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Book AppointmentHave you ever noticed tiny, hard bumps on your skin that seem to appear out of nowhere? These small bumps, called milia, can leave otherwise smooth skin looking uneven. They show up at any age and are most common on the face, especially around the eyes and cheeks. They are harmless and painless, but because they appear in such visible spots, many people want to understand what they are and how to get rid of them. Here is what milia are, why they form, and how to keep them from coming back.
What Are Milia?
Milia, sometimes called milk spots, are small, white or yellowish keratin-filled cysts that form just beneath the surface of the skin, usually less than two millimeters across. They are benign and rarely cause any discomfort, though they can be a cosmetic concern when they appear on the face or around the eyes. They are extremely common in newborns: roughly 40 to 50 percent of infants develop milia in their early days, almost always resolving on their own. They can also occur at any age, which is where adult skincare habits come in. For a general medical overview, the American Academy of Dermatology is a reliable starting point.
Primary vs. Secondary Milia
Milia fall into two main types. Primary milia form from keratin that gets trapped beneath the skin with no outside cause, which is why they are so common in healthy newborns and why they often clear on their own within a few weeks.
Secondary milia develop after the skin has been disrupted, by burns, blisters, rashes, or procedures such as laser treatments and chemical peels, or by prolonged use of heavy creams that block pores. Because they can signal recent skin trauma, secondary milia are worth discussing with a dermatologist if they persist or worsen.
How Do Milia Form?
Normally, your skin sheds dead skin cells to make room for new ones. When that shedding process is disrupted, the dead cells get trapped beneath the surface, harden, and form a small cyst. The keratin inside is a protein that is essential to healthy skin; it simply has nowhere to go. That is why milia look like stubborn whiteheads but do not respond to acne treatments. Common contributors include:
- Skin damage from burns, rashes, or injury, which disturbs normal shedding
- Prolonged sun exposure, which can thicken the outer layer of skin and trap cells
- Heavy creams and oily products that clog pores
- Genetics, since thicker, oilier, or acne-prone skin tends to form milia more readily
- Long-term use of topical steroids
Where Milia Appear
The eyelids, forehead, nose, and cheeks are the most common sites, since the skin there is thin and prone to blockages. In adults, the delicate skin around the eyes is a frequent spot. Less commonly, milia can appear behind the ears or around the genitals. One specific variant, milia en plaque, clusters behind the ears or on the eyelids and most often affects women between the ages of 40 and 60.
How Dermatologists Remove Milia
First, the most important rule: never try to squeeze or pop milia at home. They sit beneath an intact layer of skin, so picking at them only risks inflammation, infection, and scarring without removing the cyst. When milia are bothersome or persistent, a dermatologist can remove them safely and quickly in the office using methods such as fine-needle extraction, electrodesiccation, light laser, cryotherapy, or microdermabrasion, often in a single short visit with minimal downtime. You can read about the in-office options on the milia removal page.
How to Prevent Milia
If you are prone to milia, a few habits meaningfully reduce how often they form. Start with your products and routine:
- Use non-comedogenic products that are formulated not to clog pores, and avoid heavy creams around the eyes. My guide to choosing skincare products can help you read a label.
- Add gentle exfoliation with salicylic or glycolic acid to support healthy cell turnover, and consider a retinoid if your dermatologist recommends one. A simple, consistent skincare routine matters more than an aggressive one.
Then protect against the sun. Because UV damage thickens the outer skin and traps cells, daily sun protection is genuinely preventive here: use a broad-spectrum sunscreen of at least SPF 30, and add a wide-brimmed hat and sunglasses. See sunscreen options or the Skin Cancer Foundation for guidance on daily protection.
Myths and Facts About Milia
Two misconceptions come up constantly. The first is that milia are contagious; they are not. They result from trapped keratin, not an infection, so they cannot spread from person to person. The second is that milia are a form of acne. They look like whiteheads, but the cause is entirely different: acne comes from clogged pores, oil, and bacteria, while milia come from trapped dead skin cells. That distinction is why acne treatments do not clear them, and why an accurate diagnosis from a board-certified dermatologist is worth getting if you are unsure what you are dealing with.
Frequently Asked Questions
What causes milia to develop?
Milia form when keratin and dead skin cells become trapped beneath the surface instead of shedding normally. Sun damage, heavy skincare products, skin trauma such as burns or rashes, and genetics all make them more likely.
Are milia different from acne?
Yes. Acne is driven by clogged pores, oil, and bacteria, while milia are keratin-filled cysts with no bacterial component. They look similar but need different care, which is why squeezing or using acne products on milia does not work.
Can I remove milia at home?
It is not recommended. Home removal risks irritation, infection, and scarring. Gentle exfoliation with AHAs or BHAs and over-the-counter retinoids may help prevent new milia, but existing ones are best handled by a dermatologist.
Can skincare products help prevent milia?
Yes. Ingredients that support exfoliation and cell turnover, such as retinoids and alpha- and beta-hydroxy acids, help keep pores clear and reduce how often milia form. If your skin is sensitive, ask a dermatologist for tailored recommendations.
The Bottom Line
Milia are harmless and often resolve on their own, especially in infants. But if they persist, bother you, or keep coming back, you do not have to live with them. A consultation with a board-certified dermatologist like Debra Jaliman, MD can confirm what you are dealing with and remove them safely. Learn more about milia removal options.
