but there is no need to treat it as it will resolve on its own. For older children and adults, the choice to treat milia is up to you.

One thing you should not do is pop milia. Unlike pimples (which you should not pop, either), milia are not pores filled with fluid. They are cysts filled with a hard plug of compacted dead skin cells, much like a grain of sand. Because they do not develop inside a pore, there is no opening to push the contents out of. Attempting to pop them will only damage your skin and potentially cause scarring, especially around the delicate eye area.

How to Treat Milia

Milia can be treated, but it takes time for them to go away completely. If you would like to treat your milia, the first step is to be sure that the white bumps on your skin are, in fact, milia. Other skin conditions can create similar-looking outbreaks. The best way to confirm that you do, indeed, have milia is to see a dermatologist.

  • Over-the-counter exfoliating products. You can try an over-the-counter exfoliating product containing salicylic acid or glycolic acid to treat your milia. The acne medication adapalene (Differin) may also help. Unfortunately, milia do not go away quickly. You will need to use the product for several months before you see improvement.
  • Topical retinoids. Your dermatologist may prescribe a topical retinoid to treat your milia. These medications are stronger than over-the-counter options and can help loosen the plugs and bring them to the surface so the milia can go away.
  • Manual extraction. While you should not try to pop milia on your own, your dermatologist can perform a manual extraction to get rid of them. Using a small surgical blade called a lancet, your doctor makes a tiny opening in the skin. Using fingers or a comedone extractor, the doctor will carefully remove the hard plug of material. No anesthesia is needed, and you’ll only feel a tiny prick.

Preventing Milia

You cannot prevent milia; however, taking good care of your skin will make milia less likely to develop. Avoid harsh skin care products. Use a mild cleanser and exfoliate regularly. Protect your skin from the sun with clothing, hats, and sunscreen. If you have any concerns, see your dermatologist.