What to Know About Milia Under the Eyes: Causes, Treatment, and Prevention
A dermatology-backed approach to keep delicate skin smooth and blemish-free.
Milia Under the Eyes: What Are These Tiny White Bumps?
Anyone who’s ever discovered small, white bumps beneath their eyes knows how persistent—and sometimes frustrating—they can be. These bumps, called milia, often cause concern due to their delicate location, but rest assured: they are usually harmless, non-contagious, and treatable. This comprehensive guide will walk you through everything you need to know about milia under the eyes, from understanding what they are to safe removal options, preventive skincare, and expert answers to the most frequently asked questions.
Table of Contents
- What Are Milia?
- How to Identify Milia Under the Eyes
- Causes and Risk Factors
- Diagnosis and When to See a Doctor
- Treatment Options
- Tips for Preventing Milia
- Frequently Asked Questions
What Are Milia?
Milia (singular: milium) are small, dome-shaped cysts that typically measure between 1 to 2 mm in diameter. They are filled with keratin—the same protein found in your skin, hair, and nails—and form when keratin becomes trapped beneath the skin’s surface. Although they often appear in newborns, they can develop at any age, especially in areas where the skin is thinner or more delicate, like under the eyes.
- Milia are not a form of acne and do not contain pus.
- Unlike pimples, milia are not inflamed or red. They tend to be white, yellowish, or sometimes flesh-toned.
- Usually painless and only noticeable for their appearance.
How to Identify Milia Under the Eyes
Distinguishing milia from other skin issues can be confusing. Here are key characteristics to look for:
- Appearance: Tiny, white or yellowish bumps that resemble pearls or grains of sand under the skin’s surface. They feel firm—sometimes described as “tiny beads” under the skin.
- Location: Most commonly found around the eyes, but can also be present on the cheeks, nose, forehead, eyelids, and even the chest or upper arms.
- Texture: Not painful, not itchy, and do not have an opening or pore like whiteheads or acne. The texture is smooth and firm when pressed.
- Persistence: Milia can remain unchanged for weeks, months, or even years if not treated, but may disappear on their own in some cases.
If you’re ever uncertain about a new skin change—especially around the eyes—consulting a dermatologist can rule out other causes such as syringomas, sebaceous hyperplasia, xanthelasma, or even chalazia (styes).
Causes and Risk Factors for Milia Under the Eyes
The most common mechanism behind milia formation is the failure of dead skin cells to exfoliate properly. Instead of shedding, these cells—rich in keratin—become trapped just below the skin’s surface, where they harden into cysts.
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Risk factors and contributing causes include:
- Skin Trauma or Damage: Skin injuries from burns, rashes, or excess sun exposure can disturb normal exfoliation and lead to milia formation.
- Chronic Use of Heavy Creams or Oily Products: Oil-based cosmetics or thick eye creams can create an environment in which dead skin cells can become trapped, particularly where the skin is thin and there are fewer oil glands (like the under-eye area).
- Genetic Predisposition or Skin Conditions: Some genetic skin disorders, long-term corticosteroid use, or chronic skin conditions like rosacea may increase milia likelihood.
- Poor Hygiene or Makeup Habits: Not adequately cleansing the face or sleeping in makeup can block normal skin cell turnover, making milia more likely.
- Age: As we age, the skin’s regenerative process slows, making milia more common in adults than previously thought.
It’s important to note that, in many cases, milia appear without any clear cause, and not all cases are preventable.
Diagnosis and When to See a Doctor
Visual examination is usually enough for a diagnosis of milia. Your doctor may simply inspect the area or gently touch the bumps to confirm that they’re firm and not infectious or inflamed.
- Milia are most often diagnosed based on appearance alone.
- If there are numerous bumps, or if they recur persistently, the doctor may consider looking for an underlying skin disorder or another medical reason.
- Other skin conditions that resemble milia and may require differentiation include syringomas, cholesterol deposits, whiteheads, sebaceous hyperplasia, and eyelid cysts.
When to see a dermatologist:
- If milia persist for several months with no improvement
- If they multiply rapidly or become red, painful, or swollen
- If you experience significant bothersome cosmetic concerns
- If bumps appear alongside other unexplained symptoms
Treatment Options for Milia Under the Eyes
Milia under the eyes are generally harmless, but if you want them removed for cosmetic reasons, certain treatments can safely and effectively clear them. However, do not attempt to pop, squeeze, or pierce milia yourself—especially under the eyes where the skin is fragile and the risk of complications is higher.
Home Remedies and Self-Treatment
- Gentle Exfoliation: Using a mild exfoliant (such as a cleanser with glycolic or salicylic acid) can help slough away dead skin cells, although great caution must be used near the eyes.
- Topical Retinoids: Prescription or low-strength retinol creams can promote healthier cell turnover and may loosen existing milia over time. Only use products specifically approved for use near the eyes.
- Don’t pick or squeeze: Picking at milia can cause irritation, infection, or scarring, and is not recommended.
Professional Treatments
For persistent milia, dermatologists offer a range of treatment options:
- Sterile Needle Extraction: A specialist sterilizes the area, uses a fine needle or blade to gently open the cyst, and then extracts the keratin. This procedure is quick, nearly painless, and leaves little to no scarring when performed by a professional.
- Chemical Peels: Peels containing glycolic or salicylic acids are applied to prompt deeper exfoliation and remove keratin buildup in the outer layers of skin. They are generally reserved for milia not immediately adjacent to the eye for safety reasons.
- Dermabrasion: Mechanical exfoliation removes dead cells and promotes regeneration, though it is also more often applied elsewhere on the face.
- Laser Therapy: Laser ablation targets and opens the cysts without harming surrounding tissue.
- Cryotherapy: Liquid nitrogen can freeze and destruct milia, but this approach is less common for the sensitive undereye area due to risk of pigmentation changes or scarring.
Note: These procedures should always be performed by an experienced healthcare provider, especially near the eyes where the risk of injury is significant.
How to Prevent Milia Under the Eyes
While not all causes of milia can be prevented, certain skin habits help reduce the likelihood of developing these cysts—particularly for those prone to recurring issues:
- Gentle Cleansing: Wash your face twice daily with a gentle cleanser suited to your skin type. Never use harsh scrubs or cleansers around the eyes.
- Regular (But Careful) Exfoliation: Exfoliate your face two to three times per week, being cautious not to overdo it around delicate eye skin.
- Select Lightweight Skincare Products: Avoid heavy, oil-rich creams or occlusive ointments under the eyes.
- Use Sunscreen: Protect delicate eye-area skin with a broad-spectrum, fragrance-free sunscreen of SPF 30 or higher; sun damage impairs skin renewal and increases risk of milia.
- Remove Makeup Thoroughly: Always remove eye makeup before sleeping to prevent buildup and clogged pores.
- Choose Eye Products Carefully: Look for non-comedogenic, hypoallergenic eye creams or serums formulated for sensitive skin.
Frequently Asked Questions (FAQs) About Milia Under the Eyes
Can I pop or remove milia at home?
No, do not attempt to pop or squeeze milia at home. The skin under the eyes is extremely sensitive and improper removal can cause scarring, infection, or permanent pigment changes. Always consult a dermatologist for safe removal.
Do milia under the eyes go away on their own?
In many cases—especially in newborns—milia will resolve without intervention within a few months. In adults, milia may sometimes disappear spontaneously, but persistent or multiply occurring bumps often require professional treatment if removal is desired.
Are milia contagious or dangerous?
Milia are not contagious or dangerous; they are a harmless buildup of keratin and not caused by bacteria, fungi, or viruses.
Are certain people more prone to getting milia?
Some people naturally have a higher chance of getting milia due to genetic skin characteristics, frequent use of heavy creams, chronic sun exposure, or other medical conditions. However, milia can affect anyone at any age.
How can I tell the difference between milia and whiteheads?
Milia are firm, dome-shaped, and do not have an opening or visible pore. Unlike whiteheads, they do not become red or inflamed and cannot be popped. Whiteheads, or closed comedones, are filled with sebum and dead cells, associated with acne, and may have a slight redness around them.
Expert-Backed Takeaways
- Milia are harmless, protein-filled cysts that often appear under the eyes where the skin is thinnest.
- They are not a form of acne and usually do not require medical attention unless persistent, multiplying, or bothersome.
- Safe removal should be handled by a dermatologist—DIY methods increase risk for irritation and scarring.
- Prevention centers on gentle cleansing, regular exfoliation, sunscreen, and using non-comedogenic products.
- If you are ever in doubt or notice changes, prompt evaluation by a qualified doctor is recommended.
References
- https://aventusclinic.com/milia-white-spots-under-the-eyes/
- https://www.medicalnewstoday.com/articles/326681
- https://skinsight.com/skin-conditions/milia/
- https://my.clevelandclinic.org/health/diseases/17868-milia
- https://vitalskinderm.com/conditions/milia
- https://www.allaboutvision.com/conditions/milia/
- https://my.clevelandclinic.org/health/diseases/23321-syringoma
- https://www.healthdirect.gov.au/milia
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