Milia bumps on the face: what they are and what to do

What are milia bumps?

Milia look like tiny pearly white bumps and are especially common on the cheeks and eyelids. They affect children and adults. One cyst is a milium; several are milia. Ordinary milia usually cause no pain or discomfort, although some less common forms itch or appear within a raised patch.12

Are the bumps milia or something else?

Not every small facial bump is a milium. Syringomas are harmless sweat gland growths that commonly cluster around or beneath the eyes. They are usually yellow or the same colour as the surrounding skin, rather than the tiny white cysts typical of milia. Syringomas can also resemble pimples. A clinician can examine the bumps and sometimes take a small skin sample when the diagnosis is unclear. Acne creams, including those containing salicylic acid, may not remove syringomas.3

Why do milia appear?

Milia form when dead skin cells become trapped beneath the skin. Some develop after burns, blistering rashes or sun damage. Heavy creams or ointments can also trigger secondary milia. Long term steroid cream use is another possible cause; do not use prescribed steroids longer than your clinician directs.2

What should you do at home?

1. 1Wash your face daily with warm water and gentle soap.
2. 2Pat your skin dry rather than rubbing.
3. 3Apply sunscreen before going outdoors.

Adults can consider an exfoliating product, but exfoliation is an option, not an admission fee to the skincare aisle. Do not squeeze, scrape or pick milia: doing so can cause infection or permanent scarring. Most cases cannot be prevented.2

How long do milia take to disappear?

Primary milia in children and adults can clear within weeks, but some persist for months or longer. Waiting is a reasonable choice if confirmed milia do not bother you. Treatment is optional, so the skincare shopping basket does not get the deciding vote.1

How can a clinician remove milia?

A clinician can open the cyst with a sterile needle or blade and remove its contents. Other procedures include freezing or treatment using an electric current. These are professional treatments, not instructions for home extraction. For widespread milia, topical retinoids, medicines applied to the skin, may help. Chemical peels, dermabrasion and laser treatment have also been reported to work for very extensive milia. Discuss the extent and location of the bumps before choosing a procedure rather than treating every case the same way.1

Can milia occur on the eyelids?

Yes. Eyelids are a common site for primary milia. A rarer form, milia en plaque, produces multiple cysts within an inflamed patch and can also affect an eyelid.1

Can milia occur under the eyes?

Yes. Milia commonly occur under the eyes. Because syringomas also occur there, the location alone cannot tell you which kind of bump you have.23

Can milia occur on the arms?

Yes. A rare form called multiple eruptive milia causes groups of cysts to appear over weeks to months on the face, upper arms and upper abdomen. These bumps can itch.2

What if the bumps are on a baby's face?

Newborn milia commonly appear across the cheeks, nose and chin. They are not acne and usually disappear during the first few weeks of life without treatment or lasting effects. Similar cysts can appear on the gums or roof of the mouth and also clear by themselves. A clinician can usually identify these cysts by looking at the skin or mouth, without tests.4

When should you get the bumps checked?

See a clinician if the bumps worsen, are not improving after a few months, or you want removal. If you are unsure they are milia, have them examined before choosing treatment.12