Can milia go away without medical treatment?

What are the small white bumps?

Milia are tiny cysts containing keratin, a skin protein, just beneath the skin's surface. They look pearly white and commonly appear around the eyelids and cheeks. Dead skin trapped in small pockets can form these bumps. Milia are not acne, even when irritation makes the surrounding skin look red. Rough sheets or clothing can irritate them without changing the white centre. Appearance alone is not always enough to tell milia apart from other bumps.123

How to care for milia at home

1. 1Wash your face daily with warm water and gentle soap.
2. 2Pat the skin dry gently rather than rubbing it.
3. 3Use sunscreen when you go outdoors.
4. 4Leave the bumps alone while you wait for them to clear.

An elaborate skincare routine is not required for watchful waiting, despite the bathroom shelf's obvious ambitions. Avoid further skin trauma, especially where bumps appeared after an injury. Milia can develop as skin heals after burns, blistering rashes or procedures such as dermabrasion. The practical aim is to care for the skin without trying to force the cyst out.1

Will exfoliation help?

Adults can consider an over the counter exfoliating product, but exfoliation is optional rather than necessary. There is no fixed timetable for clearing milia this way. For widespread milia, topical retinoids, medicines applied to the skin, may help. They are a treatment option rather than a requirement for harmless bumps. If your goal is to avoid medicines and procedures altogether, observation remains an option.13

Do not squeeze, scrape or use a needle

Trying to squeeze or scrape milia at home can cause infection or permanent scarring. Needle extraction belongs in a healthcare professional's office, not a home routine. Professional removal involves opening the cyst and releasing its contents; ordinary washing does not perform that procedure.3

What if the milia are on a baby?

Newborn milia need no treatment and usually resolve within eight weeks. The tiny white or yellowish spots are commonly on the face. Similar cysts can appear on the gums or roof of the mouth, where they are called Epstein pearls. These also disappear on their own, with no lasting effects. Do not apply lotions or oils intended for adults to a baby's delicate skin. Baby acne is a different condition, so do not treat newborn milia as acne.234

Can you prevent more milia?

There is no known way to prevent all milia. Some develop after skin injury, and certain topical medicines can rarely be associated with them. Heavy creams or ointments can also trigger secondary milia. Do not use prescribed steroid creams for longer than directed. Preventing further skin trauma is useful, but buying more skincare is not a prevention plan with a receipt.123

When should you get the bumps checked?

Arrange an assessment if the bumps worsen, are not improving after a few months, or you are unsure they are milia. Numerous bumps appearing in crops, or bumps grouped on a raised inflamed patch, can be less common forms that deserve assessment. A clinician can usually identify milia by examining the skin. Having them checked does not mean you must have them removed.123