What Are Milia?
Milia (singular: milium) are small, dome-shaped, white or yellowish cysts that appear just beneath the skin's surface. They are typically 1–2mm in diameter and feel firm to the touch. Milia form when keratin — the structural protein of skin cells — becomes trapped beneath the skin surface and cannot shed normally. Unlike whiteheads (closed comedones), milia do not have a pore opening and contain keratin rather than sebum. They most commonly appear around the eyes, nose, cheeks, and forehead.
Types of Milia
Primary milia form spontaneously without a clear preceding event — common in newborns (neonatal milia, usually resolving within weeks), and in adults from blocked sebaceous glands or eccrine sweat ducts. Secondary milia develop following skin trauma: burns, blistering, dermabrasion, prolonged use of heavy topical steroids, or as a feature of certain blistering skin conditions (like epidermolysis bullosa). The mechanism in both cases is disrupted keratin shedding.
Treatment Options
Many primary milia resolve spontaneously over weeks to months without intervention. For persistent milia, gentle retinoid use can improve cellular turnover and accelerate resolution — AHAs similarly help. Extraction by a trained aesthetician or dermatologist (using a sterile lancet to create a small opening and express the cyst) is the most reliable and immediate treatment. Do not attempt at-home extraction — unprepared trauma can cause scarring.
Prevention note: Heavy, occlusive creams applied around the eyes can contribute to milia formation in predisposed individuals. If you are milia-prone, opt for lighter eye area formulations and ensure regular, gentle exfoliation.
See Exfoliation and Acne & Congestion.