17868 Milia

Overview

Milia are tiny, white or yellowish bumps that appear on the skin when keratin, a protein in skin and hair, becomes trapped just below the outer skin layer. They are harmless and not a sign of a serious illness.

Yes, milia are very common. They can happen at any age, including in newborns and older adults.

Milia can affect anyone, but they are especially common in newborns, people with sun-damaged skin, and older adults who use heavy creams or ointments.

Symptoms

Common symptoms

• Small, 1 to 2 millimetre white or yellow bumps
• Smooth, dome-shaped and firm
• No pain, itching, or swelling
• Appear on the face, especially the eyelids, cheeks, and nose
• Can also appear on the shoulders, chest, or genitals

Symptoms in children

• Newborns often get milia on the nose, cheeks, or chin
• Bumps may also appear inside the mouth, where they are called Epstein pearls
• They are harmless and usually disappear within 1 to 3 months

Symptoms in older adults

• Small white bumps around the eyes, cheeks, or forehead
• Skin may be thinner or more easily damaged by the sun
• Milia in adults can last longer and may be more noticeable

Causes

Main causes

• Keratin getting trapped under the outer layer of skin
• Dead skin cells not shedding properly
• Skin injury, such as sunburn, blisters, burns, or a scrape
• Heavy or oil-based skincare products that block the skin surface

Risk factors

• Being a newborn, especially if born early
• Long-term sun damage to the skin
• Older age with thinner skin
• Using thick creams, ointments, or petroleum-based skin products
• Long-term use of certain steroid skin treatments

When to see a doctor

See a doctor urgently if:

• Signs of a skin infection, such as swelling, heat, pain, pus, or fever
• Bumps that suddenly change in colour, shape, or size
• Bumps that bleed or become very painful

Book a routine appointment if:

• Milia in adults that last longer than a few months
• Milia that bother you or affect your confidence
• When you are not sure if the bumps are milia or something else
• Baby milia that do not go away after 3 months

Diagnosis

A doctor can usually diagnose milia just by looking at your skin. They will check the size, colour, and location of the bumps and ask a few questions about your skincare routine and medical history.

Tests that may be done

• No tests are needed for typical milia
• The doctor might use a magnifying tool called a dermatoscope to look more closely
• In rare cases, a small skin sample may be taken if the bump looks unusual

What to expect at your appointment

No special preparation is needed. The doctor will look at the affected area, answer your questions, and tell you whether the bumps are milia or something else. Most of these checks take only a few minutes.

Treatment

Milia often disappear on their own, especially in children. If you want them removed for cosmetic reasons, a qualified doctor or skin specialist can do this safely in their clinic using a sterile method.

Self-care at home

• Wash your face gently once or twice a day with a mild, soap-free cleanser
• Do not squeeze, pinch, or try to pop milia — this can cause scars or infection
• Use light, water-based moisturisers instead of heavy creams if you are prone to milia
• Protect your skin from the sun with sunscreen and a hat
• Stop using any thick ointment, oil, or greasy product near the area

Medical treatments

When milia do not go away, a healthcare provider can remove them in the clinic. One common method is to nick the skin surface with a sterile needle and lift out the tiny cyst. Another is to use a small extraction tool. Some prescription skin creams that contain vitamin A can help the skin shed cells and may gradually clear milia. A dermatologist might also use freezing, laser treatments, or short-wave diathermy for stubborn milia. Your provider will explain the options and recommend the safest one for your skin.

When is surgery considered?

This is not a major surgery. Milia removal is a minor outpatient procedure done in a clinic or treatment room. It is very safe when performed by a trained professional.

Living with this condition

For most people, milia are only a cosmetic concern and can be left alone. If you decide to have them removed, the procedure is quick. Meanwhile, keep your skin clean and moisturised, and do not pick at the bumps.

Lifestyle tips

• Wear sunscreen every day to protect your skin from sun damage
• Avoid rubbing or scrubbing the skin too hard
• Choose gentle, fragrance-free skin products
• If you notice milia after using a certain product, stop using it and see if they improve

Diet and exercise

There is no strong evidence that a special diet or exercise can cure milia. Eating a balanced diet and staying active helps keep your whole body healthy, and a healthy body usually means healthier skin.

Mental health and emotional wellbeing

Even though milia are harmless, they can make some people feel self-conscious, especially when they appear on the face. It is completely normal to feel that way. If milia are causing you distress, talk to a healthcare provider. They can reassure you or discuss safe removal options.

Prevention

Milia cannot always be prevented, especially in babies. In adults, you can reduce the risk by avoiding heavy, greasy skin products, gently exfoliating no more than once or twice a week if your skin tolerates it, and protecting your skin from sun damage. Never try to scrape or cut milia at home.

Vaccines

There is no vaccine for milia.

Screening programmes

No routine screening is needed for milia. Your doctor will only check them if you have concerns or if they appear unusual.

Complications

If left untreated

• Most milia stay harmless and may disappear on their own
• An individual milium can last for weeks to months, but it rarely causes other problems
• Picking or squeezing milia can lead to redness, scarring, or skin infection

Long-term outlook

The outlook for milia is very good. In babies, they usually clear within weeks. In adults, they can last longer, but safe removal by a qualified professional is effective and generally leaves the skin smooth. With good skincare and patience, milia are unlikely to cause any long-term health problems.

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