Those Pesky White Bumps Around Your Eyes Are Probably Milia

Ever notice teeny, tiny bumps around your eyelids, cheeks, or nose? Let us formally introduce you to these tiny cysts formally known as milia. Luckily, this common skin condition doesn’t typically cause harm or discomfort, but it can become a nuisance if you’re looking to clarify and even out your skin texture. It can also contribute to an uneven or patchy finish during any attempt to blend out your favorite foundation or concealer. Whether you embrace milia or want to figure out how to get rid of them, the choice is entirely yours.

According to Dr. Pooja Rambhia M.D., a board-certified dermatologist at Union Derm in New York City, milia bumps are filled with keratin and can commonly occur in people of all ages, including newborn babies. “Milia are harmless and typically do not cause pain or discomfort, however, they can be cosmetically bothersome to patients,” she confirms.

Regardless if you’re comfortable with these little constellations of bumps on your face or you entirely loathe them, both attitudes are perfectly OK. But it’s beneficial to understand where exactly milia comes from, if they’re preventable, and how to treat them should you so desire.

Where Do You Get Milia?

While they might be most noticeable on the eyelids, cheeks, and nose, Dr. Hadley King, M.D., a board-certified dermatologist in New York City, says that they can be found on other areas of the skin as well, including the neck and chest. She also notes that just because you have milia now, doesn’t mean you’ll have them forever. “Milia may eventually resolve on their own, but for faster resolution, a dermatologist can puncture them and clean out the contents,” she says. More on that, later.

What Causes Milia?

You may be wondering why these tiny cysts crop up to begin with. Milia comes from a blockage or occlusion of skin glands, which causes the production of little cysts from the trapped keratin, or skin cells. “This can happen as a form of acne, blockage by topical creams or heavy ointments, even certain types of skin trauma and sun exposure can trigger the production of milia,” says Dr. Rachel Nazarian, M.D., a board-certified dermatologist at Schweiger Dermatology Group in New York City. Comedogenic products may be the culprit of milia cysts, and even skin care practices like slugging can contribute to the blockages, particularly in areas where the skin is thinner and more delicate, like the under-eye area. “Less commonly, milia can also occur following damage or trauma to the skin, as seen in blistering skin disorders,” says Rambhia. More often than not, though, some people are just naturally more prone to milia than others.

Milia can also be mistaken for other skin conditions, which is why getting a diagnosis from your dermatologist is necessary. “They’re very close to the surface, so they often resemble whiteheads,” says Nazarian. They also can be mistaken for keratosis pilaris but usually differ in their location and can be singular or in a cluster. “They can be one single bump — called a ‘milium’— or, sometimes they are multiple, sprinkled around the eyes, forehead, and other areas of the face and body,” she says.

Can You Prevent Milia?

“If you are prone to milia, you may not always be able to prevent them, but using topical retinoids, exfoliating regularly, and avoiding comedogenic products can help,” says King. Incorporating retinol or AHAs and BHAs into your routine on a daily basis can help to unclog pores and remove dead skin cells that accumulate, therefore reducing the likelihood of new milia forming.

How To Treat Milia At Home

Treating milia at home can be done in a few ways, according to the experts. First and foremost, introducing exfoliation into your routine using products with salicylic or glycolic acid is key to eliminating dead skin cells, reducing the appearance of existing milia, and can even help discourage the skin from producing more of them. “Over-the-counter or prescription-strength topical retinoids will promote cell turnover that can reduce the appearance of milia over time,” Rambhia adds. If you’re new to retinol, this is a friendly PSA to start with a lower concentration once you begin incorporating it into your regimen, and then gradually increase frequency as your skin increases tolerance, to mitigate irritation.

Like pimples, the experts also urge you not to pick at your milia. “Milia are under the skin, so picking or squeezing won't help,” says King. If you do this, you can traumatize the skin and this can lead to scarring and infection. Instead, opt for a dermatologist visit where they can puncture the milia in a sterilized environment.

How To Treat Milia In Office

There are a few ways that a dermatologist can go about removing milia from the skin based on how embedded the cyst is within your epidermis. “For more superficial milia, simple extractions can be done easily and quickly to evacuate the hardened cyst from the skin,” says Rahmbia. This process is also recommended by Nazarian, who shares exactly how it’s done: “A small needle is used to safely create a path for the cyst to come out — your dermatologist can easily perform this comfortable technique without the risk of damage or scarring that can happen if you attempt it at home,” she says. In other words: Do not try this at home. Other alternatives include microdermabrasion, which resurfaces the skin to correct uneven texture and tone, and electrodesiccation, which uses a pinpoint electrode to generate an electrical current that produces heat which carefully destroys the milia.

It’s also possible to address milia via ablative lasers like CO2 or Erbium: YAG, says Rambhia. “[These resurfacing lasers] are able to precisely target and vaporize the milia while minimizing damage to surrounding skin,” she notes.

Further, chemical peels are another option for removing milia because they often utilize acids that exfoliate the skin by loosening the bonds between dead skin cells, promoting shedding and preventing them from clogging up pores. “This can prevent milia from forming and reducing the appearance of existing milia, with the added benefit of improving overall skin texture and tone,” says Rambhia.

Addressing Milia On Different Skin Tones & Types

Because there are a variety of treatment options for milia, it’s important to note that not all are equal when it comes to addressing every skin tone or type. “Treatment of milia on different skin tones, specifically, requires consideration of the risk of post-inflammatory hyperpigmentation,” says Rambhia. Treatments like ablative lasers can create complications like post-inflammatory pigmentary alteration, so they may not be the most appropriate treatment option for darker skin types, she explains.

This is why extraction remains the number one method in removing milia for all of the dermatologists. “Generally speaking, less aggressive treatment approaches such as use of topical exfoliants (like retinoids) or manual extraction are the safest as they have the lowest risk of causing hyperpigmentation,” says Rambhia.

If you have a sensitive skin type, the experts also urge to proceed with caution when it comes to all removal options. “If someone has very sensitive skin, they may find their skin has a slight healing period following milia removal,” Nazarian shares. “Ultimately, it's important to remember that milia are very common, not dangerous, and are incredibly easy for the appropriate medical professional to treat.”

Make sure you’re addressing your teeny tiny milia bumps as you would any other part of your skin or body: by either embracing them as a part of you or addressing them with diligent care.