The Best Ways to Treat and Prevent Milia

Milia, those pearly bumps that are sometimes called whiteheads, are very common blemishes. They aren't inflamed, so if you aren't prone to inflammatory acne, you can still develop milia.

There's generally no medical reason to treat milia, so if they aren't really bothering you, just leave them be. However, if you do want to get rid of them, you have a few options for treating milia.

Ways to Treat Milia
Verywell / Brianna Gilmartin

Causes of Milia

Milia are small cysts that form when dead skin cells get trapped under your skin. They sometimes happen spontaneously and sometimes happen in response to skin damage.

Milia that occur spontaneously are called primary milia. They're most common on the:

  • Eyelids
  • Forehead
  • Cheeks
  • Genitals

These milia typically clear up on their own in a few months or less.

Secondary milia are sometimes permanent. They occur after your skin has been damaged in some way, such as by:

  • Injury or irritation
  • Rash
  • Burn
  • Abrasive skin treatment
  • Inflammatory skin condition
  • Excess sun exposure

Heavy skin-care products can contribute to milia as well.

Primary Milia
  • Occurs spontaneously

  • Often on eyelid, forehead, cheek, genitals

  • Usually clear on their own

Secondary Milia
  • Caused by skin damage

  • Occur in the location where the skin is damaged

  • May be permanent

How to Get Rid of Milia

Multiple milia are visible under a woman's eye.

vchal / Getty Images

First things first, don't ever try popping or squeezing a milium. (Milium is the singular of milia. So, you have one milium or many milia.)

The contents of milia are not fluid like the contents of a pustule. Pustules, as in your typical pimples, are filled with a soft core of dead skin cells, sebum, and pus. When you put pressure on a pustule, the fluid contents flow from the pore. (But you really shouldn't be popping pustules either.)

Unlike a pustule, a milium is not an acne pimple but rather a tiny cyst. The little white lump inside the milium is very hard. It's made of a plug of keratinized (hardened) dead skin cells that have become trapped just below the surface of the skin. 

Try as you might, squeezing milia will get you nowhere. That little bump is simply too hard, almost like a grain of sand. Because milia form under a thin layer of skin and not in the pore (like acne blemishes do) there is no opening in the skin by which the plug could escape anyway.

Use an OTC Exfoliating Product

Instead of trying to (unsuccessfully) pop out a milium, you can start off with an over-the-counter (OTC) salicylic acid or glycolic acid product. The acne treatment medication Differin (adapalene) can also help. These products help exfoliate the skin.

If you have just a few little bumps here and there, an OTC product may be all you need to get the results you're looking for. Be ready to use them for the long haul, though. Milia are stubborn and it can take months to see any improvement.

If you have lots of milia, if they've been around for ages even while using OTC treatments, or if they're in a spot that's difficult for you to treat with OTC products (like your eyelid) then the next step is to see a dermatologist.

Get a Topical Retinoid Prescription

If you're prone to developing milia, and some people just are, your dermatologist may recommend you use a prescription topical retinoid.

Topical retinoids help the skin to exfoliate effectively. When dead skin cells are sloughed away more rapidly, it can help prevent plugs of keratin from getting trapped beneath the skin's surface.

Topical retinoids also help loosen the keratin plug in existing milia and help them come to the surface so they can go away.

Go to a Pro for Manual Extractions

The absolute best treatment for milia is manual extraction, done by a professional. It's the most effective and the results are immediate.

During the procedure, a tiny opening is made in the surface of the skin with a small surgical blade called a lancet. The hard plug of material that makes up the milium is gently pushed out through the opening with the technician's fingers or a tool called a comedone extractor. This procedure is sometimes called de-roofing.

Although it sounds horrid, it's truly not that painful. No anesthetic is needed; at worst you'll feel a prick. 

Most often, milia extractions are done at the dermatologist's office. In some cases, milia extractions may also be done by an esthetician at a salon or skin spa. Some states don't allow estheticians to pierce the skin, though, so legally they can't remove milia.

Warning: Don't Self-Extract

Do not try to self-extract milia. You could do some serious damage to your skin, especially around the delicate eye area, and even cause permanent scarring. 

Prevention

Several milia are visible on a cheek.


LeventKonuk / Getty Images

Primary milia can't be prevented, nor can secondary milia from causes you can't avoid. However, you can protect your skin from excessive sunlight and irritating skin-care products. Exfoliating, to help clear away dead skin cells, may also help.

Frequently Asked Questions

How can you get rid of milia on your eyelids?

If you have persistent milia on your eyelids or around your eyes, don't try to remove them yourself. See a dermatologist or an opthalmologist who can diagnose and safely treat conditions around the eyes.

What is the cost for a dermatologist to remove milia?

The cost for milia removal may differ depending on the office, but some practices give estimates of about $200 to $300.

A Word From Verywell

Because milia are just a cosmetic issue the vast majority of the time, the choice to treat them or not is up to you. Treatment isn't necessary, and they can and do go away all on their own over time. If milia bother you, though, treatments can improve them. Just be aware it takes time, often several months, to really clear them.

Other things can cause white bumps on the skin. Unless you're 100% sure it's milia, you may want to have your bumps checked out by your physician.

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