What Are Milia—And How Can You Get Rid of Them?

A close-up of milia under a woman's eye

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Milia are tiny cysts that form just under the surface of the skin, most commonly on the face. Milia may appear as white- or yellow-colored bumps. On darker skin tones, milia may present with a faint blue color.

One cyst is referred to as a milium. Milia is the word used when there is more than one cyst. Because milia often appear as tiny, white-colored bumps, they may be confused with whiteheads or pimples, but milia is not a form of acne.

Milia might appear on their own or develop in response to something else, like damage to the skin.

Milia are benign, meaning they are not harmful to a person’s health. Often, milia go away on their own. Because of this, milia do not require treatment. But, there are things you can do to get rid of the cysts and potentially prevent them in the first place.

What Are Milia?

Milia are cysts made of dead skin cells and may appear one at a time or as a group of bumps. One cyst usually measures 1 to 3 millimeters in size, but it can be larger.

Milia show up on any part of the body. It is very common for milia to develop on the face, typically on the cheeks, nose, or eyelids. In most cases, milia goes away on its own after a few weeks or months.

Anyone can get milia, regardless of their skin tone, age, or sex. It is most common among newborns, with about 50% of babies being born with milia. Parents of newborns may confuse milia for baby acne. However, baby acne does not usually appear until after two weeks of age.

Older children and adults might be more likely to develop milia if they:

  • Don’t properly care for their skin
  • Use oil-based skin care products
  • Have a skin condition like dandruff or rosacea
  • Don’t get proper sleep
  • Use steroid medications for the long term

What Causes Milia?

Our skin naturally exfoliates itself. This means that our body sheds old skin cells to make room for new, healthy skin cells. 

Sometimes, old skin cells do not fall off and are trapped under the skin. The old skin cells harden and form small cysts. These firm, round cysts are called milia.

There are different reasons why a person might develop milia. Milia are very common for babies because their skin is still learning how to shed old skin cells.

For older children and adults, the cause of milia depends on what type of milia they have. There are two main types of milia: primary and secondary. 

Primary Milia

Primary milia appear spontaneously. With primary milia, old skin cells are trapped under the surface of the skin, forming small cysts.

Types of primary milia include:

  • Congenital milia: This form of milia happens spontaneously and is usually found on the face, typically on the nose.
  • Benign primary milia of children and adults: These can develop spontaneously on the eyelids, cheeks, forehead, and genital area.
  • Milia en plaque (MEP): This is a rare type of milia that affects people whose assigned sex at birth was female and who are now 40 to 70 years old. The milia clump together on a patch of skin and can grow to reach several centimeters in size.
  • Multiple eruptive milia: This is a rare condition that causes a group of itchy cysts to form on your face, upper arms, and upper abdomen.
  • Genodermatosis-associated: This type of milia is related to skin-related genetic conditions like Brooke-Spiegler syndrome, pachyonychia congenita type 2, and basal cell nevus syndrome.

Secondary Milia 

A person might get secondary milia after a skin injury, medication use, or skin disease. It’s believed that secondary milia develops in the sweat ducts due to blockage.

Types of secondary milia include:

  • Disease-associated: Milia that occur with blistering skin diseases like epidermolysis bullosa.
  • Medication-associated: Milia that form due to long-term use of topical steroids or nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Trauma-associated: Milia that commonly occur after skin graft, skin burn, or radiotherapy.

How to Get Rid of Milia

Milia are harmless bumps and typically do not require treatment. Congenital milia often go away on their own.

Other types of milia do not resolve on their own and may require removal. A person may choose to have milia removed to change their appearance. Other people may remove milia if the cysts cause discomfort.

If you want to have milia removed, talk to a healthcare provider about which options may work best for you. Milia may return even after treatment.

There are several ways to get rid of milia:

Extraction

A healthcare provider makes a tiny cut using a needle or scalpel. The provider then applies pressure to the skin to remove the milia. This process is also known as deroofing.

Chemical Peels

An exfoliant helps the skin shed old cells and resurface new, healthy cells. A chemical peel is a chemical exfoliant that breaks down dead skin cells that are causing milia.

 Common active ingredients in a chemical peel include:

  • Lactic acid
  • Glycolic acid
  • Salicylic acid

Retinoids

Topical retinoids are another option to treat certain types of milia, like milia en plaque. The retinoid is applied on the milia, as prescribed by a doctor.

Can You Remove Milia at Home?

Do not try to pop, squeeze, or scrape off milia. This could lead to bruising, scarring, or a skin infection.

Over-the-counter retinol, face peels, or exfoliators may help with certain types of milia. Talk to a healthcare provider first before using over-the-counter treatments for milia.

How to Prevent Milia

It is not possible to completely prevent milia. There are steps you can take to reduce the chance of milia developing on the skin. This includes:

  • Washing your face every day (Use warm water and a gentle soap. Pat your skin very gently when drying.)
  • Not using oils or lotions meant for an adult on a baby, since infant skin is sensitive
  • Avoiding spending many hours in the sun
  • Using sunscreen with at least SPF 30 when you spend time outside

A Quick Review

Milia are harmless cysts that form when old skin cells are trapped under the surface of the skin. Milia is common among newborns but can happen to someone of any age. They might appear spontaneously or in response to something like skin injury or medication use. Milia usually go away on their own after a few weeks. For older children and adults, some types of milia can last longer. If your milia does not go away and you’d prefer it to not be there, talk to a healthcare provider about potential treatment options.



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