How to get rid of milia, and why you shouldn't squeeze them

Key takeaways

• Milia are tiny, hard, pearly-white bumps made of trapped keratin, a skin protein. They aren’t acne, and they usually don’t hurt or itch.

• They’re very common in newborns, affecting about 40% to 50%, and usually clear within a few weeks. In adults they can last weeks to months.

• Common triggers in adults include sun damage, heavy creams, burns, blistering and long-term steroid creams.

• Don’t squeeze or scrape them. They won’t come out that way, and you can scar or infect your skin.

• Gentle exfoliation, a retinoid and daily sunscreen may help. A dermatologist can remove stubborn milia quickly with a sterile needle or blade.

What are milia?

DermNet describes a milium as “a small cyst containing keratin (the skin protein),” and says that when there are several, they’re called milia. They show up as tiny pearly-white bumps just under the skin, usually 2 mm or smaller. They’re most common on the face, especially the eyelids, cheeks and nose, but can appear elsewhere.

Cleveland Clinic explains they form when old skin cells don’t shed and new skin grows over them, trapping them underneath. DermNet says milia are common at all ages and in both sexes.

There are two main types:

• Primary milia form on their own, often on the eyelids, forehead and cheeks. They affect both children and adults.

• Secondary milia form after damage to the skin, such as burns, rashes, blisters or sun exposure. Cleveland Clinic says they can also form as a reaction to a heavy skin cream or ointment.

Milia vs whiteheads

They’re easy to mix up, but they’re different things. Cleveland Clinic says “Milia aren’t a type of acne.” A whitehead forms when oil and dead skin plug a pore, while a milium is a small cyst of keratin under the surface.

A few ways to tell them apart:

• Feel. Milia are small, firm bumps under the skin rather than a plugged pore.

• Comfort. The American Academy of Ophthalmology says milia “do not itch or cause any pain or discomfort.”

• Location. Milia often appear on the eyelids and cheeks, and in newborns on the nose.

If you’re dealing with clogged pores instead, our guide to getting rid of blackheads covers what helps.

What causes milia?

In babies, milia are part of normal newborn skin. In adults, common triggers include:

• Sun damage. Cleveland Clinic lists damage from sun exposure.

• Heavy creams and oil-based products. Cleveland Clinic mentions heavy skin creams and ointments, and the American Academy of Ophthalmology mentions oil-based makeup or skin care that clogs pores.

• Skin injury. DermNet lists burns, dermabrasion and blistering rashes.

• Long-term steroid creams. Cleveland Clinic lists long-term use of steroid creams or ointments, and the American Academy of Ophthalmology lists long-term steroid use.

Do milia go away on their own?

Often, yes. In newborns, DermNet says they heal within a few weeks of birth, and the American Academy of Family Physicians notes they sometimes last into the second or third month. In adults, Cleveland Clinic says milia can last a few weeks to a couple of months before clearing, and DermNet says some can persist for months or longer.

How to get rid of milia at home

• Leave them alone first. Many clear on their own, especially in babies.

• Exfoliate gently. Cleveland Clinic suggests an over-the-counter exfoliant, and the American Academy of Ophthalmology suggests exfoliating two to three times a week. Our guide to AHA vs BHA explains the options.

• Try a retinoid. Cleveland Clinic lists over-the-counter adapalene gel or prescription tretinoin, and DermNet says topical retinoids may help widespread milia. Our guide to retinal vs retinol explains how retinoids compare.

• Switch to lighter products. If heavy creams seem to be the trigger, try a lighter moisturizer around the affected area.

• Wear sunscreen daily. The American Academy of Ophthalmology suggests SPF 30 or higher every day, even when it’s cloudy. Our guide to mineral vs chemical sunscreen covers gentle options for around the eyes.

The American Academy of Ophthalmology suggests asking your doctor before starting any at-home treatment. That matters most for milia near the eyes.

Why you shouldn’t squeeze milia

Milia don’t work like pimples. Cleveland Clinic says you shouldn’t try to squeeze or scrape them, since “this can scar your skin or cause an infection.” The American Academy of Ophthalmology adds that “milia cannot be removed this way.” Around the eyes in particular, leave removal to a professional.

How dermatologists remove milia

Removal is quick in a dermatologist’s office. DermNet says a milium can be “de-roofed using a sterile needle or blade” and the contents gently removed, or destroyed with cryotherapy (freezing) or diathermy and curettage. For very widespread milia, chemical peels, dermabrasion and laser treatment have been reported to work.

When to see a doctor

Cleveland Clinic suggests seeing a healthcare provider if your or your baby’s milia aren’t improving after a few months, or if they get worse. Australia’s healthdirect advises checking with a doctor if a newborn has a colored rash or crusting around the milia. It’s also worth seeing a dermatologist if you’re not sure the bumps are milia, or if you want ones near your eyes removed.

Frequently asked questions

What is the main cause of milia?

Milia form when keratin gets trapped under the skin. In adults, sun damage, heavy creams, skin injury and long-term steroid creams are common triggers. In newborns, they’re a normal part of early skin.

Can you squeeze out milia?

No. Milia aren’t pimples, and squeezing or scraping them can scar your skin or cause an infection. A dermatologist can remove them safely with a sterile needle or blade.

How long do milia last?

In newborns, they usually clear within a few weeks, though some last into the second or third month. In adults, they can last a few weeks to a couple of months, and sometimes longer.

Are milia caused by stress?

Major medical sources such as Cleveland Clinic and DermNet don’t list stress as a cause of milia. Sun damage, heavy products and skin injury are the documented triggers.

Can retinol get rid of milia?

It may help. Cleveland Clinic lists adapalene and tretinoin among treatments, and the American Academy of Ophthalmology says retinol may help some stubborn milia. Check with a doctor before using a retinoid near your eyes.