Milia are small, firm, white or yellowish bumps that sit just under the surface of the skin. They’re typically less than 3 millimeters across, about the size of a grain of sand, and have a smooth, dome-shaped surface that doesn’t come to a point like a pimple. Unlike acne, they don’t appear red or inflamed, and squeezing them won’t release anything because the contents are solid, not liquid.
Size, Color, and Texture
Each milium (the singular form) looks like a tiny pearl embedded in the skin. They range from pure white to pale yellow and feel hard or gritty to the touch. The firmness is the most distinctive feature: these bumps are small cysts made of keratin, the same protein that makes up your hair and the outer layer of your skin. That keratin gets trapped beneath the surface and forms a solid little pocket, which is why milia feel nothing like the soft, pus-filled head of a whitehead.
Milia tend to appear in clusters rather than as single spots. You might notice a scattering of five or ten tiny bumps grouped together in one area. They don’t itch, hurt, or change color over time. They just sit there, looking like permanent raised dots under the skin.
Where They Show Up
In adults, milia appear most often on the face, especially around the eyes, on the upper cheeks, and across the nose and forehead. The delicate skin around the eyelids is a particularly common spot. Less frequently, they can develop on the chest, arms, or genitals.
In newborns, they cluster on and around the nose. Roughly 40% to 50% of U.S. newborns develop milia, sometimes called “milk spots.” Babies can also get them on the gums or the roof of the mouth, where they’re known as Epstein pearls. These look like tiny white beads along the gum line and are completely harmless.
How Milia Differ From Whiteheads and Other Bumps
Milia and whiteheads (closed comedones) can look similar at a glance, but they behave differently. A whitehead is a clogged pore filled with oil and dead skin cells. It’s slightly soft, often has a faint ring of redness, and responds to acne treatments like salicylic acid or retinoids. Milia are harder, sit more superficially, and don’t respond to typical acne products because there’s no pore blockage involved. The keratin is trapped in a tiny cyst unrelated to the oil glands that cause acne.
Syringomas are another lookalike. These are small sweat gland growths, usually 1 to 3 millimeters, that tend to be yellow or skin-toned rather than white. They often appear in clusters under the eyes, just like milia, but they’re slightly flatter and more translucent. A dermatologist can usually tell the difference on sight, though occasionally a skin biopsy is needed to confirm.
Sebaceous hyperplasia, another common facial bump, tends to have a central dimple or indentation and a slightly waxy, yellowish look. Milia never have that central dip. They’re uniformly smooth and round on top.
What Causes Them
Primary milia form when dead skin cells get trapped near the surface instead of shedding naturally. The keratin collects inside a tiny cyst that develops from a fine hair follicle. This can happen for no obvious reason, and some people are simply more prone to it than others.
Secondary milia develop after some kind of skin injury. Burns, blistering conditions, laser resurfacing, and dermabrasion can all trigger them. The healing process sometimes traps keratin beneath newly formed skin, creating bumps in areas that were damaged.
Heavy skincare products are a well-known trigger in adults, particularly around the eyes. Ingredients like petrolatum, mineral oil, lanolin, and thick synthetic waxes create an occlusive seal on the skin that can trap dead cells underneath. Even heavy botanical oils applied thickly overnight can contribute. If you keep getting milia in the same area, your eye cream or moisturizer is worth examining.
How Long They Last
In newborns, milia almost always resolve on their own within a few weeks to a couple of months. No treatment is needed, and you should avoid picking at them or applying products to a baby’s skin to try to speed things up.
In adults, milia are more stubborn. They can persist for months or even years because the keratin cyst sits in a closed pocket with no natural exit route. Over-the-counter exfoliants containing retinol or glycolic acid sometimes help prevent new ones from forming, but they rarely dissolve existing bumps. The most reliable way to remove an established milium is extraction by a dermatologist or trained aesthetician, who uses a sterile needle or small blade to open the skin surface and lift out the tiny cyst. The procedure takes seconds per bump, and the skin heals quickly with minimal scarring.
When Milia Signal Something Else
A few scattered milia on the face are extremely common and purely cosmetic. But certain patterns can point to an underlying issue. Widespread milia appearing suddenly in an adult, especially in unusual locations like the trunk or limbs, can occasionally be associated with genetic skin conditions or autoimmune blistering disorders. Milia that develop in a line along a scar or after a rash are typically secondary milia and tend to improve as the underlying skin continues to heal. If you notice a large number appearing rapidly or in areas you’ve never had them before, that’s worth a professional evaluation to rule out an underlying cause.