Milia are small, firm white bumps that form when the protein keratin gets trapped just beneath the surface of your skin. They look like tiny white pearls, typically 1 to 2 millimeters across, and the under-eye area is one of the most common places they appear. Unlike whiteheads or pimples, milia aren’t filled with pus or oil, and they won’t respond to squeezing or typical acne treatments.
Why Milia Form Under the Eyes
The skin around your eyes is the thinnest on your face. That thinness makes the area especially sensitive to anything that disrupts its natural shedding process. Normally, dead skin cells rise to the surface and flake off on their own. When that process stalls, keratin can become trapped in a tiny pocket beneath the outer layer of skin, forming a small cyst.
Heavy eye creams and ointments are a well-known trigger. Occlusive products, those that create a seal over your skin, can interfere with the natural exfoliation cycle and trap keratin underneath. Common occlusive ingredients include mineral oil, petroleum, lanolin, beeswax, dimethicone, and squalene. That doesn’t mean you should avoid all moisturizers, but thick, rich formulas applied heavily around the eyes are more likely to cause problems in people who are prone to milia.
Primary vs. Secondary Milia
Primary milia develop spontaneously, often with no clear external cause. They arise from the tiny hair follicles (called vellus follicles) found on facial skin. Newborns get them frequently: 40 to 50 percent of babies are born with milia, and those typically resolve on their own within weeks to months. In adults, primary milia tend to cluster around the eyes, cheeks, and forehead.
Secondary milia, sometimes called traumatic milia, result from damage to the skin. Sun damage, burns, blistering skin conditions, and certain cosmetic procedures can all trigger them. They can also form as a reaction to a heavy skin cream or ointment, which makes the delicate under-eye area particularly vulnerable given how often people apply rich eye products there.
How to Tell Milia From Other Bumps
Several other conditions can cause small bumps near the eyes, and they look different up close. Milia are distinctly white, round, and hard to the touch. They don’t itch, hurt, or change size from day to day.
- Syringomas are small growths caused by overactive sweat glands. They tend to be yellowish or skin-colored rather than white, and they often appear in clusters on the lower eyelids. Under a microscope, a syringoma has a characteristic tadpole or comma shape that distinguishes it from a milia cyst.
- Xanthelasma are flat, yellowish patches caused by cholesterol deposits under the skin. They’re larger and softer than milia and tend to sit on or near the inner corner of the upper eyelid.
- Fordyce spots are caused by enlarged oil glands in the skin. They’re slightly yellowish and often appear along the lip line or inner cheeks, though they can show up near the eyes.
If you’re unsure what you’re dealing with, a dermatologist can usually identify milia on sight. In rare cases where the diagnosis is uncertain, a small skin biopsy confirms it.
Why You Shouldn’t Try to Remove Them at Home
Milia sit in a small encapsulated pocket under the skin’s surface. Unlike a pimple, there’s no opening for the contents to escape. Squeezing or poking at them won’t work and risks scarring, infection, or damage to the thin skin around your eyes. The American Academy of Ophthalmology specifically warns against attempting to squeeze or pop milia, noting that they cannot be removed this way.
This is especially important for the under-eye area. The skin there heals slowly and scars easily, and the proximity to your eye makes any unsterile instrument a genuine risk.
Professional Removal Options
A dermatologist can remove milia quickly in an office visit. The standard method involves using a sterile needle or lancet to create a tiny opening in the skin over the cyst, then gently pressing out the trapped keratin with a small tool or cotton-tipped applicators. The whole process takes seconds per bump, and the micro-wound heals fast because the incision is so small.
For stubborn or widespread milia, some dermatologists use other approaches like electrodessication, which uses a tiny electric current to break down the cyst. These techniques are straightforward and low-risk when performed by a professional, though the under-eye area may show slight redness for a day or two afterward.
Prevention and Skincare Adjustments
If you get milia repeatedly under your eyes, your skincare routine is the first place to look. Switching from a thick, occlusive eye cream to a lighter, gel-based formula can make a real difference. Check ingredient lists for mineral oil, petroleum, and lanolin, which are the most common culprits in heavy eye products.
Gentle chemical exfoliation helps keep keratin from building up in the first place. Cleansers or serums containing glycolic acid, salicylic acid, or citric acid encourage the natural shedding of dead skin cells. Use these carefully around the eyes since the skin is sensitive, and a lower concentration is usually sufficient.
Topical retinoid creams, which contain vitamin A, are another option dermatologists recommend for preventing milia. Retinoids speed up skin cell turnover, making it harder for keratin to get trapped. Over-the-counter retinol products work for mild cases, while prescription-strength retinoids may be needed for persistent problems. Start slowly with retinoids near the eyes, applying a small amount every other night to gauge your skin’s tolerance.
Sun protection also plays a role. UV damage thickens the outer layer of skin over time, which can make it harder for dead cells to shed normally. A lightweight, non-comedogenic sunscreen around the eyes helps reduce that risk without adding the heavy occlusive layer that triggers milia in the first place.
How Long Milia Last Without Treatment
In newborns, milia almost always disappear on their own within a few weeks to months. Adults aren’t as lucky. Milia in adults can persist indefinitely because the trapped keratin has nowhere to go. Some individual bumps may eventually resolve, but many will stay the same size for months or even years without intervention. If the appearance bothers you or new ones keep forming, professional removal combined with a skincare adjustment is the most reliable path to clearing them.