Small white bumps that most commonly appear around the eyes, on the cheeks, or on the nose are known as milia. Although they are completely harmless, many people experience them as an aesthetic concern, especially when they appear in larger numbers. Unlike pimples, milia cannot be squeezed out at home, and attempts to do so can lead to redness, scarring, and further irritation. This is why it is important to understand what milia are, how they form, who is more prone to them, and which methods are safe and effective for their removal.
What are milia, and why do they form?
Milia are small cyst-like formations that develop when keratin, a protein found in the upper layers of the skin, becomes trapped beneath the surface of the epidermis. Unlike acne, milia are not associated with inflammation, bacteria, or clogged sebaceous glands. Essentially, they consist of dead skin cells that have not been properly shed and instead remain trapped under the skin’s surface.
There are several reasons why milia may develop:
• Natural skin renewal processes – in some individuals, skin cell exfoliation occurs more slowly
• Use of heavy cosmetic products – especially creams that clog pores
• Sun damage, which affects the skin’s ability to regenerate naturally
• Scarring after burns or dermatological procedures
• Genetic predisposition – in some people, milia appear more frequently without a clear external cause
Are milia the same as blackheads or acne?
At first glance, milia can easily be mistaken for blackheads, small pimples, or even pustules. However, these skin changes have very different causes, structures, and treatments. Distinguishing between them is essential in order to respond correctly and avoid worsening the condition.
Milia are tiny, round bumps located just beneath the surface of the skin. They are usually white or yellowish-white in colour, measure between 1 and 3 millimetres, and are almost always painless. They do not cause redness, do not itch, and have no opening through which their contents could be released. For this reason, they cannot be extracted using standard methods applied to acne or blackheads, and any attempt to squeeze them may result in skin damage, redness, or scarring.
Blackheads (open comedones), on the other hand, form when sebaceous glands and hair follicles become clogged with sebum (oil), dead skin cells, and environmental impurities. On the surface of the skin, they often appear as dark dots due to oxidation of the sebum when exposed to air. Blackheads typically occur on oilier areas of the face—such as the nose, forehead, and chin—and are more common in individuals with enlarged pores and increased sebum production.
Acne involves inflammatory processes. Pimples may be red, painful, filled with pus, and prone to infection. Their development is linked to bacteria, hormonal changes, and inflammatory responses in the skin. Unlike milia, acne often responds to topical treatments with antibacterial, retinoid, or keratolytic effects, whereas milia usually remain unchanged and resistant to standard acne products.
It is also important to mention closed comedones (whiteheads), which are the most similar in appearance to milia but still have a different structure. Closed comedones result from the accumulation of sebum and skin cells within pores that are closed at the surface. If they become infected, they can develop into inflammatory acne. With milia, this does not occur—the trapped substance is keratin located within the superficial layers of the skin, not within sebaceous glands.
Comparison of common skin lesions
| Skin change | Content | Has an opening | Inflammation | Can be squeezed | Typical location |
|---|---|---|---|---|---|
| Milia | Keratin | No | No | No | Eyes, cheeks |
| Blackheads | Sebum + dead skin cells | Yes | No | Yes | Nose, forehead |
| Pimples / acne | Sebum + pus + bacteria | Possible | Yes | Yes | Face, back |
| Closed comedones | Sebum | No | No | Sometimes | Forehead, chin |
Due to their similar appearance, incorrect self-diagnosis can lead to inappropriate treatment. For example, using aggressive anti-acne products on milia will not produce results and may further dry out or irritate the skin.
If you are unsure what type of lesion is present on your face, a dermatological examination is recommended to ensure accurate diagnosis and appropriate treatment.
Who is more prone to developing milia?
Milia can appear in anyone—children, adults, and older individuals—but certain groups are more likely to develop them:
• People with sensitive skin, especially skin prone to irritation
• Individuals with existing skin conditions such as rosacea or seborrhoeic dermatitis
• Those who use heavy creams or pore-clogging products
• People who do not exfoliate regularly or have slower skin regeneration
• Smokers and individuals exposed to UV radiation, as sun damage slows natural skin renewal
Can milia be prevented?
Complete prevention is not always possible, but certain habits and skincare choices can significantly reduce the risk of milia formation:
• Use lightweight, non-comedogenic moisturisers
• Perform regular and appropriate exfoliation (mechanical or chemical)
• Protect the skin from sun exposure with suitable SPF products
• Cleanse the face thoroughly, especially in the evening
• Avoid heavy, occlusive products containing mineral oils or paraffins
• Choose products that support cell turnover, such as those containing retinoids (if recommended by a dermatologist)
Professional removal of milia – what actually works?
When milia do not resolve on their own and become an aesthetic concern, seeking help from a dermatologist or trained aesthetic professional is the safest option. Home removal is not recommended, as the skin around the eyes and cheeks is particularly sensitive and prone to irritation, infection, or scarring.
The most effective professional treatments include:
• Mechanical extraction with a sterile needle – the dermatologist creates a tiny opening and removes the contents without damaging surrounding tissue
• Microdermabrasion – a gentle exfoliation that removes superficial skin layers and stimulates renewal
• Chemical peels – acids such as glycolic or salicylic acid help dissolve dead skin cells
• Laser treatments – precise removal for stubborn cases or larger numbers of milia
• Cryotherapy (freezing) – less commonly used, but effective in selected cases
It is important to note that no treatment can guarantee that milia will never return, especially if there is a genetic predisposition or a chronic underlying cause such as sun damage or unsuitable cosmetics.
What should never be done at home?
Although numerous “DIY” milia removal methods can be found online, most of them cause more harm than benefit. Common mistakes include:
• Attempting to squeeze milia – this damages the skin and does not remove the contents
• Using sharp objects such as needles without proper sterilisation – high risk of infection
• Applying strong acids or abrasive pastes may cause irritation and redness
• Using natural remedies such as lemon juice or baking soda – uncontrolled acids and abrasives can further damage the skin
Professional removal in a clinical setting is always safer, more effective, and aesthetically preferable.
When should you seek professional advice?
Although milia are harmless, their persistence and visibility on the face often cause cosmetic concern. If they do not resolve spontaneously, increase in number, or cause discomfort, a dermatological examination is recommended. Professional evaluation helps distinguish milia from other skin conditions and determine whether specific treatment or tailored skincare is needed.
At-home removal attempts may lead to infection, irritation, or scarring, so self-extraction should be avoided. After assessment, a dermatologist can recommend a skincare routine that reduces the tendency for milia formation, including proper cleansing, non-comedogenic products, and gentle exfoliants that promote natural skin renewal.
White bumps should not be ignored
Milia are common, especially in sensitive or dehydrated skin, and although they are not dangerous, they can be persistent and aesthetically bothersome. Instead of attempting removal at home, better long-term results are achieved through proper skincare, cosmetic adjustments, and professional advice. Observing your skin, understanding its reactions, and taking a gentle approach to care can help prevent the recurrence of milia and contribute to a healthier-looking complexion.