An Overview of Milia

"Milk cysts" are commonly confused for acne

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Milia, also known as "milk cysts." are small, non-inflamed cysts that develop on the skin. The tiny bumps look like whiteheads and develop when skin cells called keratin gets trapped beneath the skin's surface. Not to be confused with acne pustules, milia are neither red nor inflamed.

A beautiful woman looks in the mirror in the bathroom, care for the skin
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Milia are white to yellowish, hard, raised cysts that develop under the outermost layer of skin. They almost look like a grain of sand or a hardened milky capsule.

Milia are generally small, around 1 to 2 millimeters in diameter, although some can grow larger. Milia won't pop even if you try, and, more annoying, take a long time to resolve.

While milia can occur anywhere, they are most common around the eyes and on the cheeks, nose, and forehead. Milia aren't painful, and they don't itch. While aggravating, milia are completely harmless.

Milia tend to hang around a lot longer than your average pimple. While most acne breakouts will naturally heal within a few day's time, milia can easily last for weeks or months.

There is an aggressive form of the condition known as multiple eruptive milia in which an outbreak develops on the head, neck, and trunk over the course of weeks or months. Eruptive milia outbreaks are rare and, unlike other forms of milia, are typically accompanied by inflammation.


Milia develop when a plug of skin cells, called keratin, becomes trapped just beneath the surface of the skin. Milia happen when the skin doesn't exfoliate, or shed dead cells, properly.

Although milia are often lumped into the comedonal acne category, they aren't acne. Acne comedones develop when a pore becomes blocked. Milia occur just under the top layer of the skin, not within the pore.

Milia are incredibly common and can occur at any age. In fact, up to 50% of healthy newborns will develop milia, which usually resolve on their own within the first few weeks.

While the vast majority of milia cases develop for no apparent reason, some people are more prone to them than others. If you have acne and blackheads, you probably have milia as well. But milia can also occur on its own when your skin is completely clear.

Multiple eruptive milia are believed to be caused by genetic mutations that are passed from parent to child. Eruptive milia often accompany rare genetic skin disorders like Gardner syndrome that affect children early in life.

Milia can also be triggered by an injury to the skin, such as burns, sunburns, and blistering rashes. Certain medications are also known to cause milia, most especially topical corticosteroids and the chemotherapy drug 5-fluorouracil.

Milia that occurs spontaneously is called primary milia, while those that develop after the clearing of an inflammatory skin disease or trauma is referred to as secondary milia.


Milia can often be diagnosed by appearance alone. With that said, there are other problems that cause small white bumps on the skin. If needed, the dermatologist can extract a cyst during the office visit and examine it under the microscope.

If you aren't sure what that a skin abnormality, call your doctor or seek an appointment from a qualified dermatologist.


Most milia will go away on their own, given enough time. In some cases, it can take months to years. If you have no intention of waiting it out that long, you can ask your doctor for medications that help speed up cell turnover. Options include topical retinoids and glycolic acid.

Another option is to have the bumps extracted by a professional. The process is relatively simple and gives immediate results.

Milia extraction is not easily performed at home. It involves making a tiny micro-incision on the skin and extracting the skin plug with a pair of tweezers and a magnifying glass. In some cases, a topical exfoliant may be applied beforehand to remove dried cells on the surface of the skin.

Ask a dermatologist's advice for the best way to treat your milia.


While there's nothing you can do to completely prevent milia, there are a few steps you can take to minimize your chances of developing them. If you're prone to milia, you may first want to take a good look at what you're putting on your skin. Thick, heavy moisturizers or eye creams can be a trigger and make it more likely to develop pearly bumps.

You may also want to change any skincare products that are contributing to their development. Look for products that are labeled "oil-free" or non-"comedogenic." These products are less likely to clog your pores and trigger keratin overgrowth.

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