Milia are small bumps consisting of keratin trapped under the skin. These bumps often develop around or under the eyes. They are not harmful and usually go away on their own.
Milia frequently occur in newborn babies, though they also occur in children and adults. It can be easy to mistake milia for acne.
Simple skin care habits may help prevent milia. In this article, learn more about milia under the eyes, including their causes and possible treatments.
Milia are small spots, or cysts, that appear under the skin. Some people call them “milk spots.” They are usually white, yellowish, or the same color as a person’s skin.
Milia occur when keratin becomes trapped under the skin. Keratin provides strength to skin cells, nails, and hair. As these skin cells die, the keratin may collect and become trapped in the pore, forming a little cyst, or a milium.
Milia are not a type of acne, though many people mistake them for acne blemishes or pimples at first. They can appear in other areas on the body, but in adults, they may be
Milia develop as a natural product of skin exfoliation. As old cells on the surface of the skin die and shed, new cells replace them underneath. If the dead cells do not fall off as they should, they may harden into milia.
Milia are common in newborn babies because their skin is just beginning to shed. Other causes include:
- skin damage from an injury, a rash, or the sun
- long-term corticosteroid use
- certain autoimmune or genetic conditions
Factors that may make milia more likely include:
- use of oil-based makeup or skin care
- skin conditions such as rosacea or dandruff
- issues with hygiene
- lack of sleep
Sometimes, though, there is no clear reason why some people develop milia while others do not.
A visual examination is usually enough for a doctor to be able to diagnose milia.
If a person has a lot of bumps, a doctor may also want to check for underlying conditions that could be leading to multiple milia.
Conditions that a doctor may mention during the diagnosis of milia include genetic skin disorders, such as genodermatosis. They may also investigate conditions that do not cause milia but can have a similar appearance,
- sebaceous hyperplasia
- comedonal acne
- flat warts
- idiopathic calcinosis cutis
Many cases of milia clear up without any treatment. In newborns, no treatment is necessary, as the bumps usually go away within a few months.
Some adults try to speed up the process by gently exfoliating the skin. However, this is not safe for milia located very close to the eyes, and not all types of exfoliation are beneficial for all people.
It is important to speak with a doctor before using these techniques, especially around the eyes.
People should never squeeze a milium as they would a pimple. This will not help and could damage the skin, leaving a scar.
Potential treatments include:
- Gentle exfoliation: People can wash the face with a gentle physical exfoliation method, such as a muslin cloth or konjac sponge. Avoid harsh scrubs or face brushes.
- Chemical exfoliation: This involves using mild acids to exfoliate dead skin cells. Examples include lactic, glycolic, or salicylic acid. Use a product designed for use around the eyes, and always follow with sunscreen when going outside, as acids increase sensitivity to UV damage.
- Topical retinoids: Retinoids are derivatives of vitamin A that increase skin cell turnover. They also increase sensitivity to the sun, and are not safe for people who are or may become pregnant.
People may need to take special care with using some of these treatments around the eyes. For example, a 2022 review includes evidence that retinoids may contribute to dry eye disease.
People with dark skin tones may also need to exercise caution with exfoliants and retinoids, as they can sometimes lead to hyperpigmentation.
Professional options
If milia do not resolve on their own, a dermatologist may suggest professional treatments, such as:
- Dermabrasion: This is an exfoliating skin treatment that involves using an abrasive tool to remove outer skin cells.
- Chemical peels: These treatments involve the application of stronger acids than at-home exfoliating acids.
- Laser therapy: During laser ablation, a dermatologist uses a tiny laser to focus on the milium itself, opening the pore.
- Cryotherapy: Cryotherapy uses liquid nitrogen to freeze and destroy the milia.
All of these more intensive treatments have some risks, especially in the sensitive eye area.
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Not all cases of milia are preventable, as some people may be more susceptible to them than others.
However, general prevention tips include:
- gently cleansing the skin twice a day
- exfoliating two or three times a week
- wearing sunscreen of SPF 30 or above every day
Below are some commonly asked questions about milia under the eyes.
Milia can develop occasionally due to keratin in skin cells getting trapped instead of shedding. Other potential causes include skin damage, long-term use of corticosteroids, and some genetic or autoimmune conditions.
Milia usually go away on their own in time. Regular cleansing and gentle exfoliation may help speed the process, but it is important to be very careful with the delicate skin around the eyes.
People can take steps to help milia go away, but they should never try to pick, pop, or cut open milia to remove them. This can cause further damage, scarring, or infection.
Yes, many cases of milia go away on their own. If they do not, or a person has lots of milia, people can speak with a doctor.
Milia are tiny cysts that develop due to harmless buildups of keratin under the skin. They are common on the face and around or under the eyes.
Milia are not pimples, and attempting to pop them can cause further inflammation and scarring. The pores need to clear out the built up keratin for the milia to go away.
Gentle cleansing and exfoliation may help to speed up the process, but it is important not to use any irritating or potentially harmful substances close to the eyes.
Anyone who experiences recurring or persistent milia in the same area may want to speak with their doctor or dermatologist for a full diagnosis and to discuss treatment options.