Under-eye bumps are almost always one of three things: milia, syringomas, or xanthelasma. Each looks slightly different, forms for a different reason, and responds to different treatments. Identifying which type you have is the first step, because a remedy that works for one can be useless for another.
Identify What You’re Dealing With
The most common under-eye bumps are milia: tiny white or yellowish cysts, usually 1 to 2 millimeters across, that feel firm and pearly. They form when the protein keratin gets trapped beneath the surface of the skin. Unlike whiteheads, milia have no opening to the surface, which is why squeezing them does nothing.
Syringomas look similar but tend to appear in clusters. They’re round, firm papules between 1 and 3 millimeters, and they can be yellow, translucent, or skin-colored. They develop from an overgrowth of cells in the sweat glands and are especially common in women in their 20s and 30s. If you notice a group of small, uniform bumps arranged symmetrically under both eyes, syringomas are the likely culprit.
Xanthelasma stands out from both. These are soft, flat, yellowish patches rather than distinct round bumps. They sit on or near the eyelids and are made of cholesterol deposits. More than half of people with xanthelasma have an underlying lipid disorder, so a cholesterol panel is worth requesting if you notice these patches forming.
Why Milia Form (and Keep Coming Back)
Milia develop when dead skin cells or keratin get trapped in a small pocket just below the skin’s surface. Under the eyes, where skin is thinner and has fewer pores, that trapped material has nowhere to go. Heavy skincare products are a major contributor. Shea butter, thick mineral oils, petrolatum, beeswax, and heavy plant waxes can form a seal over the skin that traps keratin underneath. These ingredients work well on thicker skin like elbows and knees, but under the eyes they can trigger new milia or keep existing ones from resolving.
Sun damage also plays a role. UV exposure thickens the outer layer of skin over time, making it harder for dead cells to shed naturally. Skin injuries, including burns and aggressive cosmetic procedures, can cause milia to develop during the healing process.
At-Home Treatments That Help
You can’t pop milia. The American Academy of Ophthalmology warns against squeezing or picking at them, since milia have no pore opening and the attempt will only damage or scar the surrounding skin. What you can do is encourage the skin to turn over faster so the trapped keratin works its way out on its own.
Retinol is the most effective over-the-counter option. It speeds up cell turnover, which thins the layer of skin trapping the cyst and helps it surface. Look for an eye-specific retinol product and start with a low concentration (0.25% to 0.5%) a few times per week. Topical retinoids have been shown to resolve milia, though it can take several weeks to see results. Be patient, and expect some mild peeling or dryness as your skin adjusts.
Gentle chemical exfoliants containing alpha hydroxy acids like glycolic or lactic acid can also help by dissolving the bonds between dead skin cells. The under-eye area requires caution, though. Salicylic acid, a common beta hydroxy acid, is an eye irritant with the potential to cause serious damage, so products containing it should stay well below the eye. For the immediate under-eye zone, glycolic acid at low concentrations (around 5% to 8%) in a product designed for the face is a safer choice.
Professional Removal Options
If milia don’t resolve with topical treatments after a couple of months, a dermatologist can remove them in minutes. The standard technique is manual extraction: the surface of each bump is nicked with a tiny blade or needle, then the intact cyst is pressed out using forceps or a comedone extractor. The procedure is quick, involves minimal discomfort, and leaves little to no scarring when done by a trained professional. Pricing varies, but as a benchmark, some dermatology practices charge around $70 for extraction of up to five lesions.
For larger numbers of milia or for bumps that recur frequently, dermatologists may use electrocautery or laser therapy to destroy the cysts more thoroughly.
Treating Syringomas
Syringomas don’t respond to topical treatments. Because they originate deeper in the skin, from sweat gland tissue, they require professional intervention. Electrocoagulation using a radiofrequency device is one well-studied approach. In a pilot study of 20 patients with under-eye syringomas, 60% achieved greater than 70% clearance of lesions after treatment. The procedure doesn’t always require local anesthesia, and experienced physicians report better long-term results with electrocoagulation compared to more superficial methods because it penetrates deeper into the tissue. CO2 laser ablation is another option that dermatologists use for syringomas, though recurrence is possible with any method.
Treating Xanthelasma
Xanthelasma can be removed surgically, with laser treatment, or with chemical peels, but addressing the underlying cause matters more. If your cholesterol or triglyceride levels are elevated, managing them with lifestyle changes or medication can slow the formation of new deposits. Your doctor will typically order a full lipid panel including LDL, HDL, triglycerides, and apolipoprotein B100 levels.
Preventing New Bumps
Switching your under-eye products is often the single most effective preventive step for milia-prone skin. Swap rich eye creams for lightweight, water-based eye serums or gels. Specifically avoid formulas that list shea butter, petrolatum, heavy mineral oil, or beeswax high in the ingredient list. These occlusives sit on the skin’s surface and trap keratin underneath rather than allowing it to shed.
A consistent, gentle exfoliation routine helps keep the skin’s surface from thickening. Using a retinol product two to three times per week maintains faster cell turnover and reduces the chance of keratin getting trapped again. Wearing sunscreen daily protects against the UV-induced skin thickening that contributes to milia formation over time.
If you’ve had milia removed professionally and they return in the same area, it’s worth examining not just your eye cream but anything that contacts that skin: your moisturizer, sunscreen, primer, and concealer. Sometimes the culprit is a product you wouldn’t suspect.