Does milia spread?

What are the white bumps?

Milia are tiny, harmless cysts containing keratin, a protein in skin. They sit just beneath the surface and look pearly white. They commonly appear around the eyelids, cheeks, forehead and nose, although they can occur elsewhere. Milia are not whiteheads or another type of acne. The name "milk spots" is a nickname, not a skincare shopping list.123

Why do more milia keep appearing?

Primary milia form when keratin becomes trapped under the skin. Secondary milia develop after skin damage, including burns or blistering. New cysts can appear as injured skin heals, so several bumps in the same area do not mean one bump has infected the next. Heavy skin creams or ointments can also trigger secondary milia. Some medicines, including steroid ointments and medicines that suppress the immune system, are associated with them.123

Rare patterns can make the change look especially noticeable. Multiple eruptive milia produce crops of bumps over weeks to months, usually on the face, upper arms or upper trunk. Milia en plaque describes multiple cysts within a raised, inflamed patch, often on an eyelid, cheek, jaw or behind an ear. These patterns are reasons to have the bumps assessed rather than assume every new white spot is ordinary milia.2

Can squeezing milia cause more bumps?

Do not squeeze, scratch, scrape or burst milia. Skin trauma can encourage new cysts, and attempting removal yourself can cause scarring or infection. Reducing further injury helps reduce the development of new lesions. Professional extraction uses a sterile needle or blade to open the cyst and remove its contents; it is not a home treatment.123

What should you do about milia?

Treatment is usually unnecessary because milia are harmless. Removal for appearance is optional, even if the skincare aisle has never met a face it wanted to leave alone. For everyday care, wash your face daily with warm water and gentle soap, then pat dry gently. Use sunscreen outdoors. Most cases cannot be prevented, so prevention does not mean guaranteeing that no new bumps will appear.1

Adult milia can clear within a few weeks, but some persist for months or longer. If the bumps bother you, a dermatologist can discuss extraction, freezing or other removal methods. Topical retinoids, medicines applied to the skin, may help widespread milia. Having existing cysts removed and preventing future cysts are separate goals.23

What if your baby has milia?

Newborn milia usually disappear without treatment in the first few weeks of life and leave no lasting effects. Similar harmless cysts can occur on the gums or roof of the mouth. Do not apply adult lotions or oils to a baby's milia. If you are unsure whether the bumps are milia or acne, do not try acne treatment unless a dermatologist recommends it.145

When should you get the bumps checked?

Arrange an appointment if the bumps worsen, remain after a few months or you want them removed. A clinician can usually diagnose milia by examining the skin; white bumps can have other causes. For a newborn, seek advice if a coloured rash or crusting develops around the bumps. A child who is unwell with a rash needs assessment rather than assuming the rash is milia.1236