It’s easy to confuse them with whiteheads: small, pale bumps that appear overnight, often clustered under the eyes, on the cheeks, or along the nose. But before you reach for tweezers or start squeezing (don’t!), listen up—what looks like a minor breakout or whiteheads might actually be milia, a completely different skin issue that won’t respond to your usual acne treatments, and certainly not to squeezing.
“Milia are small cysts that form just beneath the skin’s surface,” explains Dr. Emmaline Ashley, a cosmetic physician and head of education at Acquisition Aesthetics. “They’re filled with keratin, a protein found in your hair, nails, and the outer layer of skin.” Milia appear as pearly-white bumps, but they aren’t inflamed, infectious, or related to acne.
Whiteheads, by contrast, are a type of acne caused by pores clogged with oil, dead skin, and bacteria. “Milia are firmer, deeper, and don’t extract as easily as whiteheads,” warns Dr. Ashley.
What causes milia?
Our skin is a living organ that renews itself monthly. As part of this natural cycle, dead skin cells should shed from the surface to make way for new ones. But sometimes this process doesn’t go as planned, leading to milia.
These small, pearly bumps form when dead skin cells and keratin get trapped under the skin instead of shedding properly. They often appear around the eyes and cheeks, where the skin is thinner and more prone to buildup.
“Clinically, milia are smooth, dome-shaped, and firm to the touch,” says Dr. Ashley. “Unlike whiteheads, they don’t come to a head, aren’t red or inflamed, and usually aren’t tender unless irritated.”
According to Dr. Hussein Yassine, a board-certified dermatologist and founder of Skin Expert Clinic, milia are common in newborns and adults with dry or damaged skin. They can be triggered by factors like using heavy, occlusive products—such as petroleum jelly, mineral oils, lanolin, beeswax, paraffin, rich natural oils, or butters like cocoa and shea—which can disrupt natural exfoliation. Even ingredients like dimethicone in makeup can contribute if applied too heavily. Overusing rich eye creams, not removing makeup properly, or using occlusive products in hot, humid climates can also encourage milia.
A less common type, traumatic milia, can occur after skin stress, like from laser treatments or dermabrasion, where the healing process traps keratin under the skin.
How to treat milia
Milia are usually harmless and often go away on their own over time. But if they persist or are cosmetically bothersome, experts recommend a mix of consistent at-home care and professional treatments. “A skilled clinician can use a sterile needle to gently open the lesion,” says Dr. Ashley. “For more extensive cases, cryotherapy, diathermy, or laser ablation may be suggested.”
Dr. Yassine also recommends retinol or in-office peels to help renew the skin and promote exfoliation. “HydraFacials are another effective option for deep pore cleansing,” he adds.
For at-home care, consistency is key. Gentle exfoliating ingredients can gradually help reduce milia and prevent new ones from forming.To prevent milia from forming, look for products containing retinoids to increase cell turnover and reduce keratin buildup, as well as AHAs and BHAs—especially if you’re also dealing with acne or clogged pores. However, be cautious. “Since milia often appear in delicate areas like around the eyes, it’s important to be gentle,” advises Dr. Ashley. “Avoid over-exfoliating and don’t try to remove them yourself at home.”
Here are some product recommendations:
– Medicube Zero Pore Pads: $19 (originally $31) on Amazon
– Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant: $37 on Amazon
– CeraVe Resurfacing Retinol Serum: $19 (originally $22) on Amazon or Walmart
– Glo Skin Beta-Clarity BHA Drops: $52 (originally $56) on Amazon
– Medik8 Surface Radiance Cleanse: $27 on Medik8
– Chanel N°1 Revitalizing Mask: $100 on Chanel
Although you can’t completely stop milia from coming back, experts agree that keeping your skin barrier healthy and sticking to a gentle, regular exfoliation routine can greatly lower your risk. Use lightweight, non-comedogenic products around the eyes, avoid heavy creams that can trap dead skin and keratin, and consider using a mild chemical exfoliant once or twice a week. “Always wear daily SPF, as long-term sun exposure is a common cause of milia in adults,” she adds.
Additional product suggestions:
– Clinique Moisture Surge 100H Auto-Replenishing Hydrator: $47 on Amazon
– Blue Lagoon Skincare BL+ Eye Cream: $165 on Blue Lagoon Skincare
– MAC Cosmetics Hyper Real Skin Serumizer: $63 (originally $90) on Nordstrom
– SkinCeuticals Physical Fusion UV Defense SPF 50: $45 on Bluemercury
Frequently Asked Questions
Of course Here is a list of helpful and clear FAQs about milia
FAQs Milia vs Whiteheads
Q What exactly is milia
A Milia are tiny white or yellowish bumps that form when keratin gets trapped under the surface of your skin They are small cysts not acne
Q How is milia different from a whitehead
A A whitehead is a clogged pore filled with oil bacteria and dead skin cells Its a form of acne and can be inflamed Milia are just trapped keratin have no opening and are not infected or inflamed
Q What causes milia to form
A Common causes include using heavy poreclogging skincare products skin damage not exfoliating enough and in newborns underdeveloped sweat glands They can also just appear for no obvious reason
Q Can I pop a milia like a pimple
A No please dont Unlike a whitehead milia are encased under a layer of skin Trying to pop them at home usually leads to redness scarring and potential infection and the milia often remains
Q How can I treat milia at home
A The safest athome approach is consistent gentle exfoliation Use products with ingredients like salicylic acid glycolic acid or retinoids to help speed up skin cell turnover and bring the keratin to the surface
Q Are there any specific ingredients I should look for in products
A Yes Look for chemical exfoliants and retinoids These help dissolve dead skin cells and unclog the area Avoid heavy oils and petrolatumbased products on areas prone to milia
Q When should I see a professional about milia
A You should see a dermatologist or licensed esthetician if the milia are persistent widespread in a sensitive area or if your athome efforts arent working after several weeks
Q How does a professional remove milia