What are milia?
Milia are tiny, pearly white bumps just beneath the skin, often on the eyelids and cheeks. They contain keratin, a protein in skin. They can affect children and adults and can appear elsewhere on the body. One cyst is called a milium; several are milia.2
Milia are not whiteheads or a type of acne. Dead skin cells become trapped beneath the surface and form small cysts. Ordinary milia do not cause pain or discomfort and are not contagious. Some less common forms can itch or appear together on a raised patch.1
Is milia considered cosmetic?
Adults can have milia removed to improve their appearance, but leaving harmless milia alone is also an option. Removal is optional, not a compulsory maintenance appointment for having a face. The distinction matters when deciding whether to seek treatment: disliking the bumps is a reason to discuss removal, not evidence that they are dangerous.23
For adults in Norfolk and Suffolk, NHS referral for milia removal is not routinely funded, and treatment for cosmetic reasons is not funded. Local exceptions for benign lesions include interference with vision or physical function, significant recurrent infection or bleeding, and an underlying syndrome. Exceptional cases can be considered through an individual funding request. These are local funding rules, not a reason to leave an unidentified bump unchecked.4
Will milia go away without treatment?
Milia often clear by themselves within a few months. In children and adults, some disappear within weeks, while others persist for months or longer. Waiting is a reasonable choice for confirmed milia that do not bother you. Choosing no treatment is still a choice, even if it leaves the skincare shopping basket disappointingly empty.2
Newborn milia usually disappear within a few weeks and need no treatment. The bumps can appear on the face or inside the mouth, and these newborn cysts leave no lasting effects. Do not use adult lotions or oils on a baby's milia.135
What if you want milia removed?
A clinician can open a milium with a sterile needle or blade and remove the contents. Other options include freezing or procedures that destroy and remove the cyst. For widespread milia, topical retinoids, medicines applied to the skin, may help. Chemical peels, dermabrasion and laser treatment are further options for very extensive milia. Treatment depends on the number and type of bumps, rather than every milium needing the same procedure.2
Do not squeeze, scrape or puncture milia yourself: doing so can cause infection or permanent scarring. For everyday care, wash your face daily with warm water and gentle soap, pat dry, and use sunscreen outdoors. Adults can discuss exfoliation or treatment with a healthcare professional if the bumps persist.1
When should you get the bumps checked?
Arrange an assessment if the bumps worsen or are not improving after a few months. A clinician can usually identify milia by examining the skin. Other cysts and skin growths can resemble milia, so an uncertain diagnosis matters more than the cosmetic label. Milia can also follow skin injury or occur with certain inherited disorders.123
For a baby, swollen, red or hot skin, blisterlike spots, poor feeding or worsening symptoms need advice from a doctor or nurse that day. Do not assume these changes are ordinary milia.5
Where this answer comes from
- 1Milia (Milk Spots): Causes & Treatmentmy.clevelandclinic.org
- 2Milium, miliadermnetnz.org
- 3Milia: MedlinePlus Medical Encyclopediamedlineplus.gov
- 4Benign Skin Lesions and Mild Inflammatory Skin Disorders in Adults >18 Yearsnwknowledgenow.nhs.uk
- 5My baby has a rash :: West Yorkshire Healthier Togetherwyhealthiertogether.nhs.uk
