5 Things You Need to Know About Milia

From acne to sensitive skin, there's no shortage of beauty woes. However, there may be one you're suffering from that you may not even know by name. Have you ever noticed small, pearly-white bumps on your cheeks and around your eyes? Unlike acne, which most of us know when we see it -- and how could you not when it's probably big and red and right in the middle of your face -- most of us have these small white bumps but have absolutely no idea what they are, what caused them or how to get rid of them.

First things first: These bumps aren't a rash, nor are they caused by an infection or an allergy. They're called milium, and milia is harmless. Most people find they only notice their milia because they see it in the mirror, not because it's bothersome.


There are two primary types of milia: primary and secondary, and here we'll talk about what causes each type as well as what the treatment options are and how to prevent them.

Primary milia occur most often in infancy, and we'll start our list of things to know with pediatric milia, next.

5. Pediatric milia

Infants are no strangers to rashes and other skin conditions and irritation, from diaper rash and cradle cap to baby acne and milia. About 40 percent of newborns develop pediatric milia, and it usually appears within the first week after delivery [source: Agrawal].

Pediatric milia and baby acne are often confused with one another, but in truth the conditions not only look dissimilar (they're different colors) they are caused by different things. Baby acne is exactly what you think: red pimples. Baby acne tends to develop about three to four weeks after birth, and it typically affects the face (on the cheeks, the nose and the forehead) [source: MedlinePlus]. While there have been theories why so many newborns develop acne around the one-month milestone, there is currently no known reason for why this skin issue develops.


Pediatric milia, like baby acne, typically appears on the face (on the cheeks, chin and forehead) but instead of red pimples this condition is small white bumps no more than two millimeters in diameter [source: Agrawal]. The condition is completely harmless and happens when dead skin cells get trapped near the surface of the skin instead of flaking off. When the condition happens inside the mouth it's called Epstein's pearls.

Just like baby acne, pediatric milia and Epstein's pearls disappear on their own, without treatment.

4: Causes of primary milia

While primary milia is most often seen in infants (pediatric milia) this form may develop on any person of any age and any race. Primary milia develop spontaneously.

It's theorized that primary milia occur in newborns because the sebaceous glands (your oil glands) aren't yet fully developed in infancy, and the skin just isn't able to exfoliate naturally [source: The Permanente Medical Group]. For children and adults, primary milia develops when your dead skin cells and your sweat become trapped in pouches near the surface of your skin, and, without a way of escaping your body, become small cysts of keratin.


Primary and secondary milia may look alike but they aren't caused by the same problem. Let's talk about the reasons we develop secondary milia, next.

3: Causes of secondary milia

Secondary milia look similar to primary milia but it develops because of clogged sweat ducts in the skin. This usually happens after there has been some kind of trauma to the skin, specifically any time your skin blisters such as with a burn, poison ivy rash, or a harsh session of dermabrasion.

Sunburns and sun exposure are also common causes of milia. For example, sun exposure damages the surface layers of the skin, and that damage causes the skin to thicken. When dead skin cells try to make their way to the surface of the skin to flake off and can't – there's that thick skin in the way -- they begin to form small white cysts of keratin as the skin cells build up. These cysts are milia.


Some chronic skin disorders are known to be associated with the appearance of milia. Tattoos, use of strong topical corticosteroids, and allergic rashes such as contact dermatitis have also all been known to trigger the development of secondary milia.

2: Treating milia

Primary milia is made of keratin, a protein in our skin, and develop when dead skin cells get trapped in the surface of the skin. It's a totally harmless skin condition and, while you might not like to look at it, it will go away after several weeks without any treatment [source: CNN].

While milia is present, changing your skin-care routine to be as gentle as possible. Choose non-comedogenic products and forgo anti-aging topical creams, which may help with healing. And despite how you may think using exfoliating products could help the condition, since it's caused by the inability of dead skin cells to flake off the skin, they won't help. In fact it's best to skip exfoliating areas where you see milia to reduce skin irritation (which, remember, is a contributing cause for developing milia).


If you have the secondary-form of milia (which you may not figure out until the milia has been with you for a few months and you visit your physician for advice) you'll need professional treatment. These treatments include options such as prescription retinoid cream, like Retin-A®, as well as alpha hydroxy acid peels. For some milia, bumps may need to be removed with a procedure that combines a lancing tool such as a scalpel or needle to pierce each milium and a comedone extractor to remove it (like a blackhead) [source: Skin Sight].

1: Prevention

While there is no way to prevent milia from developing there are a few things you can do to help minimize the risk of its appearance.

One of the most common reasons we develop milia is because of skin damage from sun exposure. Always wear sunscreen, all year round and even when it's overcast. Milia may also occur from what you think is good skin care. Despite your best skin-pampering efforts some skin care products may cause irritation. Even that thick, heavy night cream you've been using may be the cause of those small white dots on your face. Products that cause irritation, burning or friction increase your risk for developing milia, but those creamy and comedogenic skin care products aren't without some responsibility, too. If a product can block dead skin cells from being exfoliated from the surface of your skin, it can cause milia to develop.


For more information, see the links on the next page.

Lots More Information

Related Articles

More Great Links

  • Agrawal, Ruchir. “Pediatric Milia.” 2012. (Nov. 16, 2012) http://emedicine.medscape.com/article/910405-overview
  • CNN. “Milia.” 2012. (Nov. 16, 2012) http://www.cnn.com/HEALTH/library/milia/DS01059.html
  • Cooper, Susan. “Milia.” Medscape Reference. 2012.(Nov. 16, 2012) http://emedicine.medscape.com/article/1058063-overview#showall
  • Hale, Elizabeth. “Ask the Expert: How much sunscreen should I be using on my face and body?” (Nov. 16, 2012) http://www.skincancer.org/skin-cancer-information/ask-the-experts/how-much-sunscreen-should-i-be-using-on-my-face-and-body
  • Johns Hopkins Medicine. “Birthmarks in Infants.” (Nov. 16, 2012) http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/birthmarks_in_infants_85,P00986/
  • Mayo Clinic. “Baby acne.” 2012. (Nov. 16, 2012) http://www.mayoclinic.com/health/baby-acne/DS01060
  • Nguyen, DoanPhyong. “Baby Acne and Milia.” Women's Healthcare Topics. (Nov. 16, 2012) http://www.womenshealthcaretopics.com/baby_acne.htm
  • Skin Sight. “Milia.” 2011. (Nov. 16, 2012) http://www.skinsight.com/adult/milia.htm
  • The New York Times. “Milia.” 2011. (Nov. 16, 2012) http://health.nytimes.com/health/guides/disease/milia/overview.html
  • The Permanente Medical Group. “My Doctor Online: Milia.” (Nov. 16, 2012) http://mydoctor.kaiserpermanente.org/ncal/mdo/presentation/conditions/condition_viewall_page.jsp?condition=Condition_Milia.xml
  • University of Maryland Medical Center. “Milia – Overview.” 2011. (Nov. 16, 2012) http://www.umm.edu/ency/article/001367.htm
  • U.S. National Library of Medicine – MedlinePlus. “Baby acne.” 2011. (Nov. 16, 2012) http://www.nlm.nih.gov/medlineplus/ency/imagepages/19645.htm