The tiny white spots that appear on the delicate skin beneath the eyes are a frequent cosmetic concern. These small, harmless bumps are typically the result of a very common skin condition. Understanding the nature of these spots and the factors that contribute to their formation is the first step toward managing them safely.
What Are These White Spots?
The most common cause for small, white, dome-shaped bumps under the eyes is milia. These are miniature cysts that form just beneath the skin’s surface, not a form of acne. Milia are characterized by their pearl-like white or yellowish appearance and typically measure between one and two millimeters in diameter.
The composition of these spots is trapped keratin, which is a structural protein found in skin, hair, and nails. When dead skin cells fail to shed properly, the keratin collects and becomes encased, forming the firm cyst. Unlike a pimple, milia do not have a pore or opening, making manual extraction impossible.
While milia are the most likely culprit, other lesions can appear in the same area. Syringomas are small, flesh-colored or yellowish bumps resulting from an overgrowth of sweat gland cells. Xanthelasma are soft, yellowish patches often linked to cholesterol deposits. These conditions differ in color, texture, and origin, but milia remains the primary cause of the distinct white spots.
Factors Contributing to Their Formation
Milia formation is fundamentally linked to a disruption in the skin’s natural exfoliation process. When old skin cells die, they are supposed to shed, but if they become trapped, they harden into keratin-filled cysts. This spontaneous occurrence is known as primary milia and is common in adults, often clustering around the eyelids and cheeks.
Secondary milia develops following external triggers or trauma to the skin. Chronic sun exposure is a significant factor, as ultraviolet damage can thicken the skin, making it difficult for dead cells to shed normally. Skin injuries, such as burns, blistering, or aggressive skin resurfacing treatments like dermabrasion, can also lead to their development.
Certain topical products can also play a role in trapping dead skin cells. Heavy, oil-based creams or occlusive makeup applied to the eye area may create a barrier that prevents proper exfoliation. Long-term application of strong corticosteroid creams can sometimes contribute to milia formation. These external influences impair the skin’s turnover rate, allowing keratin buildup to occur.
Safe Management and Removal Strategies
Managing these spots involves adopting a gentle, preventative skincare regimen. Switching to lightweight, oil-free, and non-comedogenic eye creams and makeup helps prevent the accumulation of material that might trap dead skin cells. Daily use of a broad-spectrum sunscreen with an SPF of at least 30 is also important to mitigate sun damage, a known risk factor for secondary milia.
Chemical exfoliants encourage cell turnover and help prevent new milia from forming. Ingredients such as alpha-hydroxy acids (AHAs) like glycolic acid or retinoids (Vitamin A derivatives) promote the shedding of surface skin cells. Products containing these active ingredients should be used cautiously around the delicate eye area, as they can increase sun sensitivity and cause irritation.
For existing or persistent milia, professional intervention is the safest and most effective removal method. A dermatologist can perform a procedure called deroofing, which involves using a sterile instrument to create a tiny opening and gently extract the trapped keratin. Other professional options include cryotherapy, which uses liquid nitrogen to freeze the milia, or laser ablation.
It is important to avoid attempting to pick, scratch, or squeeze the spots at home. Milia are encased cysts without an exit pore, meaning manual extraction will only cause trauma, leading to potential scarring, inflammation, or infection. If the spots multiply rapidly, change color, or if there is any uncertainty about the diagnosis, consult a dermatologist for correct identification and treatment.