What is milia? Causes, removal and lookalikes

Milia are tiny, hard, white bumps that sit just under the skin, most often around the eyes, on the cheeks and on the nose. They look like whiteheads, and they are a separate condition: closed cysts of keratin that a doctor opens to remove. They are harmless, and they are common: up to half of newborns have them, and many adults get them too. This guide explains what milia are, what they look like, why they form, how they are treated, and which bumps only look like milia. Each section links to a guide that covers that part in depth.

Skinli gives general education and is not a doctor. Never pick, pop or cut milia near your eyes. A dermatologist can confirm what a bump is and remove milia safely.

Milia in plain words

A milium (the singular; milia is the plural) is a tiny closed pocket of keratin, the tough protein that makes up the top layer of skin. StatPearls, a medical reference hosted by the U.S. National Library of Medicine, describes milia as "benign and transient subepidermal keratin cysts that present as small, firm, white papules." Benign means harmless. Subepidermal means just under the epidermis, the top layer of skin. A papule is a small raised bump.

MedlinePlus, from the same library, puts it more simply: "Milia occur when dead skin becomes trapped in small pockets at the surface of the skin or mouth."

Each milium has a wall of skin cells around a solid core. StatPearls says the center holds "keratinous material." That solid core is why the white "seed" of a milium looks like a tiny grain, and why pressing on one does not empty it the way pressing on a pimple can.

What milia look like

StatPearls describes newborn milia as "small, white-to-yellow, smooth, dome-shaped papules measuring less than 3 mm," and adds that "in darker skin, they may show a subtle blue tint." They appear "singly or in clusters." The NHS says the spots "may appear white or yellow, depending on your child's skin colour."

Where they appear depends on age:

• Newborns: "mainly over the nose, scalp, eyelids, cheeks," plus the gums and the roof of the mouth, StatPearls says. MedlinePlus says "Bumps that appear across the cheeks, nose, and chin."
• Older children and adults: milia that appear on their own "tend to occur on the eyelids, cheeks, forehead, and genitalia," according to StatPearls.
• Anywhere after skin damage: secondary milia can form where skin was burned, blistered or injured.

StatPearls says they can also appear on "the upper trunk, extremities, and genital area." The face is the most common site.

Milia usually cause no discomfort. StatPearls calls them "commonly asymptomatic" and describes them as firm.

Who gets milia

• Newborns. StatPearls says congenital milia occur "in up to 40% to 50% of healthy full-term neonates." In babies born early they "may be delayed."
• All ages. StatPearls says "milia can affect persons of any age, but is most commonly seen in neonates."
• Everyone. StatPearls reports no clear difference between races or between men and women, except for milia en plaque, which it says is "more common in females."

A 2008 review in the Journal of the American Academy of Dermatology says milia "are frequently encountered as a primary or secondary patient concern in pediatric and adult clinics." It also says "there are few studies on the origin of milia."

The types of milia

StatPearls divides milia into two groups.

Primary milia appear on their own. They include:

• congenital milia in newborns,
• benign primary milia of children and adults, the common adult type,
• milia en plaque, a rare red patch "studded with numerous milia,"
• multiple eruptive milia, many milia that appear "suddenly over weeks to months,"
• and milia linked to rare inherited skin disorders.

Secondary milia follow something that affected the skin. StatPearls says they come "in association with underlying skin pathology, medications, or skin trauma," and "most often follow burns, skin grafting, dermabrasion, or radiotherapy." Dermabrasion is a clinic treatment that sands away the top layers of skin. It also names blistering diseases, long-term steroid creams on thinned skin, and some anti-inflammatory pills.

The guide what causes milia goes through every cause the sources name, including rare ones such as tattoos, friction and isotretinoin.

Are milia harmful?

No. StatPearls says "No systemic complications have been documented. Milia are benign and asymptomatic lesions." MedlinePlus says of newborn milia, "There are no lasting effects."

Three cautions still apply:

1. Picking causes the harm. Squeezing or cutting milia at home can scar and let in infection. The NHS says "do not pick or squeeze spots because this can cause scars." Near the eyes, the risk is higher. See can you pop milia.
2. Some lookalikes are not harmless. Basal cell carcinoma, the most common skin cancer, can appear as a "Cluster of shiny bumps," the American Academy of Dermatology (AAD) says, and "you cannot rule out or know whether you have this skin cancer by looking at pictures."
3. Unusual milia may point to something else. StatPearls says "persistent and widely distributed milia may require investigation for other causes." A 2025 report in BMJ Case Reports described eyelid milia as "the sole ocular finding of systemic sarcoidosis," a disease that often involves the lungs, lymph nodes and skin.

How milia are diagnosed

A doctor usually knows milia on sight. StatPearls says "Milia lesions are diagnosed on clinical findings," meaning by examining them, and MedlinePlus says "No testing is needed." When there is doubt, StatPearls says "incision and drainage of the keratinous content of milia can corroborate the diagnosis": opening the bump and finding the hard keratin core confirms it. A 2026 report in the journal Cureus describes a dermatologist using dermoscopy, a lighted magnifier on the skin, where milia "characteristically appear as well-defined, homogeneous white to yellowish structures."

How to get rid of milia

For babies, do nothing. MedlinePlus says "In children, no treatment is needed." For adults, removal is a choice made for appearance. MedlinePlus says "Adults may have milia removed to improve their appearance."

Option	Who does it	What the sources say
Wait	You	Newborn milia clear in weeks; adult milia "may continue without treatment" (StatPearls)
Extraction with a tiny incision	A clinician	"evacuation with a tiny incision and tangential pressure" (StatPearls)
Needle deroofing	A clinician	Often used for eyelid milia (StatPearls eyelid chapter)
Topical retinoid	Prescribed or advised by a doctor	Listed for multiple milia; case reports only (StatPearls)
Electrocautery	A clinician	Listed for multiple milia (StatPearls)
Laser (CO2, Er:YAG)	A dermatologist	Small case reports with good results (2010, 2011 reports)
Acid exfoliants and scrubs	You	No study shows they clear milia

Each option has its own guide:

• Milia removal explains how doctors extract milia, the laser and electrocautery options, and whether milia come back.
• Retinoids for milia sets out the case reports behind retinol, adapalene and tretinoin, and the label rules.
• Exfoliating acids for milia covers salicylic acid, glycolic acid, scrubs and peels, and why strong peels can cause milia.
• Can you pop milia explains why home removal goes wrong and what to do instead.

A 2010 study in the Journal of Cosmetic and Laser Therapy treated four patients with a CO2 laser and reported "marked improvement after a few sessions," with "No-one had recurrence" over 12 to 36 months. A 2014 review of milia en plaque says every treatment offers "cosmetic improvement but recurrence can occur." Removal treats the bumps you have. New milia can still form, and milia en plaque often returns.

Milia around the eyes

The eyelids and the skin under the eyes are the most searched milia sites, and the riskiest place to pick. The StatPearls chapter on eyelid bumps says milia there "are often surgically removed with a 'deroofing' technique using a needle," and that "The risk for scarring and a poor functional or cosmetic outcome is higher on the eyelids than elsewhere on the body." A 2011 laser report adds that near the eye "even minimal scarring can result in ocular complications." The adapalene label says "Avoid product contact with eyes." The guide milia under the eyes covers causes, removal and the eyelid bumps that look like milia.

Milia on the lips

Milia on the lips are reported less often. White lip spots can also be Fordyce spots, oil glands that open onto the lip. Cold sores can also start as a small bump. The guide milia on lips compares them.

Milia in babies

Milia are one of the most common findings on a newborn's skin, and they clear without treatment. They are often confused with baby acne, which MedlinePlus says is a different condition. The guide milia in babies covers what they look like, how long they last, and the signs that need a doctor.

Milia and acne

Milia are a separate condition from acne. MedlinePlus says calling irritated milia "baby acne" "is incorrect" because milia are not a true form of acne. Whiteheads, a common lookalike, are acne: the AAD says a whitehead forms "when excess oil and dead skin cells build up and plug the opening of a pore." The guide milia vs whiteheads compares them point by point, and closed comedones and how to get rid of whiteheads cover whiteheads themselves.

You can have both at once. The 2026 Cureus report describes a teenager with acne who developed milia under his eyes during isotretinoin treatment, and whose milia were removed while his acne treatment continued.

Bumps that look like milia

StatPearls says "The principal differential diagnosis is sebaceous hyperplasia," enlarged oil glands, and names acne whiteheads, flat warts and milia-like calcium deposits as others. Around the eyes, syringomas and xanthelasma look similar. Molluscum contagiosum, a viral bump, and basal cell carcinoma can also look pearly. The guide white bumps that are not milia describes each one as the sources describe it. On the nose, the normal oil plugs in pores are covered in sebaceous filaments and whiteheads on the nose.

Milia on brown and black skin

Milia can look different on darker skin. StatPearls says "in darker skin, they may show a subtle blue tint," and the NHS says the spots on babies "may appear white or yellow, depending on your child's skin colour."

Treatment choices matter more on darker skin, because some treatments can leave dark marks. The AAD warns that people with darker skin tones should "avoid strong chemical or mechanical exfoliation," because aggressive exfoliation can lead to increased pigmentation, meaning dark spots. A 2020 report in Dermatologic Surgery described treating milia in people with skin types IV to VI, the darker skin types on the Fitzpatrick scale, with a short-pulse Er:YAG laser. Ask any clinician who treats your milia how they reduce the risk of dark marks on your skin tone.

What the research does not know yet

Milia are common, yet the research on them is thin. The 2008 review in the Journal of the American Academy of Dermatology says "there are few studies on the origin of milia." A 2020 review in the International Journal of Women's Dermatology says "The exact etiology of multiple milia remains unknown," etiology meaning cause.

Treatment research is thin too:

• No randomized trial of any milia treatment turned up in a PubMed search on 2026-09-26 for milia with retinoid, tretinoin or adapalene in the title.
• The laser evidence comes from single cases and a series of four patients.
• No study tests salicylic acid, glycolic acid, scrubs, eye creams or products sold as milia removers.
• No study measures how often milia return after extraction.

That is why every guide in this hub says what each source found and how strong it is, and why the safest plan for milia that bother you is a visit to a dermatologist.

Can milia be prevented?

MedlinePlus says "There is no known prevention." Some triggers of secondary milia can be avoided: long-term steroid creams on the face, skin injuries, and picking. If you plan a strong peel or laser resurfacing, ask the clinic about aftercare, since a 1997 paper on laser resurfacing listed milia among problems that "can be controlled or avoided with proper postoperative care." That paper is covered in what causes milia.

Questions to ask a dermatologist

• Are these milia, or another type of bump?
• Is there a cause I can change, such as a cream or a medicine?
• Which removal method suits the number and place of my milia?
• Is a retinoid worth trying first, and where can I safely apply it?
• If they come back, how soon should I return?

When to see a doctor

See a dermatologist for milia that bother you and have lasted for months, for many milia that appear at once, for milia after blisters or in an older child, and for any bump on the eyelid you want removed. See a doctor promptly for a bump that grows, bleeds, crusts, changes or spreads, for a pearly or shiny bump that is new in adult life, and for spots on a baby who also has a fever or seems unwell. If you also have acne, Skinli's free photo plan at /analyze builds an acne routine; it does not assess milia.