Those small white dots under your eyes are most likely milia, tiny cysts that form when dead skin cells (keratin) get trapped beneath the surface. They’re painless and harmless, but they won’t go away on their own the way a pimple does. Removing them takes either the right skincare routine or a quick in-office procedure, depending on how many you have and how long they’ve been there.
What Those White Dots Actually Are
Milia are the most common cause of white dots under the eyes. Each bump is a small pocket of keratin, the same protein that makes up your hair and nails, sealed under a thin layer of skin. Unlike whiteheads, milia have no opening to the surface, which is why squeezing them does nothing. They typically measure 1 to 2 millimeters across, feel firm to the touch, and can stick around for months or even years without treatment.
Not every white or yellowish bump in this area is milia, though. Two other possibilities are worth knowing about:
- Syringomas are slightly larger bumps (1 to 3 millimeters) caused by an overgrowth of sweat gland cells. They’re usually skin-colored or slightly yellow, appear in clusters, and tend to show up around or under the eyes. Heat, stress, and exercise can trigger the sweat glands to overwork, making them more prominent.
- Xanthelasma are flat or slightly raised yellowish patches rather than round dots. Half of the people who develop them have high cholesterol, and their presence is linked to a higher risk of heart disease, diabetes, and thyroid problems. If your bumps look more like soft yellow plaques than tiny hard dots, getting your cholesterol and blood sugar checked is a good idea.
Topical Treatments That Work
For mild or newer milia, the right over-the-counter products can gradually loosen the keratin plug and bring it to the surface. The key ingredients to look for are chemical exfoliants and retinoids.
Salicylic acid and glycolic acid are the two most effective exfoliants for milia. Salicylic acid is oil-soluble, so it penetrates into the clogged pore itself. Glycolic acid works on the surface, dissolving the top layer of dead skin so trapped keratin can escape. Look for cleansers or serums containing one of these acids and use them consistently for several weeks before expecting results. Citric acid is another option, though less commonly found in targeted products.
Retinoids (vitamin A derivatives) speed up skin cell turnover, which helps prevent new keratin from getting trapped and loosens existing plugs. Adapalene is available without a prescription and is a good starting point. Stronger prescription retinoids like tretinoin work faster but can be irritating, especially on the thin skin under the eyes. Whichever form you choose, apply it just once per day, ideally at night, and pair it with sunscreen during the day since retinoids increase sun sensitivity.
Superficial chemical peels using glycolic or salicylic acid take this a step further. You can find at-home peel pads at mild concentrations, or get a stronger professional peel done at a dermatologist’s office. Professional peels use higher concentrations and produce faster results, but the under-eye area is delicate, so starting gentle is the safer approach.
Professional Removal Options
When milia are stubborn or clustered, a dermatologist can remove them in a single visit. The most common method is manual extraction: a tiny incision is made with a sterile needle or blade, and the keratin ball is pressed out with a comedone extractor. It’s quick, usually takes under 15 minutes for a few bumps, and the results are immediate.
For more extensive cases or for syringomas, other options include radiofrequency ablation (which uses heat to destroy the cyst without cutting), electrocautery, and dermabrasion. In one documented case, radiofrequency ablation combined with extraction showed no recurrence over 11 months of follow-up. Dermabrasion has shown complete regression at six months for widespread milia patches.
Cost varies depending on the number of bumps and your location. As a rough guide, a straightforward extraction session runs around $200 for up to 15 minutes of work, while more extensive sessions can reach $500. Many practices also charge a separate consultation fee of $125 to $200 before scheduling the procedure. Insurance rarely covers milia removal since it’s considered cosmetic.
What Recovery Looks Like
Recovery after professional removal is fast. Small scabs form at each extraction site and fall off on their own within about a week. During that time you may have mild discomfort that over-the-counter pain relief can handle. If your job isn’t physically demanding, you can return to work the same day. The main thing to watch for is signs of infection: increasing redness, warmth, swelling, or pus at the treatment site.
Why You Shouldn’t Try to Extract Them Yourself
It’s tempting to go at a milia bump with a needle, but the skin under your eyes is some of the thinnest on your body. Unlike a pimple, milia have no opening, so no amount of squeezing will push the contents out. What you will do is damage the surrounding tissue.
Using unsterilized tools or your fingers introduces bacteria directly into the skin. What started as a painless bump can turn into a red, swollen, infected spot that takes weeks to heal and may need antibiotics. Even if you manage to break through the skin, you risk leaving behind a scar, a dark spot, or uneven texture. These marks are especially likely in the under-eye area because the skin is so thin and prone to discoloration. The area around the eyes is also vulnerable to swelling, bruising, and longer-term damage that’s far more noticeable than the original milia.
Preventing New Milia From Forming
Once you clear existing milia, the right skincare habits can keep them from coming back. The biggest factor is what you’re putting around your eyes. Heavy, occlusive products are the primary culprit because they form a seal over the skin that traps keratin underneath.
Ingredients to avoid in your eye cream if you’re milia-prone:
- Shea butter: Excellent for dry elbows, but it creates a thick barrier around the eyes that traps dead skin cells.
- Heavy mineral oil and petroleum jelly: Helpful for repairing a damaged skin barrier elsewhere on the face, but applying thick layers under the eyes overnight is a common trigger for new bumps.
- Beeswax and heavy plant waxes: These give creams a rich, buttery texture but don’t absorb well. They sit on the surface and block normal skin shedding.
Switch to lightweight, water-based eye serums or gel formulas instead. Keeping up a gentle exfoliation routine with a glycolic or salicylic acid product a few times a week also helps dead skin cells shed normally rather than getting trapped. If you use retinoids for anti-aging, you’re already getting some milia prevention as a side benefit, since the faster cell turnover keeps pores clear.
Sun damage thickens the outer layer of skin over time, making it harder for dead cells to shed, so consistent sunscreen use plays a role in prevention too. Look for a lightweight, non-comedogenic formula for the eye area rather than relying on your regular moisturizer with SPF, which may be too heavy for this delicate skin.