Eye Education

Everything You Need To Know About Milia

Maybe at first you thought that tiny pearl-like bump below your eye was a zit. But you couldn’t get it to budge with your usual acne-busting routine, and it’s been hanging around for weeks. What’s the deal?

Well, it’s probably not a pimple, even though it looks like a whitehead. It’s most likely a milium cyst. Milium (singular) or milia (plural) are small white bumps that can form under your eyes and on your lids.

They may be annoying and look weird, but are they dangerous? Here’s everything you need to know about milia—what causes them, how to treat them and the science behind them.

What are milia?

Milia are small, hard bumps, or cysts, that commonly develop around your eyes and on your face. They are benign, meaning they aren’t likely to affect your health. The bumps are made of keratin, a protein that’s a big component of our hair, nails and skin.

Milia are super common in babies. About half of all newborns get them, usually on the chin, cheeks or nose. People of any age can get milia, though, and they tend to show up without warning. They usually stick around for a while, too, which can be frustrating.

What do milia look like?

Milia are white or yellowish raised bumps. They’re very small—usually about the width of a pencil lead or the tip of a crayon—and the keratin inside them makes the bumps feel solid.

You can have one milium cyst, or many. If you have more than one, they may appear in a scattered pattern across your eyelids and under your eyes.

Unlike pimples, milia don’t become red, crusty or painful. This photo gallery from Skinsight will give you a good idea of what milia look like in adults. And this gallery of milia lookalikes from the Skin Nerd can help you tell whether you’ve got milia, acne or something else.

What causes milia?

Milia happen when dead skin cells get trapped in tiny hollows just below your skin’s surface. Normally your body would shed these dead cells as part of its natural cell regeneration process. But instead the trapped cells harden into little white balls of keratin.

If a cyst forms spontaneously, it’s called primary milia. If something else happens that causes a cyst to form, it’s called secondary milia.

Secondary milia can form anywhere on your body. Possible triggers include:

  • Burns, blisters, sunburn or other skin injuries.
  • Skin treatments like laser resurfacing or dermabrasion.
  • Long-term sun damage.
  • Certain medications including steroid creams.
  • Heavy moisturizers, including oil-rich skin creams, lanolin, paraffin or petroleum oil.

How can I get rid of milia?

Milia treatment tends to be of the “less is more” variety. Often, milia on eyes disappear the same way they appeared—on their own. In the meantime, they can last weeks or months [sadface].

Milia on your eyelids and under your eye need to be handled with care, because their location means they’re harder to treat than milia on your cheeks. If you really can’t wait them out, your best bet is to see a doctor for professional removal, called extraction or excision.

You might be tempted to pop milia or pick at the bumps. If you do, you could unintentionally   cause secondary milia to become infected which could lead to bruises and scars.

Steaming your skin or treating milia with warm compresses won’t get rid of them, either. But it can help open your pores, making milia easier to extract at your doctor’s office.

A good skincare routine also might prevent the buildup of dead skin cells that can lead to milia. It’s no guarantee—some people are just naturally prone to these little cysts. But you can make them less likely by washing your face with an oil-free cleanser and using skin products that have a mild exfoliant. This Allure primer on milia has a few suggestions for brands to try.

Do I need to see a doctor about milia?

Most of the time you don’t need a doctor to handle milia near your eyes—they’ll disappear on their own. But if you’re really irritated by them, a dermatologist can confirm that the bumps on your face are milia and suggest techniques for removal that are safe for your eyes.

Depending on the size and location of your cysts, these might include:

  • Extraction: An in-office procedure in which your doctor uses surgical instruments or a tool called a comedone extractor to take out the cyst.
  • Topical medication: Creams containing retinoids, a type of acid that unblocks pores, can prep milia for removal and lower your likelihood of developing more.
  • In-office skin treatments: Some doctors recommend a series of acid peels or microdermabrasion treatments to prepare milia for extraction. But if you’re not careful, these treatments could dry or damage your skin, putting you at risk for secondary milia.

The Sightbox community is growing! If you need an annual eye exam, contact lens fitting and year’s supply of contacts, join today to pay monthly for your vision care.