Small White Bumps Under the Skin (Milia): What They Are and How to Remove Them Safely

Milia are small, white, pearl-like bumps that sit under the skin. They form when keratin (a skin protein) becomes trapped beneath the surface and cannot shed on its own. They are common on the face, the bridge of the nose, around the eyes and on the cheeks, in both babies and adults. Although milia are harmless, many people worry about their appearance and mistake them for acne, so they try to squeeze them out, which can leave scars.

What causes milia?

Milia form when keratin becomes trapped under the skin and forms a tiny cyst. By cause, there are 2 main types.

• Primary milia — appear on their own with no clear cause. They usually clear up within a few weeks and are common in newborns.

• Secondary milia — appear after the skin has been injured, for example by burns, scarring or long-term use of steroid creams.

What milia look like and how to tell them from acne

It is important to tell milia apart from acne, because they are treated differently.

• Milia — small, firm, white bumps with a smooth surface, no opening and no inflammation.

• Whiteheads — caused by a blocked pore together with oil. They usually have an opening and may be red and inflamed.

Because milia have no opening like acne does, squeezing them yourself usually does not work and risks scarring.

How to remove milia safely

Important: do not squeeze, push or pick at milia, as this can cause scarring or infection. Wash your face gently and avoid using steroid creams for long periods. For safe removal, a dermatologist can offer the following options.

• Incision and extraction — a fine needle or small blade opens the skin and the keratin is pressed out (incision and expression).

• Laser — a CO2 or erbium:YAG laser is used to remove the bumps precisely.

• Retinoid cream — a retinoid cream can help small milia come out on their own.

• AHA — AHA (glycolic acid) helps exfoliate the skin so milia come off more easily.

The right option depends on the number, size and location of the milia, and the doctor will assess this for each person individually.

Frequently asked questions

Can I squeeze milia myself? No. Do not squeeze, push or pick at milia yourself. Unlike acne, the skin over a milium has no opening, so squeezing usually does not work and may cause scarring, inflammation or infection. A dermatologist should remove them using the correct method.

How are milia different from acne? Milia are tiny cysts of keratin trapped under the skin. They look like firm white bumps with no opening and no inflammation. Whiteheads are different: they are caused by a blocked pore together with oil, and are often inflamed.

Do milia go away on their own? Primary milia, especially in newborns, usually clear up within a few weeks. In adults, milia can last a long time and may not go away on their own. If they bother you cosmetically, a doctor can remove them.

How does a doctor remove milia? Dermatologists have several options, such as opening the skin with a fine needle and pressing the keratin out (incision and expression), a CO2 or erbium:YAG laser, a retinoid cream to help small milia come out on their own, and AHA (glycolic acid) to help exfoliate the skin. The right method depends on the number and location of the milia.

If you have small white bumps on your face that will not go away and you want them removed safely without leaving marks, consult a dermatologist at Siam Dermatology. Call +66 61 448 7000 or LINE @siamderm for an assessment and a suitable removal method.

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed July 16, 2026