Milia are tiny white cysts, only 1 to 2 millimeters across, that form when keratin (a protein your skin naturally produces) gets trapped beneath the surface. They look like a grain of sand or a hard, milky capsule stuck under your skin. Unlike acne, you can’t pop them out, and squeezing will only cause bruising, scarring, or infection. But there are effective ways to get rid of them, both at home and in a dermatologist’s office.
Why Milia Won’t Pop Like a Pimple
Milia and whiteheads look similar at first glance, but they form differently. A whitehead develops when bacteria, dead skin, and oil clog and close off a pore. Milia don’t develop inside a pore at all. They’re small cysts that sit under the outer layer of skin, formed by trapped keratin that likely originates from the outer root sheath of tiny hair follicles on your face. Because there’s no open pore connecting them to the surface, there’s no path for the contents to come out when you squeeze.
This is why picking at milia doesn’t work. The cyst wall is intact and sealed beneath the skin. You’d have to break through healthy tissue to reach it, which risks scarring and infection. That distinction also explains why milia aren’t red, inflamed, or painful the way acne is. They’re just sitting there, inert, under your skin.
What Causes Them
Primary milia, the kind that show up on your face for no obvious reason, are most common in adult women and result from an obstruction in the upper portion of a hair follicle. They tend to cluster around the eyes, cheeks, and forehead.
Secondary milia form after something damages your skin: burns, blisters, rashes, sunburns, dermabrasion, or even tattoos. When skin heals from blistering or peeling, small fragments of the outer skin layer can get trapped beneath the new surface, forming cysts. Heavy creams and ointments can also trigger milia by creating an occlusive barrier that traps keratin underneath.
Home Treatments That Help
You won’t dissolve a milium overnight, but consistent at-home care can help existing ones resolve and prevent new ones from forming.
Chemical Exfoliants
Gentle exfoliation helps prevent keratin from building up under the skin. Look for cleansers containing salicylic acid, glycolic acid, or citric acid. These ingredients encourage skin cell turnover, which can gradually bring trapped keratin closer to the surface. Start with once a week. Exfoliating too frequently irritates the skin and can actually make things worse. If your skin tolerates it well after a few weeks, you can slowly increase frequency.
Retinoids and Retinol
Products containing vitamin A derivatives are one of the most commonly recommended treatments for milia. Retinoids speed up the rate at which your skin sheds old cells and replaces them with new ones, which helps prevent the keratin trapping that creates milia in the first place. Apply a retinoid or retinol product once per day to clean, dry skin. If you’ve never used one before, expect some dryness and mild peeling as your skin adjusts over the first few weeks. Over-the-counter retinol is a lower-strength option; prescription retinoids are stronger and work faster.
Switch to Lighter Products
If you’re using thick moisturizers, heavy eye creams, or occlusive balms in areas where milia keep appearing, that could be part of the problem. Swap to lightweight, non-comedogenic formulas, especially around the eyes where milia are most common and the skin is thinnest. This single change prevents new milia from forming in many people.
Professional Removal Options
If milia bother you cosmetically or haven’t budged after weeks of at-home treatment, a dermatologist can remove them in a quick office visit. The most common method is manual extraction: a clinician uses a small needle or scalpel blade to create a tiny opening in the skin over the cyst, then applies gentle pressure with a comedone extractor or curette to push the keratin plug out. It’s fast, minimally painful, and usually heals without a visible scar.
For multiple milia or stubborn cases, other options include electrodesiccation (using a tiny electric current to destroy the cyst), electrocautery, or laser therapy. These are typically reserved for larger clusters or milia that keep recurring in the same spot.
Cost varies depending on location and how many milia you need removed. In major cities like New York, extraction starts around $300. In other areas, it may be less. Most insurance plans consider milia removal a cosmetic procedure and won’t cover it.
Milia Around the Eyes
The skin around your eyelids is the thinnest on your body, which makes this area especially prone to milia and also the trickiest to treat. Active ingredients like retinoids and chemical exfoliants can be too harsh for the eyelid area, causing irritation, redness, and peeling. If your milia are concentrated near or on your eyelids, professional extraction is generally the better route. A dermatologist can safely work in that delicate area with precision tools and minimal risk of scarring.
Heavy eye creams are a common culprit for milia in this zone. If you notice small white bumps forming after starting a new eye product, stop using it and see if the pattern changes over the next several weeks.
How Long They Last Without Treatment
In newborns, milia (sometimes called milk spots) are extremely common and typically disappear on their own within a few weeks. In adults, the story is different. Adult milia can persist for months or even indefinitely because the cyst sits in a stable pocket under the skin with no natural mechanism to push it out. Some will eventually resolve on their own, but there’s no reliable timeline. If a milium has been there for more than a month or two with no change, it’s unlikely to vanish without some form of intervention, whether that’s consistent exfoliation, retinoid use, or professional extraction.
Preventing New Milia
Once you’ve dealt with existing milia, keeping them from coming back is mostly about skincare habits. Use a gentle exfoliating cleanser with salicylic acid or glycolic acid once or twice a week to keep dead skin from accumulating. Apply sunscreen daily, since sun damage and sunburn peeling can trap skin fragments and trigger secondary milia. Avoid heavy, occlusive moisturizers on areas where you’re prone to breakouts, particularly around the eyes and cheeks. And if you use retinol as part of your routine, maintaining that habit long-term helps keep skin turnover steady enough to prevent new keratin from getting trapped.