What Is Milia? How Is Milia Treated?

Milia are small white or yellowish keratin cysts that form just under the surface of the skin. They are usually seen around the eyes, cheeks, forehead, and nose. At first glance, they may look like acne or whiteheads; however, milia are not acne and usually cannot be removed by squeezing.

Milia are generally harmless and do not cause pain, redness, or inflammation. However, when they are visible on the face or around the eyes, they may cause cosmetic discomfort. They are common in babies and usually go away on their own. In adults, they may last longer and may sometimes require dermatological intervention.

What Is Milia?

Milia are small cystic structures that form when keratin, a protein found in the skin, becomes trapped in pores or under the skin. Keratin is a protective protein naturally present in the skin. Normally, skin cells shed and renew themselves; however, when this shedding process is disrupted, keratin may accumulate under the skin and create the appearance of milia.

Milia are usually 1-2 millimeters in diameter, firm, round, and pearly white in appearance. Unlike acne, they do not contain inflammation. Therefore, they do not look red, painful, or swollen. Many people describe milia as “white spots around the eyes” or “small white bumps on the face.”

What Causes Milia?

Milia formation is not linked to a single cause. Slowed skin renewal, thick cosmetic products, sun damage, certain skin procedures, and skin trauma may make milia formation easier. In some people, milia may also develop without an obvious cause.

Factors that may contribute to milia formation include:

• Keratin buildup: Keratin that cannot be shed from the skin surface may form small cysts under the skin.
• Thick cosmetic products: Heavy creams, oil-based products, and pore-clogging skincare products may increase the risk of milia.
• Sun damage: Long-term sun exposure may disrupt skin renewal.
• Skin trauma: Milia may develop after burns, irritation, laser procedures, peels, or some dermatological treatments.
• Incorrect skincare: Harsh peels or irritating applications may affect the skin barrier.
• Aging: Slower skin renewal may cause milia to become more persistent in adults.
• Genetic tendency: Some people may be more prone to developing milia.

Milia are usually not a sign of a serious disease. However, if milia-like lesions are widespread, recurrent, or accompanied by different skin findings, dermatological evaluation is important.

Where Is Milia Most Commonly Seen?

Milia may be seen in different parts of the body, but they most often appear on the face. They may be more noticeable in areas with thin and sensitive skin. The eye area is one of the most common regions.

Milia are most commonly seen in these areas:

• Under the eyes
• Around the eyelids
• Cheeks
• Forehead
• Around the nose
• Chin
• Around the lips
• Nose and cheeks in babies

Milia around the eyes should not be squeezed or removed with a needle at home due to the sensitivity of the area. Incorrect interventions in this area may increase the risk of scarring, infection, or irritation.

What Are The Types Of Milia?

Milia may occur for different reasons. They are most commonly classified as primary and secondary milia. Primary milia usually develop spontaneously, while secondary milia may occur after skin damage or a procedure.

Primary Milia

Primary milia are a type of milia that appear without any obvious skin damage. They may be seen in babies and adults. In babies, they usually appear around the nose and cheeks and often disappear on their own.

In adults, primary milia may especially be seen around the eyes, cheeks, and forehead. Slower skin renewal and keratin buildup may play a role in this process.

Secondary Milia

Secondary milia may develop after skin trauma, burns, irritation, dermatological procedures, or certain skin diseases. Damage to the skin barrier may make it easier for keratin to become trapped under the skin.

Secondary milia may develop after:

• Sunburn
• Skin burns
• Laser procedures
• Dermabrasion
• Chemical peeling
• Long-term irritation
• Some blistering skin diseases

In this type of milia, evaluating the underlying cause and protecting the skin barrier are important.

What Are The Symptoms Of Milia?

Milia usually do not cause noticeable complaints. Most of the time, a person notices small, firm, white bumps on the skin when looking in the mirror. Pain, itching, or redness is generally not expected.

Symptoms of milia include:

• Small white or yellowish bumps on the skin
• Firm and round appearance
• Usually 1-2 millimeter lesions
• Painless and non-inflammatory structure
• Concentration around the eyes and face
• Not easily coming out when squeezed

Milia do not become red or form a head like acne. Therefore, trying to squeeze them at home usually does not work and may cause skin damage.

Can Milia Be Confused With Acne?

Milia may be confused with whiteheads or closed comedones in appearance. However, milia are not acne lesions. Acne is usually related to sebaceous glands, clogged pores, and inflammation. Milia are small cysts formed when keratin becomes trapped under the skin.

Main differences between milia and acne:

• Milia are not inflamed.
• They do not empty like acne when squeezed.
• They are usually firm and round.
• They do not cause redness or pain.
• They may be more common around the eyes.
• Acne treatments may not always be effective on milia.

For this reason, if it is unclear what the white bumps on the skin are, evaluation by a dermatologist is more appropriate.

How Is Milia Treated?

Milia treatment varies depending on the person’s age, the area where milia are located, how widespread they are, and the level of cosmetic discomfort. Milia seen in babies usually do not require treatment and may disappear on their own. In adults, if milia persist for a long time, they may be removed with dermatological methods.

Main approaches used for milia include:

• Observation: Small milia that do not cause discomfort may regress on their own.
• Professional extraction: A dermatologist may remove milia content with sterile methods.
• Topical products: Retinoids or mild exfoliating ingredients may be recommended for suitable skin types.
• Chemical peeling: It may be applied in selected cases to support skin renewal.
• Laser or electrosurgery: It may be preferred for resistant or widespread milia after specialist evaluation.

The most important point in milia treatment is not to squeeze the lesions or intervene with sharp tools at home. Professional support is safer, especially for milia around the eyes.

What Can Be Done For Milia At Home?

Home methods do not directly remove milia; however, they may help reduce new milia formation and support skin renewal. In this process, regular and gentle care without irritating the skin is important.

Points to consider at home:

• The skin should be cleansed daily with a gentle cleanser.
• Heavy and oily creams should be avoided.
• Non-comedogenic products should be preferred.
• Sunscreen should be used regularly.
• Harsh peels should be avoided.
• Makeup removal should not be neglected.
• Retinol or acid-containing products should be used with expert advice.

Needle removal, squeezing, or scraping should not be done at home. These practices may increase the risk of infection, discoloration, and scarring.

How Can Milia Formation Be Prevented?

It may not always be possible to completely prevent milia formation. However, regulating skincare habits, avoiding pore-clogging products, and protecting the skin from sun damage may reduce the risk.

To reduce milia formation:

• A moisturizer suitable for the skin type should be used.
• Heavy oil-based products should be limited.
• Heavy creams should be used carefully around the eyes.
• Sunscreen should be added to the daily routine.
• The skin should be cleansed regularly but gently.
• Post-procedure skincare recommendations should be followed.
• Irritating applications should be avoided.

Regular dermatology follow-up may be helpful for choosing the right products, especially in people prone to milia formation.

When Should Milia Be Shown To A Doctor?

Milia are usually harmless; however, it is better to consult a dermatologist if lesions last long, spread, or cause cosmetic discomfort. Also, some skin lesions that are thought to be milia may be confused with different problems.

Dermatological evaluation should be sought in the following situations:

• If milia have not gone away for a long time
• If they are located on the eyelid or around the eyes
• If their number is gradually increasing
• If redness, pain, or discharge develops
• If they appear together with different skin lesions
• If irritation occurs after at-home intervention
• If they cause cosmetic discomfort

Accurate diagnosis is important for choosing the right treatment. Although milia treatment may seem simple, specialist intervention may be required in sensitive areas.

Happ Health Online Dermatology Support

Although milia are usually harmless skin problems, they may cause cosmetic concerns when they are visible on the face or around the eyes. Also, some skin lesions that are thought to be milia may be confused with different dermatological problems. Therefore, correctly evaluating the type of lesion is important to avoid unnecessary and incorrect interventions.

Happ Health, as a digital health platform, provides a solution that makes it easier for users to access healthcare services from home or remotely. With an online dermatology consultation, you can have your milia-like skin lesions evaluated with expert support and receive proper guidance about skincare and treatment options suitable for your skin type.