Can milia be removed?

What exactly is being removed?

A milium is a small cyst containing keratin, a skin protein; several are called milia. They look like tiny pearly white bumps just beneath the skin, commonly on the cheeks and eyelids. Milia are cysts rather than acne, so the resemblance to a whitehead is doing some misleading publicity.12

How does professional removal work?

For an individual cyst, a clinician can make a small opening in its surface and extract the contents. This removes the cyst's contents rather than waiting for the bump to disappear naturally. Other procedures include cryotherapy, which freezes the lesion, or diathermy and curettage, which use heat and scraping. These are professional treatments, not instructions for using a needle at home.12

For widespread milia, topical retinoids, medicines applied to the skin, may help. Options used for milia include adapalene gel and prescription tretinoin cream. Chemical peels, dermabrasion and laser treatment have also been used for very extensive milia. A few isolated bumps and a large area of milia do not necessarily need the same treatment.12

Can milia be removed at home?

Do not squeeze, scrape or pick at milia. Trying to remove them yourself can cause infection or permanent scarring. Home skincare can help, but it is different from physically extracting a cyst.2

For adults, home care can include these measures:

• Wash your face daily with warm water and gentle soap, then pat the skin dry gently.
• Consider an over the counter exfoliating treatment rather than trying to scrape off individual bumps.
• Use sunscreen when you go outdoors.
• Avoid further injury to the affected skin to reduce the development of new milia.

How long do milia take to disappear?

Adult milia can clear within a few weeks to a couple of months, although some persist for months or longer. Waiting is reasonable if the bumps do not bother you. If you want them removed sooner, ask about professional removal rather than increasing your attempts to squeeze them.12

Do babies need milia removed?

Newborn milia need no treatment. They usually disappear during the first few weeks of life, commonly within eight weeks, without lasting effects. Similar cysts on the gums or roof of a newborn's mouth, called Epstein pearls, also disappear on their own. Do not use adult lotions or oils on a baby's delicate skin.234

When should you get the bumps checked?

A clinician can usually identify milia by examining the skin. Not every small pale bump is a milium: other cysts and skin growths can look similar, particularly around the eyes. Getting the diagnosis right comes before choosing a removal method.14

Adults can have milia removed for appearance alone, without requiring the bumps to submit a more serious reason.4

Arrange a visit if your or your baby's milia are not improving after a few months, if the bumps worsen, or if you want treatment because their appearance bothers you.2