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The bad news? Milia can be unsightly. The good news? You don’t have to live with them …

You look in the mirror and BAM! There’s this tiny, white bump on your cheek. You think it’s a whitehead and, naturally, proceed to pinch it. Nothing happens, besides feeling eye-watering pain because you pressed so hard. Plus, it appears to ‘run’ away when you apply pressure.

This is not like any blemish you’ve ever encountered. So, what is it? And most importantly, how do you get rid of it?18383705 - scowling girl squeezes her acne with a towel on her head

Hello, milia.

Milia (pronounced me-LEE-ah) most commonly occur in infants—especially on a newborn’s nose or forehead— but also can occur in children and adults. Luckily, milia—or milium for one— are not dangerous. However, they can make you feel insecure about your looks, especially when they appear in groups on your face. Of course, I understand, you want those facial milia gone!

What is Milia?

Those white or yellowish bumps you discovered are keratin-filled cysts that form just under the skin. They occur when dead skin cells get trapped.

However, it’s not that easy to get rid of milia.

Learning how to do it right is paramount. Especially if you have sensitive skin, you don’t want to damage your skin with poor milia removal techniques. If it doesn’t bother you appearance wise—best to leave it alone. Occasionally, they can dissolve on their own.

What Causes Milia?

There are several factors that cause milia in adults. Most commonly, they occur due to dead skin building up and getting trapped in the pores near the surface of the skin. If it doesn’t get expelled naturally, it can become small cysts. This type of milia is called Primary Milia.

The other type of milia is Secondary Milia. Primary and secondary milia look the same but develop from very different reasons. Secondary Milia happens when something clogs the sweat ducts. This usually is caused from some kind of skin trauma or infection, such as blistering, laser treatments, chemical peels, and herpes.

Other possible contributing lifestyle factors include: lack of sleep; smoking; poor personal hygiene; using oil-based beauty products in excess; and long-term steroid use.

How to Remove Milia at Home

Although tempting, if those pesky white bumps are near your eyes—either on the lids or  under-eye skin—don’t remove it on your own. If it’s not in a sensitive area, such as your forehead or cheek, there are a few simple techniques to remove it safely.

But first, know that milia are not like a pimple that appears and goes away in a few days.

They don’t usually go away on their own. And you can’t pop it like you would a pimple. Milia removal usually requires an incision. The cysts are usually deep below the skin’s surface. Again, getting a milium isn’t harmful. But it is more than understandable if you want to remove it for aesthetic purposes.

Here are the seven highly effective steps to safely removing milia at home:

  • Sanitize a sharp needle (the finer point the better) and tweezers or comedone extractor.  

25741944 - young brunette with tweezers in her hand on white background

  • Clean your face with gentle cleanser and rinse it thoroughly.
  • Dry your face completely with a clean towel.
  • Gently make a tiny incision on the top or on the side of the milium sufficient enough to excise it.
  • Using the tweezers or extractor, apply gentle pressure to remove the milium up and out of the small opening.
  • Apply an antiseptic or rubbing alcohol to the incision.
  • When finished, continue with your regular skincare routine.

Again, milia aren’t like pimples. There isn’t more to extract by simply squeezing harder or repeatedly. Don’t continue to squeeze the area after the white bead has been removed. This will only cause damage.

Other Removal Solutions

If doing a mini-surgery on yourself makes you weak in the knees, there are other less invasive—albeit less immediate—methods. Here’s just a few:

Exfoliating Scrub

A gentle and regular exfoliation treatment can help to keep your skin free of the buildup that can clog pores and cause milia. There’s also evidence that some exfoliating compounds – like salicylic acid, citric acid, or glycolic acid – may keep keratin from being overproduced in your skin. But don’t exfoliate every day, it’s far too irritating.

Manuka Honey 

Manuka Honey is a potent, and natural, antimicrobial that’s been shown to help in reducing irritation, so a honey mask is a great idea for milia. To apply a Manuka honey mask, zap the honey in the microwave for around 30 seconds first, so that the honey can be more easily applied to the face. Leave on for 10 minutes and rinse.

Apple Cider Vinegar

Apple cider vinegar is a natural astringent and is often used in place of a toner as it causes your pores to contract. This can help to keep your pores free of the debris that causes them to clog. Dilute ACV with water before applying to the face and use as either a cleanser or toner. And, here’s an interesting fact: it’s also a beauty secret of actress Scarlett Johansson 

Retinoid Cream

Some studies recommend retinoid creams to banish milia. Retinoid is a form of vitamin A but should be used sparingly – just once a day is recommended. And, you should always wear sunscreen when using products containing retinoids, as your skin is more vulnerable to UV sun exposure.

These home remedies probably won’t work instantly. But with continuous use, these milia treatments may reduce or prevent them.

Milia Removal: When to See a Dermatologist

There are a few situations where making an appointment with a skincare professional is optimal. Typically, it’s a quick and painless in-office procedure. Depending on the dermatologist, they get rid of the milia using a needle, comedone extractor or lancing tool.

So, when is it best to consult a dermatologist instead of DIY?

If you have any of these scenarios, leave it to a doctor to remove the milia:

  1. If you have an unsteady hand or feel uncomfortable about doing the removal.
  2. If you have many concentrated in one area rather than one or two.
  3. If you have milia under the eyes or on the eyelids.

How To Prevent More Milia?

So now that you’ve removed it, how do you keep milia from coming back? Of course, removing your makeup and washing your face before bed every night is vital. Also, exfoliation works wonders in preventing milia. Use a gentle exfoliant at least three times a week on your entire face, including the eyes and eyelids.

Retinol is also very helpful for both fighting and preventing milia. Apply a small amount to the face every other night; make sure to avoid the eyelids.

And other lifestyle changes that can help prevent milia include limiting your intake of cholesterol-rich foods (meat, eggs, etc), taking Vitamin D, avoiding heavy oil-based skincare or makeup products and limiting sun exposure (except for early morning sun).

In conclusion, milia aren’t harmful but they can be unsightly. If they aren’t on the eyelid or under the eye, you can simply and safely remove them at home. And to prevent milia in the future, make sure to keep your face clean, especially before bedtime, gently exfoliate regularly, and avoid sunburns.

Your Beverly Hills MD,

Dr. John Layke

 

Article updated: March 21, 2018

About the Author

Dr. John Layke

Dr. John Layke grew up in Milwaukee, WI, where he knew from a young age that he wanted to practice medicine. After completing his undergraduate degree at Marquette University, Dr. Layke went on to attend medical school at Nova Southeastern University in Fort Lauderdale, Florida, and trained in general surgery at the University of Illinois Metropolitan Group Hospitals in Chicago.