If you’ve ever noticed tiny, hard white bumps under your skin, especially around your eyes or cheeks, you might be dealing with milia. These small, stubborn cysts aren’t your typical acne or whiteheads. Unlike breakouts caused by clogged pores or bacteria, milia form when keratin—a natural protein in your skin—gets trapped just beneath the surface.

They’re harmless, not contagious, and they’re more common than you might think. But that doesn’t make them any less frustrating! In this guide, I’ll walk you through what causes milia, how to treat them safely, and, most importantly, how to prevent them from coming back.

Milia are tiny, hard white or yellowish bumps that appear just under the skin’s surface. They form when keratin and dead skin cells get trapped, creating small cysts. These pearl-like bumps are most often seen around the eyes, cheeks, and nose, but they can also appear on the upper arms or chest.

The key thing to remember? Milia are not caused by bacteria or oil. That’s what sets them apart from acne or traditional whiteheads.

Milia aren’t all the same—these tiny white bumps can show up in several different forms, each with its own causes and characteristics. The most common type is primary milia, which develops when dead skin cells become trapped beneath the skin’s surface, forming small, hard cysts. These are the classic white bumps you might notice around your eyes, cheeks, or nose.

Secondary milia, sometimes called traumatic milia, occur after the skin has been damaged—think burns, rashes, or excessive sun exposure. When the skin is healing, dead skin cells can get trapped beneath the new surface, leading to these stubborn bumps.

A rarer form, milia en plaque, appears as clusters of milia grouped together on a raised patch of skin. This type can affect both children and adults and is often seen on the cheeks, jawline, or behind the ears.

Other types include neonatal milia , which are common in newborns and usually clear up on their own within a few weeks, and juvenile milia , which are linked to inherited skin conditions. There are also multiple eruptive milia, where groups of milia appear suddenly over several weeks or months, often on the face, upper trunk, or upper abdomen.

Understanding which type of milia you’re dealing with can help you and your dermatologist choose the most effective treatment and prevention strategies, keeping your skin healthy and free from trapped dead skin cells.

If you notice persistent white bumps on your skin, a dermatologist can help determine if they’re milia. Diagnosis is usually straightforward—a skin expert will examine the affected area, looking for the characteristic appearance of milia: small, firm, white bumps just beneath the skin’s surface. Sometimes, a dermatoscopy is used for a closer look, and in rare cases, a skin biopsy may be performed to rule out other skin conditions.

It’s important to know that milia are not contagious. You can’t catch them from someone else, and you won’t spread them by touching the bumps. Milia form when dead skin cells become trapped due to factors such as skin damage, sun exposure, or certain genetic conditions, rather than from bacteria or viruses.

If you’re unsure about what’s causing your white bumps, or if they’re not going away, consulting a dermatologist is the best way to get an accurate diagnosis and a treatment plan tailored to your skin’s needs.

Milia form when your skin isn’t shedding properly. Milia happen when old skin cells and dead cells become trapped under the skin’s surface. When the skin fails to shed dead cells effectively (skin shed), and factors are preventing natural exfoliation, this buildup can contribute to milia formation, usually because of one (or more) of the following reasons:

Sunburns, blisters, or overuse of harsh skincare products can damage your skin barrier, which can also affect the underlying skin tissues. When this happens, your skin struggles to exfoliate naturally, and dead skin cells begin to accumulate beneath the surface. As the skin heals, new skin forms, but if dead skin cells are trapped, milia can develop.

Dry skin doesn’t exfoliate efficiently. Baby skin and newborn skin are especially delicate and prone to dryness, making them more susceptible to milia if not cared for gently. Without enough moisture, dead skin cells stick around longer than they should, which can contribute to milia formation.

Using rich creams, oils, or thick occlusive products, especially around the eyes, can trap dead skin cells and keratin, setting the stage for milia. Certain topical products, including steroid medications, can also increase the risk of milia when used long-term.

While exfoliating is important, going overboard can damage your skin and actually increase the risk of milia. It’s all about balance.

Long-term use of steroid creams or underlying skin trauma can also trigger the development of milia.

Milia may be stubborn, but with the right approach, you can treat them effectively, without picking or squeezing. (Seriously, don’t try to extract them at home!) Here’s the routine I recommend:

Start with a gentle exfoliating cleanser—something with mandelic acid is ideal, especially if your skin is sensitive. Mandelic acid works slowly and effectively to loosen dead skin cells without irritation. Follow with an enzyme cleanser to help dissolve buildup and support a smooth, refined texture without over-stripping the skin. If your skin is extremely delicate—think babies, or easily irritated—cleansing with a gentle, natural seed oil can be a soothing alternative that nourishes while melting away impurities.

After cleansing, mist your skin with a hydrating toner or essence. This helps calm inflammation, keeps the skin soft, and supports natural exfoliation. Hydrated skin is happy skin—and it’s much less likely to develop milia.

Look for a serum with mandelic acid—it's my top choice for treating milia, especially if you have sensitive, dry, or fragile skin. Mandelic acid exfoliates slowly and gently thanks to its larger molecular size, which means less irritation while still effectively loosening dead skin cells and keratin plugs. While glycolic acid is commonly used, it tends to be too harsh and drying for many skin types, especially around delicate areas like the eyes. For consistent results without compromising your skin barrier, mandelic is the way to go.

With consistent use, a mandelic acid serum can help bring milia closer to the surface, making them much easier—and safer—to extract using a sterile lancet. This type of exfoliation softens the surrounding tissue and loosens the keratin buildup, which allows for smoother manual removal when performed by a professional. It’s a gentle yet powerful way to prep the skin for extraction without causing unnecessary trauma.

Use an acne-safe, non-comedogenic moisturizer that strengthens the skin barrier without clogging pores. Avoid heavy creams that can trap dead skin cells. Instead, opt for barrier-repairing ingredients that mimic your skin’s natural lipids and keep everything in balance.

When it comes to treating milia, the right approach depends on how many bumps you have and how persistent they are. For most people, gentle exfoliation is key, but not all exfoliating acids are created equal. Mandelic acid, a type of alpha-hydroxy acid (AHA), is the best choice for treating milia. Its larger molecular size allows for slower absorption, making it far less irritating while still effectively loosening trapped keratin and dead skin cells. While salicylic and glycolic acids are commonly recommended, they can be too drying and disruptive to the skin’s barrier, especially for sensitive or delicate skin. Mandelic acid strikes the perfect balance, encouraging natural exfoliation without compromising the integrity of your skin.

If you’re dealing with more extensive milia, it’s best to seek professional help. While topical retinoids are sometimes recommended to increase skin cell turnover, they can be too harsh and often disrupt the skin barrier, leading to increased dryness and, in some cases, even more milia. For stubborn or clustered cases like milia en plaque, dermatologists or licensed estheticians may recommend professional treatments such as manual extraction using a sterile lancet or advanced options like laser resurfacing. These methods effectively and safely remove deeper or more persistent milia without damaging the surrounding skin.

No matter which treatment you use, it’s important to avoid thick creams that can block natural exfoliation and trap dead skin cells. Stick to lightweight, acne-safe, non-comedogenic products, and be patient; milia removal is a gradual process, but with the right routine, you’ll see smoother, clearer skin.

If you’re struggling to get rid of milia or they keep coming back, it’s time to consult an esthetician or dermatologist. A skin expert can create a personalized treatment plan to remove milia safely and help you prevent future bumps. They’ll assess your skin, recommend the best milia removal strategies, and guide you on how to avoid skin problems like permanent scarring.

An esthetican can also help you identify any underlying causes, such as skin trauma, sun exposure, or the use of thick creams, that might be contributing to your milia. With their expertise, you’ll get advice on how to keep your skin healthy, soft, and free from dead skin cell buildup.

Remember, never try to pick or pop milia at home. This can lead to skin damage and permanent scarring. Instead, trust a professional to remove milia and help you achieve a clear, glowing complexion. With the right support, you can prevent milia and enjoy healthy, beautiful skin for the long term.

• Avoid vitamin C serums with ascorbic acid if you’re prone to milia. Try gentler alternatives like tetrahexyldecyl ascorbate.

• Protect your skin from UV damage. Too much sun can interfere with your skin’s natural exfoliation.

• Watch out for pore-blocking products. Especially around the eye area, this is the most common spot for milia to pop up. Milia can also develop on the upper trunk and upper abdomen.

Milia might be small, but they can feel like a big deal when you’re trying to keep your skin clear and smooth. The good news is that with the right combination of gentle exfoliation, barrier support, and skin-loving ingredients, you can treat and prevent them safely at home.

And remember, milia are not contagious. They’re totally benign, and with patience and the right care, you’ll start to see smoother, more luminous skin in no time.

If you’d like help putting together a personalized milia-safe routine, our estheticians are always here for you. I love helping people feel confident in their skin again—and milia doesn’t have to be part of your story for long.

Need personalized guidance? My team of licensed estheticians is here to help. Whether you want to treat milia, build a milia-safe routine, or fine-tune your current one, we’re just a free skincare checkup away.