Milia: why tiny white bumps appear and why not to squeeze them
Milia explained: what the tiny white bumps under the eyes are, why they form, why squeezing fails, home care, safe removal by a dermatologist, and prevention.
Written by the Glowpedia team · not yet reviewed by our dermatologist
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Milia are tiny, hard, pearly-white bumps that often show up under the eyes, on the eyelids, nose and cheeks. They look like whiteheads, but they are not acne, and they have no opening at the surface, which is why squeezing does not work.
Quick answer: Milia are tiny cysts filled with keratin, the protein that makes up the outer skin. They are harmless and often clear on their own, especially in babies. Don't squeeze or pick them. A retinoid may help over time, and daily sunscreen helps protect skin. For quick removal, a dermatologist can open them with a sterile needle or blade in a few minutes.
What are milia?
A single bump is called a milium; several are called milia. Each one is a very small cyst, a closed pocket under the skin, filled with keratin that got trapped instead of shedding normally. They are usually white or yellowish, about the size of a pinhead, and feel firm, like a grain of sand.
Milia are common at every age and in all skin types. In newborns they are very common, often on the nose, and usually go away within a few weeks without any treatment.
What causes milia?
Doctors often split milia into two groups:
- Milia that appear on their own: common in babies, and in children and adults around the eyelids, cheeks and forehead. There is often no clear trigger.
- Milia after skin damage: they can follow burns, blistering, skin resurfacing treatments such as dermabrasion, sun damage, or some creams used for a long time, such as steroid creams.
Some people notice milia after using very rich creams around the eyes. This link is not well studied, but if you are prone to milia, a lighter eye cream is a reasonable change.
Milia vs whiteheads
| Milia | Whiteheads | |
|---|---|---|
| Feel | Hard, like a grain of sand | Soft |
| Opening at the surface | None | Tiny pore opening |
| Contents | Trapped keratin | Oil and dead skin |
| Typical places | Under eyes, eyelids, cheeks, nose | Anywhere you get breakouts |
| Squeezing | Doesn't work and damages skin | Not advised either |
If you mostly get clogged pores and breakouts, see blackheads and pores instead.
Why you should not squeeze milia
Because milia are covered by a thin layer of skin with no opening, pressing them only bruises and tears the skin around them. Picking near the eyes can lead to infection, scars and dark marks. Never use a needle at home: the skin around the eyes is thin and easy to injure.
How to get rid of milia at home
Milia do not always need treatment, and many fade with time. If you want to help them along:
- Retinoids: a gentle retinoid at night on the cheeks may help skin renew and is one of the options doctors use for many milia. Keep it off the eyelids and away from the lash line. Results take weeks to months.
- Gentle exfoliating acids: some people use a mild AHA a few nights a week on the cheeks. There is little research on this for milia.
- Leave them alone: avoid scrubs and rubbing, which add skin damage.
Retinoids and exfoliants can make skin more sensitive, so use sunscreen every day. If you are pregnant or breastfeeding, ask your doctor before using it.
Milia under the eyes: what to use
The under-eye area is where milia are most common and where skin is thinnest. Keep your routine simple there:
- A light, fragrance-free eye gel or cream, applied with a gentle tap rather than rubbing.
- No strong acids or retinoids on the eyelids. If you use a retinoid on the face, keep it below the orbital bone, the bony ring around the eye.
- Sunscreen and sunglasses outdoors, since this area gets a lot of sun.
If you use a retinoid in the evening, daily sunscreen matters even more; see retinoids + sunscreen.
Professional milia removal
A dermatologist can remove milia quickly and safely:
- Extraction: a tiny cut with a sterile needle or blade, then the keratin is gently pressed out. This usually takes minutes.
- Freezing (cryotherapy) or heat (diathermy): to destroy the bump.
- For many milia: prescription retinoids, chemical peels or laser treatment may be suggested.
Milia can come back after removal, especially if the cause continues.
How to prevent milia
- Wear a broad-spectrum sunscreen every day, because sun damage is one possible trigger (everyday sun protection).
- Choose lighter creams around the eyes if you are prone to milia.
- Remove eye makeup gently and completely, without rubbing.
- Avoid long-term use of steroid creams on the face unless a doctor tells you to.
How long do milia last?
In babies, milia usually go away within a few weeks. In older children and adults they can last for months, or longer. Home care with a retinoid works slowly, while professional removal gives an immediate result.
When to see a dermatologist
- You want milia removed, especially near the eyes.
- Many milia appear suddenly, or in patches or plaques.
- Milia appear with blisters, fragile skin or a rash, as they can be linked to other skin conditions.
- A bump grows, bleeds or changes, since it may not be milia at all.
- A baby's milia have not gone after a few months.
FAQ
Do milia go away on their own?
Often, yes. In babies they usually clear within weeks. In adults they can take months or stay until removed.
Can I use a needle at home?
No. The infection and scarring risks are high, especially near the eyes. Ask a dermatologist.
Are milia contagious?
No. They are trapped keratin, not an infection.
Should I treat my baby's milia?
No. Don't squeeze them or put adult creams on them; they usually clear by themselves.
Sources
- Milium, milia (DermNet)
- Milia (milk spots): causes and treatment (Cleveland Clinic)
- Rashes in babies and children (NHS)