Milia (Tiny White Bumps): What Causes Them, Why They Won't Pop Like Acne, and How to Remove Them Safely
Milia are small white or skin-coloured bumps about the size of a pinhead. They feel firm and raised, and usually appear around the eyes, on the cheeks, nose and forehead. Many people mistake them for whiteheads and try to squeeze them, but no amount of squeezing works because milia have no opening, unlike acne. Trying to squeeze or pick at them yourself often causes redness, dark marks and scarring without removing them. In this article, a dermatologist explains what causes milia, how they differ from acne and other bumps, why they cannot be squeezed out, and how to remove them correctly and safely, especially around the delicate eye area.
What causes milia?
Milia form when keratin, a protein found in the skin, becomes trapped beneath the top layer of skin and forms a tiny white sac. They are not caused by oil clogging the pores the way ordinary acne is, which is why they are described as tiny keratin cysts under the skin. They fall into two types:
Primary milia appear on their own at any age. They are common around the eyes and on the cheeks, and also in newborns, where they usually clear up by themselves.
Secondary milia develop after the skin has been injured, for example after burns, blistering, laser treatment, harsh scrubbing, or long-term use of certain creams. They appear in the area where the skin was damaged.
Contributing factors include accumulated sun damage, using heavy, pore-clogging products, and skin procedures that injure the skin.
How are milia different from acne and other bumps?
There are many kinds of small white bumps on the face. Telling them apart helps you choose the right way to deal with them.
Whiteheads (closed comedones) are caused by oil and dead skin cells blocking a pore. They are softer and linked to oiliness, unlike milia, which are hard keratin sacs with no opening.
Sebaceous hyperplasia shows up as yellowish raised bumps with a dimple in the centre, usually in middle age. It is caused by enlarged oil glands, not by keratin sacs.
Molluscum contagiosum causes raised bumps with a central dimple. It is caused by a virus and is contagious, unlike milia, which are not contagious.
Small sebaceous cysts and other bumps can look similar to the naked eye.
A dermatologist can usually diagnose milia from their appearance and by examining the skin with a dermatoscope. If a bump looks unusual, grows quickly, or you are unsure what it is, the doctor will consider further tests.
Why can't milia be squeezed out like acne?
Milia are keratin sacs with no opening to the surface, unlike acne, which has a pore opening. Pressing from the outside cannot push anything out.
Squeezing bruises the surrounding tissue and causes redness and dark marks, especially in Asian skin, which is prone to dark marks.
Picking at them with an unclean needle risks infection and scarring.
The skin around the eyes is very thin, so squeezing or picking at milia yourself carries an even higher risk of injury.
Removing milia means gently opening the top layer of skin and lifting out the keratin sac. This is a minor procedure that should be done by a doctor under clean conditions.
How to remove milia correctly and safely
Milia are harmless, and some of them, especially in babies and newly formed milia, may clear up on their own. Removal is done for cosmetic reasons or when the bumps are bothersome. The methods dermatologists use include:
Gently opening the skin and lifting out the keratin sac (extraction) with a sterile needle and dedicated instruments. This is the main method, and it works well and leaves only a tiny wound.
Electrocautery or a small laser for milia in many spots or in places that are hard to reach with extraction.
Topical retinoids may help when there are many milia, prescribed and monitored by a doctor.
After treatment there may be a little scabbing or mild redness, which heals on its own. Protect the skin from the sun and follow the aftercare advice to reduce dark marks, especially in Asian skin. Treatment around the eyes must be done with extra care because the skin is thin.
Prevention and skin care
Avoid heavy, pore-clogging products on areas where milia often appear.
Use sunscreen regularly to reduce accumulated skin damage.
Exfoliate gently, as advised by your doctor, if you tend to get milia repeatedly.
Avoid harsh scrubbing or aggressive procedures that injure the skin and can lead to secondary milia.
What not to do
Do not squeeze milia or pick at them with a needle yourself, especially around the eyes, because of the risk of infection, dark marks and scarring.
Do not use caustic products or strong peeling acids on delicate skin.
Do not assume the bumps are acne and use strong acne medication unnecessarily. Have a doctor assess them first.
Frequently asked questions (FAQ)
What causes milia?
Milia form when keratin, a skin protein, becomes trapped as a tiny sac beneath the top layer of skin. They are not caused by oil clogging the pores as acne is, so they are hard white bumps with no opening.
How are milia different from whiteheads?
Whiteheads are caused by oil and dead skin cells blocking a pore. They are softer and linked to oiliness. Milia are hard keratin sacs with no opening, so they cannot be squeezed out and the sac has to be removed by opening the skin.
Can I squeeze milia myself?
No. Milia have no opening, so they cannot be squeezed out. Squeezing causes redness and dark marks and risks infection and scarring, especially around the eyes where the skin is thin. A doctor should remove them under clean conditions.
Can milia go away on their own?
Some do, especially in newborns and newly formed milia. In many adults, however, they tend to last, and it is best to have a doctor remove them for cosmetic reasons and for safety.
Is it dangerous to remove milia around the eyes?
The skin around the eyes is thin, so removal must be done carefully by a doctor. Doing it yourself risks injury, infection and dark marks. The doctor gently opens the skin and lifts out the keratin sac with sterile instruments.
Can milia come back? How can I prevent them?
Yes, they can recur, especially in people who are prone to them or whose skin has been injured. Sun protection, avoiding heavy pore-clogging products, and gentle exfoliation as advised by your doctor can reduce new milia.
Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed 3 August 2026
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