Ever noticed those tiny, white bumps that form just under the surface on a baby’s skin? Some people know them as “milk spots,” or "oil seeds," but the real name they go by is milia—and they can show up on adults too. Milia isn’t really anything to be too worried about as they’re merely a cosmetic issue—they won’t scar your skin, they don’t typically lead to additional issues, and usually they go away on their own (eventually). That said, a lot of people who get milia on their faces would just rather not have them, and luckily, treatment is totally possible.
We spoke with two skincare pros to gather everything you need to know about milia, including what it is, how to treat it, and what you can do to keep it from coming back.
What Is Milia?
Milia are very small cysts that are found under the surface of the skin, according to Medical News Today. A lot of people lump them in with breakouts or mistake them for whiteheads, especially when they pop up on those areas of our complexions where some of us get acne (like on the cheeks or forehead). Unlike acne, however, you can’t pop milia (not that you should ever try that with your pimples) because they are comprised of a protein called keratin. You may have heard of keratin and how it relates to hair, but keratin also makes up your skin’s outermost layer and can build up over time, leading to bumps. “Milia occur when the skin cells don’t turnover rapidly enough and a buildup of keratin—a protein found in the skin—hardens and becomes trapped,” states Jeannel Astarita, founder of Just Ageless Body Sculpting and Beauty Lab in New York City. “These can linger for years if not treated.”
Similarly, milia can also form when dry skin on the surface just gets stuck underneath it. “When dead skin cells clump together, they can become trapped under the skin's surface, forming small, hard cysts,” explains board certified dermatologist, Dr. Dendy Engelman. “These bumps aren’t painful, nor do they cause permanent scarring, like scaring that occurs from certain types of acne.” That said, many people prefer to live with milia-free complexions for aesthetic reasons as those tiny bumps can add texture to the surface of the skin. “Milia are tiny white bumps on the skin that are often mistaken for pimples,” adds Astarita. “Upon closer inspection, they are hard, almost pearly, seed-like granules trapped under the surface of the skin.” So, even though milia isn’t technically something that breaks out on the skin, it can still be irritating—especially when it pops up around the eyes (a common spot for milia to appear on the face).
Types of Milia
On adults, milia can be classified into two general types: Primary milia and secondary milia. “Primary milia is the most common, and the same type seen in babies and adults, caused by dead skin cells that build up in the pore lining because they are unable to shed properly,” says Dr. Engelman. “Secondary milia occur when a skin condition or infection (such as herpes) leads to blistering, which actually damages the pore lining. Skin trauma, such as burns or even some types of laser treatments can also cause milia to form.” Secondary milia is sometimes known as “traumatic milia,” which can sometimes also pop up as a reaction to thick creams or ointments that may clog pores.
The Cleveland Clinic adds that in addition to primary and secondary milia, milia en plaque can appear on raised patches of skin on various parts of the face—as well as behind the ears—and usually forms on middle-aged women. Multiple eruptive milia is a very rare type of milia that pops up on various parts of the body over the course of a few weeks, and can be itchy, although most other types of milia won’t irritate the skin.
Start Using an Exfoliating Treatment
If you’re not into seeking a professional treatment to rid your face of milia, no problem. According to the experts, you can take simple measures to keep milia under control by adding a regular exfoliating treatment to your weekly or bi-weekly skincare routine, depending on how sensitive your skin is.
“Milia forms most often on under-exfoliated, dry skin or where an occlusive product is used and is clogging the pores,” explains Astarita. Exfoliating sheds old, unnecessary layers and cells from the surface of the skin. Just in the same way that people have an exfoliation regimen to keep their acne symptoms at bay, exfoliating to prevent milia can possibly keep keratin and dead skin cells from becoming trapped under the surface by getting rid of them altogether.
The Byrdie editors love to exfoliate with glycolic acid. The word "acid" makes it sound scary, but it's actually gentler on the skin than a gritty scrub. You can find a list of our favorite glycolic acid products here.
Wear Sun Protection
In addition to exfoliating, practicing smart skincare in the sun can also prevent milia from forming on the face. “Sun damage can be a contributing factor to milia because it makes skin rough and leathery, so it’s more difficult for dead cells to rise to the skin’s surface and shed normally,” says Dr. Engelman. “The resulting clogs can trigger milia formation—and they’ll stick around unless steps are taken to unclog the pores.”
Sun damage can be a contributing factor to milia because it makes skin rough and leathery, so it’s more difficult for dead cells to rise to the skin’s surface and shed normally.
To protect against sun damage, wear SPF daily (even when it's cloudy, even when it's cold) and remember to reapply throughout the day. The sun can reach you even when you think you're protected—like through your car or office window.
Try Manuka Honey
If you're looking for a more natural way to deal with your milia, manuka honey might be the right solution for you. Due to its antimicrobial properties, manuka honey can help reduce the inflammation that sometimes leads to milia. Look for skincare that contains real honey or DIY a mask with raw manuka honey from your farmer's market.
If All Else Fails, See a Dermatologist for Extractions
For some people, milia can last for a long time if it’s left alone, but in many cases milia will go away on its own within a matter of weeks. If you want to say goodbye to those bumps sooner than later, however, milia can be treated a number of ways—a dermatologist or licensed esthetician can extract milia using a lancet to draw the impacted keratin out from under the skin, or break it down with chemicals or lasers.
“A dermatologist can remove them right there in the office using a needle or a tiny lancing utensil and, sometimes, a comedone extractor,” Dr. Engelman says. “This in-office procedure is fast, painless (numbing cream may be applied) and heals quickly for most people.”
Astarita adds that occasionally milia can grow into clusters, which requires "a gentle laser resurfacing treatment like a low setting Fraxel treatment, Halo by Sciton, or a series of chemical peels [to] push the reset button on your skin."
Milia isn’t something that you should be worried about from a health standpoint, but if you’re still looking to keep your skin milia free, you’re not alone. If you wait for your symptoms to go away on their own, they will usually pass within a matter of weeks, but you can help speed up the process by adding a gentle exfoliation routine with a chemical exfoliant to your skincare practice. If you need to get rid of bumps fast, a professional, like a dermatologist or esthetician can remove them for you, but it’s best to leave treatment to the pros, so if you can, resist the urge to take matters into your own hands with an extracting tool.