Milia vs milium: what is the difference?

What do milia look like?

Milia are tiny, raised, white or pearly bumps just beneath the skin's surface. They are usually 1 to 2 millimetres across and shaped like small domes. Eyelids, cheeks and the nose are common locations, although milia can occur elsewhere. They affect babies, children and adults. Typical milia are harmless and do not hurt, but some less common types can itch or cluster on a raised patch.123

Are milia the same as whiteheads?

Milk spots is another name for milia, not a request to reorganise the dairy shelf, despite the nickname's choice of department. Baby acne is a different condition: it causes red bumps or pustules, rather than the small cysts of trapped dead skin seen in neonatal milia.2

Why do milia form?

Milia form when dead skin becomes trapped in small pockets instead of being shed. The words milium and milia describe the number of bumps, not their cause or severity, which gives grammar an unusually prominent role in skincare. The type of milia is a separate distinction, because apparently one vocabulary exercise was not enough.24

• Neonatal milia occur in newborn babies, often on the nose.
• Primary milia occur in children and adults, commonly around the eyelids, cheeks and forehead.
• Secondary or traumatic milia develop as skin heals after injury, burns or blistering.
• Multiple eruptive milia appear in crops over weeks to months.
• Milia en plaque describes multiple milia within an inflamed patch of skin.

How long do milia last?

Newborn milia commonly disappear without treatment during the first few weeks of life, although some take months. A narrow red halo can occasionally surround a newborn's white bump. Primary milia in older children and adults can clear within weeks or persist for months or longer. Persistence alone does not mean that a harmless milium needs removal.145

What should you do about milia?

• Leave confirmed milia alone if they do not bother you. Treatment is optional.
• Do not squeeze, scrape or pick the bumps. Home removal can cause infection or permanent scarring.
• Wash your face daily with warm water and gentle soap, then pat dry. Wear sunscreen outdoors.
• For a baby, avoid lotions and oils intended for adults. Childhood milia generally need no treatment.
• If appearance bothers you, ask a healthcare professional about removal rather than trying to puncture the bump yourself.

How can a professional remove milia?

A clinician can open the surface 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 related to vitamin A, may help. Chemical peels, dermabrasion and laser treatment are options for very extensive milia, not necessary treatment for an isolated bump.1

When should you get a bump checked?

Get an unexplained lump checked rather than assuming every white bump is milia. A clinician can usually identify milia by looking; testing is not normally needed. Arrange a visit if the bumps worsen or are not improving after a few months. For a sore or red lump, seek prompt medical assessment rather than attempting removal.246