A milium (plural: milia) is a tiny, dome-shaped bump that forms when keratin, a protein naturally found in skin, hair, and nails, gets trapped just beneath the surface of the skin. Unlike a pimple or whitehead, a milium has no opening to the surface and can’t be squeezed out. These firm, pearly-white bumps are typically 1 to 2 millimeters across and most often appear on the face, particularly around the eyes, cheeks, and forehead.
How Milia Form
Your skin constantly sheds dead cells. Normally, those cells rise to the surface and flake away. A milium forms when dead skin cells containing keratin become trapped in a small pocket beneath the outer layer of skin instead of shedding normally. The keratin hardens into a tiny, solid ball just under the surface, creating that characteristic white or yellowish bump. Because the keratin is sealed beneath intact skin with no pore or duct connecting it to the surface, milia feel firm to the touch and don’t respond to squeezing the way a pimple would.
Primary vs. Secondary Milia
Primary milia form spontaneously when keratin simply gets trapped with no obvious trigger. They’re the most common type and tend to show up on the eyelids, forehead, cheeks, and sometimes the genitals. Both children and adults get them, and they often appear without any clear cause.
Secondary milia (sometimes called traumatic milia) develop after something damages the skin or clogs the ducts that lead to its surface. Burns, blistering, rashes, and excessive sun exposure are common triggers. They can also form as a reaction to heavy skin creams or ointments. The key difference is that secondary milia have an identifiable cause, while primary milia seem to appear on their own.
Milia in Newborns
Milia are extremely common in babies. Between 40 and 50 percent of newborns develop them, usually across the nose, cheeks, and chin. In infants, these bumps resolve on their own within weeks to months without any treatment. They’re completely harmless and don’t indicate any skin condition or underlying health problem.
What Triggers Milia in Adults
In adults, milia can be trickier to pin down, but certain habits and products increase the likelihood of developing them. Heavy occlusive skincare ingredients are among the most common culprits. Petrolatum, mineral oil, lanolin, and thick synthetic waxes form a physical seal over the skin that can trap dead cells underneath. Even heavy botanical oils applied thickly overnight can contribute, especially around the delicate eye area where the skin is thinnest.
Sun damage is another significant factor. Chronic UV exposure thickens the outer layer of skin over time, making it harder for dead cells to shed properly. Skin injuries like burns, blisters, or severe rashes can also disrupt normal cell turnover and lead to secondary milia as the skin heals.
How to Tell Milia From Other Bumps
Milia are often mistaken for whiteheads, but the two are structurally different. A whitehead is a clogged pore filled with oil and bacteria, sitting inside a hair follicle. A milium is a solid ball of keratin trapped under intact skin with no connection to a pore. That’s why milia don’t respond to acne treatments or extraction attempts the way whiteheads do.
Syringomas are another look-alike. These are small benign growths of sweat gland tissue that tend to cluster in groups, often around the eyes. They’re typically yellow or skin-toned rather than the pearly white of milia. While both are harmless, they require different treatment approaches, so getting the right identification matters if you want them removed.
Why You Shouldn’t Try to Remove Them at Home
Because milia sit beneath a sealed layer of skin, there’s a strong temptation to pick at them with a needle or try to pop them. This rarely works and often makes things worse. Attempting to remove milia at home can cause bleeding, scabbing, and permanent scarring. Breaking the skin also introduces bacteria, raising the risk of infection in an area that was otherwise completely harmless.
Professional Removal Options
If milia bother you cosmetically or don’t resolve on their own after several months, a dermatologist can remove them through a few different methods.
The most common approach is manual extraction, sometimes called de-roofing. A dermatologist uses a sterile needle or small blade to create a tiny opening in the skin, then presses out the keratin plug. Results are immediate, and the procedure is quick with minimal discomfort.
For stubborn or widespread milia, other options include curettage (scraping the bump away with a small surgical instrument, sometimes combined with a mild electrical current to seal the skin) and laser ablation, which uses precise beams of light to vaporize the trapped keratin. Laser treatment is especially useful for clusters of milia in delicate areas.
Preventing New Milia
You can reduce your chances of developing milia by paying attention to what you put on your skin, particularly around the eyes. Avoid thick, occlusive products containing petrolatum, mineral oil, lanolin, or heavy waxes in that area. Opt for lighter, non-comedogenic moisturizers instead.
Regular gentle exfoliation helps keep dead skin cells moving off the surface rather than getting trapped underneath. Products that promote cell turnover, like those containing retinoids or mild exfoliating acids, can be helpful for adults who are prone to recurring milia. Sun protection also plays a role, since UV damage thickens the skin’s outer layer and slows the natural shedding process that keeps pores and ducts clear.
For people who get milia repeatedly, adjusting your skincare routine is often more effective than treating individual bumps as they appear. Lighter products, consistent exfoliation, and daily sunscreen address the underlying conditions that allow keratin to become trapped in the first place.