What Is Milia? The White Bumps Around the Eyes

What is milia? Milia are pearl-white bumps formed by small keratin-filled cysts just beneath the surface of the skin, and they are harmless. They are not pimples, so squeezing does not remove them, and it carries a risk of scarring and infection. In adults they often disappear on their own within weeks or months. If they do not go away or bother you, a dermatologist can open and remove them with a sterile needle or blade. If a bump grows, bleeds or does not heal, it may not be milia; get it examined.

First, know this: squeezing does not work

When you see a white dot under the eye, the first instinct is to squeeze it between your fingers. Do not do that. Milia are small cysts closed under the skin, with their top covered by skin. Even a specialist opens this cover with a sterile tool before removing the contents. Pressing with a nail does not remove the cyst; it damages the surrounding skin and can leave a scar.

The same applies to needles and opening tools that can be used at home. The eyelid area is thin and sensitive, and working very close to the eye is a separate risk. Using a needle while looking in a mirror also raises the risk of infection. No internet video removes this risk.

If you squeezed it, keep the area clean and do not apply a new product on it. If it becomes red, hot and painful, see a doctor the same day.

What is milia, and how does it form?

Skin constantly sheds its old cells. Sometimes these cells, instead of shedding, become trapped beneath the surface, harden, and form a small keratin-filled cyst. Bumps are usually single or found in small groups, and they neither hurt nor itch. They are not contagious and are not a type of acne. Sometimes there is no obvious trigger, so you do not need to think "I did something wrong."

Heavy creams are also among those often blamed. It is stated that thick, oil-based products may pose a risk around the eyes, but there is no strong measurement. Even so, if the bumps started after a new eye product, a short break is a reasonable test. For application, see the is an eye cream necessary article.

Pimple or milia? Confusing bumps

Milia are not the only thing that makes small bumps around the eyes. The table is not a diagnostic tool, but a guide showing why you should go for an examination. If you have doubts, a dermatologist can often tell most bumps apart by looking.

Do not panic at the last line, but keep in mind this detail: milia often stay the same or disappear over time. A bump that grows, bleeds, crusts, or opens a wound that does not heal is not left as "probably milia."

What to do in order when you see a white bump?

The sequence below is an example derived from general recommendations, not a fixed schedule.

1. Take your hands away. No squeezing, scraping or piercing.
2. Take a photo in the same light. After a few weeks you can more easily see whether it has grown.
3. Think about and note whether you started an eye cream, makeup product or steroid cream in recent weeks.
4. If you started a thick new cream, take a break from it. Do not stop a prescription medication without asking your doctor.
5. If the bump is painless and stable, wait. In adults it may disappear within a few weeks to a few months.
6. If it does not clear within a few months, or grows, bleeds or opens a wound, see a dermatologist.

What can you do at home?

There is no proven home remedy for milia; often the best option is waiting. Even so, there are steps that support your skin and can reduce the risk of new bumps:

• Wash your face twice a day with a gentle cleanser; you can find the technique in the how to wash your face article.
• Remove makeup before bed, cleansing the eye area without rubbing. For the method, see the how to remove makeup article.
• Apply a broad-spectrum sunscreen of at least SPF 30 every day, and reapply every 2 hours and after sweating or swimming. For the eye area, take a look at the how to apply sunscreen article.
• Take a break from thick, oil-based creams around the eye for a while.
• Do not apply over-the-counter steroid creams to your face for long periods.

Do peels and retinol work?

It is reported that some stubborn bumps may improve with peels or retinol, but there are two conditions here. First, the evidence is not strong. Second, the eye area reacts easily to these products. So ask your doctor before using them near the eyelid; if you are doing a peel, also do not exceed the general rule, i.e., do not do it more than 1-2 times a week. During pregnancy and breastfeeding, retinoids are not used at all; consult your doctor.

How is a professional procedure done?

Milia do not medically require treatment; the procedure is usually done because the appearance bothers you. The dermatologist's options vary according to the location and number of bumps:

• Opening and removing: The top of the bump is opened with a sterile needle or blade and the contents are carefully removed. It is a commonly used method for a small number of bumps.
• Freezing or burning: Cryotherapy, or electrical burning and scraping, can be applied.
• Prescription retinoid cream: For numerous and widespread bumps, options such as adapalene or tretinoin can be considered.
• Peel, dermabrasion or laser: These come up in very widespread conditions.
• Oral medication: Sometimes used for milia en plaque.

The doctor decides which method to use, looking at the location and number of bumps. Around the eyelid, have the procedure done under sterile conditions by a doctor experienced in this area. The procedure removes one bump, but does not prevent new ones from appearing.

White bumps in babies

About half of newborns have milia; they are most often around the nose and disappear on their own within a few weeks. Do not squeeze, scrape, or apply lotion or oil made for adults. If you have doubts about your baby's skin, or the bumps are accompanied by redness, discharge or fever, see a pediatrician.

Can milia be prevented?

Honest answer: largely no. Most bumps in babies and of the primary type cannot be prevented. For types that appear later, things that may help reduce the risk are limiting sun exposure, pausing thick creams, using steroid creams only on a doctor's advice, and cleansing the face regularly. Their effect has not been measured by strong studies, but they are harmless and simple steps.

Frequently asked questions about milia

Is milia contagious?

No, it is not contagious. However, dome-shaped bumps with a central dimple can be molluscum, and that can spread. So if you are unsure, get it examined.

Can I wear makeup over it?

Oil-based makeup products are counted among the risk factors. If you want to cover it, choose an oil-free product, do not skip evening cleansing, and do not try to flatten it by rubbing or scraping.

Will it leave a scar when removed?

It is known that squeezing at home can leave a scar. Procedures done by a doctor may also carry their own risks, like any procedure; ask before the procedure what to expect from it.

Did it appear because I have oily skin?

Milia form not from a clogged pore but from keratin trapped under the skin. So trying to solve it with harsh drying products usually only brings irritation.

When should you see a dermatologist?

Most milia can be expected to be harmless, but make an appointment in these cases:

• The bumps have not cleared up in a few months, are increasing, or bother you in appearance.
• The bump grows, bleeds, crusts, or heals and reopens.
• The bumps have gathered on a raised, red area, or many have appeared at once and are itchy.
• You have noticed yellow flat patches, bumps with a central dimple, or a lump on the lid.
• It started after a burn, fluid blisters, or long-term medication use.
• After squeezing, the area is red, hot, painful or swollen. In this case, seek help the same day.
• With swelling of the eyelid, you have had vision changes, pain inside the eye or sensitivity to light. In this case too, seek help the same day.