Often mistaken for whiteheads, milia are small, white, benign cysts that commonly appear on the skin — particularly around the nose, eyes and cheeks.
Milia are harmless, but for some people they can be a cosmetic concern. Nicknamed “milk spots”, milia are commonly associated with newborn babies, but they occur in adults too.
This article explains what milia are, their causes, symptoms and diagnosis, and the treatment options that may help manage them. It is general information only. If you would like a bump assessed or treated, the appropriate first step is an individual assessment with a qualified practitioner, because suitability and results vary from person to person.
What are Milia?
Milia are tiny, pearly-white bumps that form under the skin. They are primarily made up of keratin, a protein found in the skin, hair and nails.
Milia are often mistaken for whiteheads or other types of acne, but they are not related to acne and do not form from clogged pores.
What Causes Milia in Adults?
Several factors can contribute to milia in adults.
Primary Milia
Most commonly, milia occur when dead skin builds up and becomes trapped in the pores near the surface of the skin. If the build-up is not shed naturally, it can form a small cyst. This type is called primary milia.
Genetics
A predisposition to milia can run in families.
Skin Trauma
Burns, blistering injuries, or some skin treatments can trigger the formation of milia (known as secondary milia).
Sun Damage
Prolonged sun exposure can lead to skin changes that contribute to milia.
Skin Products
Heavy creams or oil-based products can trap keratin under the skin, which may contribute to milia.
Ageing Skin
As skin ages, it can become less effective at shedding dead skin cells, which may contribute to milia forming.
Symptoms of Milia
Milia are typically asymptomatic and do not usually cause pain or discomfort. Key characteristics include:
- Appearance: small, white or yellowish bumps.
- Texture: firm to the touch, not easily squeezed out.
- Location: commonly found around the eyes, nose and cheeks, and sometimes on the eyelids.
- Size: usually 1–2 millimetres in diameter.
Diagnosis of Milia
Diagnosing milia is usually straightforward and typically involves a physical examination by a healthcare provider. Their distinctive appearance usually makes them easy to identify without additional tests. In rare cases, a biopsy may be performed to rule out other skin conditions — one reason it is worth having any new, changing or uncertain lesion checked by a qualified practitioner rather than assuming it is milia.
Treatment Options for Milia
Milia often resolve on their own. Some people choose treatment for cosmetic reasons or if the milia persist. Options include:
1. At-Home Remedies
- Exfoliation: regular, non-abrasive exfoliation may help remove dead skin cells and reduce build-up.
- Over-the-counter retinoids: these may promote cell turnover and help limit keratin build-up.
- Steam: using steam to open pores can sometimes help release trapped keratin.
At-home approaches are not guaranteed to work, and results vary. Milia should not be picked or squeezed at home, as this can cause scarring or infection.
2. Professional Treatments
- Manual extraction: a dermal clinician can remove milia using a sterile needle and a comedone extractor. This should not be attempted at home, as it can cause scarring or infection.
- Chemical peels: peels with ingredients such as glycolic acid may help exfoliate the skin and reduce milia.
- Laser therapy: laser treatments such as Pico Genesis use focused energy to target milia.
Any procedure carries risks. For milia removal these can include redness, temporary swelling, changes in pigmentation, infection and, less commonly, scarring. Suitability and results differ from person to person, so the possible benefits, limitations, risks and recovery are discussed with you during an individual assessment before any treatment is carried out.
Prevention of Milia
Reducing the chance of milia involves a consistent skincare routine and protecting the skin from damage. Suggestions include:
- Non-comedogenic products: choose products that do not clog pores.
- Sun protection: regular use of broad-spectrum sunscreen can help prevent the sun damage that may contribute to milia.
- Regular exfoliation: regular, non-abrasive exfoliation may help remove dead skin cells and reduce build-up.
- Avoid heavy creams: lighter, water-based moisturisers may suit people who are prone to milia.
Conclusion
Milia are common, harmless skin cysts that can affect people of all ages. While they often resolve on their own, several treatment options may help those who wish to have them removed for cosmetic reasons. Results and suitability vary between individuals, and no outcome can be guaranteed.
If you have persistent or bothersome milia — or you are unsure whether a bump is milia or another type of lesion — a qualified dermal clinician or doctor can assess your skin and explain the options, their limitations and their risks so you can make an informed decision.
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