If you have noticed tiny white bumps on your face, don’t be alarmed. The bumps are most likely milia, or a group of milium cysts, which are collections of dead skin cells trapped within the tiny crypts (infundibula) from which hairs emerge. Milia typically occur on the nose, forehead, chin or cheeks, and sometimes on the eyelid or on the genitals. Up to half of all newborns have milia because an infant’s delicate skin has to learn how to shed dead skin cells. Milia can also occur in adults, and they’re mostly a cosmetic issue, not a serious medical condition. Even so, they can be annoying and unsightly. Learn how to deal with milia here.
There are several kinds of milia, all with different causes:
- Primary milia occur on their own, unrelated to skin damage. They usually disappear within a few weeks or months.
- Secondary milia develop after some sort of skin trauma. A sunburn, rash, blister or tattoo can prompt milia to form under the skin. Creams or ointments can also sometimes cause milia. Secondary milia may never go away.
- Neonatal milia is common in newborns—up to 50% of infants have milia, typically around the nose. Babies can be born with milia or develop it later.
- Juvenile milia are often caused by an inherited disorder. They may appear when the child is born, but it can also develop later.
- Milia en plaque is an inflammatory condition that causes the bumps to cluster on a raised patch of skin. This type of milia is uncommon.
- Multiple eruptive milia is also uncommon. These are itchy clusters of milia that appear suddenly on the face but also on the upper arms or upper abdomen.
While you may not like the appearance of milia, particularly on the face, these milium cysts are not a cause for concern. Milia don’t require treatment because they will usually disappear on their own after a few weeks or, in adults, sometimes months. However, there are some home milia treatments you can try. These include:
- Gentle exfoliation with salicylic acid, alpha hydroxy acid, or a topical retinoid may help. Exfoliating the skin will help your skin remove dead cells more quickly, but be sure to treat your skin gently.
- If your baby has milia, the best treatment is gentle washing with lukewarm water daily and patting dry. You can use mild soap meant specifically for babies if you’d like. Don’t scrub the baby’s skin or use any skin treatments meant for adults.
Don’t try to pop milia like a pimple. Milia are hard cysts beneath the skin. You can damage your skin by trying to remove a milium cyst on your own, and it can lead to scarring or infection. If you allow milia to clear up on their own, they usually don’t leave scars.
Milium Cyst Removal
If you aren’t seeing any improvement in the milia, particularly if you’ve been gently exfoliating your skin, you can visit a dermatologist. The doctor can make sure the milia are not a more serious health problem. If your dermatologist has any concerns, a skin biopsy can give you answers.
If it’s unsightly, stubborn milia, the dermatologist can remove the cysts with a needle or by freezing them.
If the milia on your infant’s face don’t disappear after about three months, bring it up with the pediatrician at the next well-baby visit.
Most of the time, milia show up on their own and can’t be prevented. They aren’t caused by not washing your face well.
However, if you treat your skin well, it will increase your chances of clear skin. Always use sunscreen, and avoid using thick creams on your face. Gentle exfoliation will help slough off dead skin cells and promote bright skin.