ConditionSkin, hair & nails
Milia (Milk Spots)
Milia are tiny, hard, white or yellowish bumps, 1 to 2 mm across, just under the surface of the skin. Each one is a small cyst filled with keratin, the protein in the skin's outer layer. They are harmless and very common, appearing in up to half of newborns and in people of all ages, especially around the eyes, cheeks and nose. Baby milia clear on their own within weeks. In adults they can persist for months, and a dermatologist can remove them quickly.
Also called: Milium (singular), milk spots, milia cysts, keratin cysts, oil seeds
At a glance
- What they are
- Tiny keratin-filled cysts just under the skin.
- Where
- Eyelids, under the eyes, cheeks, nose, forehead; in babies also the gums and palate (Epstein pearls).
- Types
- Primary (arise spontaneously) and secondary (after blistering, burns, sun damage, creams, procedures).
- Babies
- Clear on their own within a few weeks.
- Adults
- Often last months; removed by a dermatologist with a sterile needle or treated with topical retinoids.
When to get help
Book a routine appointment
- Many milia appearing suddenly in an area, especially after blistering or with skin fragility
- A bump that is growing, bleeding, crusting or changing color
- Milia near the eye that you want removed safely
- Persistent bumps that you are not sure are milia
Usually safe to manage at home
- A few tiny white bumps on a newborn's nose, cheeks or chin
- Small stable white bumps on the face that are not bothering you
What milia are
Milia form when dead skin cells (keratin) become trapped in a tiny pocket just under the surface instead of shedding normally. Unlike whiteheads, they are not blocked pores and have no opening to the surface, which is why they cannot be squeezed out.
Types of milia
| Type | Who and where | Notes |
|---|---|---|
| Neonatal milia | Newborns, on the nose, cheeks, chin | Up to half of babies; clear in weeks |
| Epstein pearls and Bohn nodules | Newborn gums and roof of mouth | Harmless; disappear within weeks |
| Primary milia in children and adults | Eyelids, cheeks, forehead, genitals | Common; may last months |
| Secondary milia | Skin after injury, burns, blistering, dermabrasion, laser, heavy creams, long-term steroid creams, sun damage | Form during healing |
| Milia en plaque | A raised patch packed with milia, often behind the ear or on eyelids | Rare |
| Multiple eruptive milia | Crops appear over weeks | Rare |
| Milia with blistering diseases | Porphyria cutanea tarda, epidermolysis bullosa, bullous pemphigoid | Seen in healed blister areas |
Milia vs whiteheads and other bumps
| Bump | Features |
|---|---|
| Milia | Hard, pearly, uniform, 1 to 2 mm, no redness, cannot be squeezed |
| Whiteheads (acne) | Softer, may be inflamed, come and go, contain oil and can be expressed |
| Syringomas | Skin-colored or yellow, flat-topped, under the eyes, often in clusters |
| Xanthelasma | Yellow flat plaques on eyelids, linked to cholesterol |
| Sebaceous hyperplasia | Yellowish bumps with a central dip, mostly on the forehead of older adults |
| Basal cell carcinoma | Pearly bump that grows, may bleed or have small blood vessels |
Causes and triggers
- normal skin in newborns as glands mature
- heavy, occlusive skincare products and makeup, especially around the eyes
- sun damage (photoaging)
- long-term use of steroid creams
- skin injury: burns, blisters, rashes, tattoos
- cosmetic procedures: dermabrasion, laser resurfacing, chemical peels
- inherited tendency in some people
Treatment
Babies
No treatment is needed. Wash the face gently with water, avoid creams and oils, and do not squeeze or scrub. Milia usually disappear within 2 to 4 weeks.
Adults: at-home care
- Leave them alone: many disappear within months.
- Gentle exfoliation: products with alpha hydroxy acids, salicylic acid or retinoids (adapalene is available over the counter) can help the skin shed and may clear milia over weeks to months, and prevent new ones. Use cautiously near the eyes.
- Avoid heavy creams around the eyes and use non-comedogenic products.
- Sunscreen daily to prevent sun-related milia.
- Do not pick or squeeze, which can cause scarring and infection, especially around the delicate eyelid skin.
Professional removal
- De-roofing (extraction): a dermatologist makes a tiny opening with a sterile needle or blade and gently presses out the keratin. Quick, effective and usually leaves no mark.
- Cryotherapy: freezing with liquid nitrogen.
- Laser or electrodesiccation for multiple milia.
- Chemical peels and prescription retinoids for widespread milia.
- Minocycline is sometimes used for milia en plaque.
Prevention
- use lightweight, non-comedogenic skincare
- exfoliate gently with a retinoid or AHA product if you are prone
- protect your skin from the sun
- avoid long-term use of steroid creams on the face
Frequently asked questions
What causes milia?
Milia form when keratin, a protein in dead skin cells, becomes trapped under the skin's surface. In babies, they are a normal part of skin development. In adults, they can appear spontaneously or after sun damage, heavy creams, burns, blisters or skin procedures.
How do I get rid of milia under my eyes?
Many clear on their own over months. Gentle retinoid or exfoliating products can help, though use them carefully near the eyes. For quick, safe removal, a dermatologist can extract them with a sterile needle. Do not try to pop them yourself.
Are milia the same as whiteheads?
No. Whiteheads are clogged pores with oil and bacteria that can become inflamed. Milia are tiny keratin cysts under the skin with no opening, so they feel hard, look pearly and cannot be squeezed out.
Do milia go away on their own?
In babies, milia almost always disappear within a few weeks. In adults, they often last for months and some persist longer. They are harmless, so treatment is optional unless they bother you.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Milia
- American Academy of Pediatrics (HealthyChildren.org): Newborn skin
- DermNet: Milia
- MedlinePlus: Milia
- Cleveland Clinic: Milia