Milia (Milk Spots): Causes and How to Get Rid of Them
Milia are small, firm, white or yellowish bumps caused by keratin trapped just beneath the skin’s surface — most often under the eyes, on the cheeks and across the nose. They are not acne, they contain no pus or oil you can squeeze out, and they usually need either patience or professional extraction rather than a stronger product.
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Explore the Acne Relief Serum →What exactly are milia?
Milia are tiny keratin cysts. Keratin is the structural protein that makes up the outer layer of skin; when a small amount becomes trapped in a pocket under the surface instead of shedding, it forms a hard, pearl-like bump 1–2 mm across. They are entirely benign, they do not become infected, and they cause no pain or itch.
Two types matter in practice. Primary milia appear without any obvious cause — they are extremely common in newborns, where roughly half are born with them, and they are common in adults around the eyes. Secondary milia follow something that disrupted the skin: a burn, blistering, prolonged sun damage, aggressive resurfacing, or long-term use of heavy occlusive creams over a small area.
Milia vs whiteheads vs miliaria: which do you have?
These three get confused constantly, and they respond to completely different care. The distinctions are easy once you know what to look for.
| Milia | Whiteheads (closed comedones) | Miliaria (heat rash) | |
|---|---|---|---|
| What’s inside | Trapped keratin — firm | Sebum and dead cells — soft | Trapped sweat |
| Feel | Hard, like a tiny bead under skin | Soft, moves slightly | Fine, sometimes prickly |
| Colour | White to pale yellow, distinct | Skin-toned to white, less defined | Clear or red |
| Where | Under eyes, cheeks, nose, eyelids | T-zone, chin, jawline | Neck, chest, back, folds — after heat |
| Linked to a pore | No visible opening | Yes — a blocked follicle | Blocked sweat duct |
| Timeline | Weeks to months; can persist | Days to weeks with treatment | Clears in days once cool |
| Itch | No | No | Often |
The naming overlap is a genuine trap: milia and miliaria are different conditions. Miliaria is heat rash — blocked sweat ducts after heat and humidity — and it resolves on its own once skin cools; we cover it in the heat rash guide. If you are unsure whether the bumps you have are comedonal, our guides to comedones and small bumps on the face show the alternatives, and sebaceous filaments vs blackheads covers the nose specifically.
What causes milia in adults?
In adults, milia usually follow one of four things:
- Heavy occlusive products used over a small area — rich eye creams, thick balms and mineral-oil-based products around the eyes are the most frequent culprit, because they slow the normal shedding of surface cells.
- Cumulative sun damage. Chronically sun-exposed skin thickens and sheds less efficiently, which is why milia cluster on cheekbones and around the eyes in people with years of unprotected exposure.
- Skin trauma — burns, blisters, aggressive laser or chemical resurfacing, or a rash that damaged the surface. Secondary milia appear during healing.
- Slow cell turnover, which is simply a feature of ageing skin and of skin that is never exfoliated.
Diet, hygiene and hormones are not established causes. Milia are not a sign that your skin is dirty, and washing more often will not shift them.
How do you get rid of milia?
Set the expectation first: you cannot squeeze a milium out. There is no pore opening to release it through, so pressure only bruises the surrounding skin and risks marking or scarring the very thin tissue under the eye. Needling them at home carries a real infection risk.
What genuinely works, in order of how most people should approach it:
- Wait. Many milia, particularly primary ones, resolve on their own over weeks to a few months as the keratin works its way out.
- Support surface turnover. Gentle, consistent chemical exfoliation helps the skin shed the cells sitting over the cyst. Salicylic acid is useful where milia sit alongside congestion; gentler alternatives suit the under-eye area. Keep to the frequency in our how often should you exfoliate guide — more is not faster here.
- Consider a topical retinoid. Retinoids increase keratinocyte turnover and are the best-evidenced topical approach for persistent milia. Start slow; our retinol for beginners guide covers building tolerance without irritation.
- Lighten what you apply near the eyes. Swap heavy occlusive balms for lighter hydration in the affected zone and give it a few weeks.
- Have them extracted professionally. This is the definitive answer for stubborn milia. A dermatologist makes a tiny opening with a sterile lancet and lifts the keratin out — a quick, low-risk procedure in trained hands, and the only reliable same-day fix.
How do you prevent milia coming back?
Prevention is mostly about two habits. Keep the layer over your skin light, particularly around the eyes, where the skin is thinnest and occlusion has the most effect. And wear sunscreen daily — cumulative UV damage is one of the few well-established contributors, and protection also stops any post-extraction marks from deepening. Our guide to applying sunscreen covers the quantity most people under-apply.
Keeping surface turnover steady with a correctly dosed active does the rest. A 2% salicylic acid and 5% niacinamide serum is a sensible base for skin that is both congestion-prone and milia-prone, because it addresses the follicular blockage that so often accompanies them.
When should you see a dermatologist?
See one if the bumps are growing, changing colour, spreading rapidly, or appearing in large numbers on an adult who has never had them — those patterns deserve a proper look rather than a guess. Also see one simply because you want them gone: extraction is minor, quick and far safer than anything attempted at home with a needle.
FAQs
Can you pop milia?
No. A milium is a closed keratin cyst with no pore opening, so squeezing releases nothing and risks bruising, marking and scarring — especially under the eyes. Extraction requires a sterile lancet and is a dermatologist’s job.
How long do milia last?
Primary milia often clear on their own over several weeks to a few months. Secondary milia, and those linked to sun damage, can persist for far longer and usually need a retinoid or professional extraction.
Does salicylic acid remove milia?
Not directly. Salicylic acid supports surface turnover and clears the follicular congestion that frequently sits alongside milia, which helps prevent new ones, but it will not dissolve an existing keratin cyst.
Is milia the same as a whitehead?
No. A whitehead is a blocked follicle filled with sebum and dead cells — soft and connected to a pore. A milium is a firm keratin cyst with no pore opening, which is why acne treatments have little effect on it.
Do eye creams cause milia?
Heavy, occlusive eye creams can contribute by slowing normal shedding in an area where the skin is very thin. If milia keep appearing under your eyes, switching to a lighter formula for a few weeks is a reasonable first test.
This article is educational and not a substitute for medical advice. The Element’s topical range is dermatologically tested and microbiome-safe; persistent or changing bumps should always be assessed by a dermatologist.