Here’s How to Get Rid of Milia Effectively (Don’t Pick Them)

dear brightly lotion on face

They’re not pimples, so save your benzoyl peroxide for your next breakout. Though milia look kind of like whiteheads, they’re not the same thing, so they require different treatment.

The good news is: milia are usually painless and don’t reflect an underlying health concern. They usually go away on their own in a few months but can be stubborn and stick around for years. Whether you’ve got persistent milia that won’t go away or you just want clear skin fast, it’s easy to get rid of milia and prevent them from coming back with a few tweaks to your skincare routine. For treatment, consider tretinoin for milia, adding a gentle chemical exfoliant to your routine, or going to a derm to get them extracted. For prevention, that exfoliant can help keep milia at bay but don’t forget the sunscreen, too.

WHAT CAUSES MILIA? (AND WHAT ARE THEY?)

Milia are small, white or yellowish cysts that commonly appear on the skin. Milia pop up when dead skin cells become trapped near the surface of the skin, forming small cysts that are often visible on the face. While they may resemble whiteheads, milia are distinct and do not have an opening, making them difficult to extract through typical means. Although milia are generally benign and painless, it’s natural to want to remove them.

Most milia in adults are random and don’t have an underlying condition Certain factors can block the skin’s ability to exfoliate dead skin cells and sebum like it’s supposed to.Let’s take a closer look at the two types: primary and secondary. Note: which kind you have doesn’t really matter; you can treat primary and secondary milia the same way.

PRIMARY MILIA

Primary milia are a result of blocked hair follicles or sweat ducts. Unlike secondary milia, primary milia are typically associated with normal skin development and are not indicative of an underlying health issue. These tiny cysts contain keratin, a protein found in the skin, and can be found on various areas of the face, particularly around the eyes, nose, and cheeks. While primary milia often resolve on their own over time, consulting with a dermatologist for personalized advice and treatment options is recommended for efficiency and safety.

SECONDARY MILIA

Secondary milia develop as a consequence of skin trauma, certain skin conditions, or as a reaction to certain products. They are often associated with factors such as blistering, burns, or inflammatory skin disorders. These cysts can appear in areas where the skin has experienced damage or trauma, and they may contain trapped debris or keratin. While secondary milia share a similar appearance to primary milia, addressing the underlying cause of the skin condition is needed in order to treat them.Talk to your dermo for proper diagnosis, management, and potential removal, as they can persist without appropriate intervention.

OTHER CONDITIONS THAT CAUSE WHITE BUMPS

White bumps on the skin may not always be attributed to milia alone; several other skin conditions share a similar appearance, and proper identification is crucial for effective treatment. These may include clogged pores, a result of trapped oils and dead skin cells; overgrown oil glands, which can lead to the formation of small, white or flesh-colored bumps; sebaceous cysts, sack-like structures beneath the skin's surface; seborrheic keratoses, often described as clay-like blobs adhering to the skin; actinic keratoses, characterized by crusty and hard skin bumps; xanthelasma, irregularly shaped bumps commonly found around the eyes or eyelids; or, in rare cases,skin cancer. 

Given the variety of potential causes for white bumps, it is essential not to self-diagnose. If in doubt, seeking professional advice through a dermatologist check-up is the best course of action to rule out other possibilities and determine the most suitable treatment approach based on the specific skin condition present.

HOW TO PREVENT MILIA

While they are generally harmless, milia can be annoying to deal with. Maintain good skincare habits and use products like Tretinoin to prevent milia.

  1. EXFOLIATE

Dead skin cells can accumulate on the skin's surface, leading to blockages in hair follicles. To counteract this, it is recommended to use a gentle exfoliating scrub or cleanser containing alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs). AHAs, such as glycolic acid and lactic acid, work to slough off dead skin cells from the skin's surface, promoting a smoother complexion and preventing the buildup that can contribute to milia. BHAs, such as salicylic acid, are oil-soluble and can penetrate deeper into the pores, helping to unclog them and reduce the likelihood of milia formation. Regular use of these exfoliating ingredients promotes healthy cell turnover, keeping the skin clear, vibrant, and less prone to the development of milia. It's important, however, to avoid excessive exfoliation, as this can lead to irritation and compromise the skin's natural barrier. Incorporating exfoliation into a balanced skincare routine can contribute to a healthier complexion overall.

      2. OPT FOR OIL-FREE PRODUCTS

Selecting the right skincare products is essential in preventing the formation of milia. Tretinoin is particularly powerful for milia prevention (check out full Tretinoin cream benefits in our blog post). Opting for non-comedogenic and oil-free formulations is crucial because these products are specifically designed not to clog pores, reducing the risk of milia development. Non-comedogenic products are formulated to be lightweight and less likely to cause blockages in the hair follicles, helping to maintain clear skin. It's particularly important to be cautious in areas prone to milia, such as around the eyes and on the cheeks. Heavy, pore-clogging creams or moisturizers can exacerbate the issue - they may create an environment where dead skin cells and oil accumulate, leading to the formation of milia. Instead, you should choose products labeled as non-comedogenic, oil-free, or formulated for sensitive skin, as these are less likely to contribute to pore blockages and can help maintain a healthy, blemish-free complexion. If you’re using a retinoid like retinol, learn if you should use retinol before or after moisturizer with our guide. 

     3. USE SUNSCREEN DAILY

Sun damage can cause milia, so develop a skincare routine that protects against sun exposure. The sun’s rays are responsible for up to 80% of external skin damage 1, so to prevent milia, sunscreen should be at the top of your list. Opt for a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher, as it provides defense against both UVA and UVB rays. Applying sunscreen diligently before stepping out into the sun forms a formidable barrier, shielding your skin from the potential harm that could lead to milia. Regular reapplication every two hours, especially during prolonged sun exposure, is essential to maintain its effectiveness. A consistent commitment to sun protection not only aids in preventing milia but also contributes to the overall health and longevity of your skin, reducing the risk of sun-induced damage and premature aging.

HOW TO REMOVE MILIA

Milia treatment is pretty simple. Use these derm-approved tips to reduce milia and prevent them from coming back. Removing milia at home can lead to further skin irritation or infection, so it’s always best to discuss with your dermo before you attempt any home treatment. Your dermo will often recommend Tretinoin for milia treatment

1. AVOID PICKING AT THEM OR TRYING TO POP THEM

You should never pick or attempt to extract milia at home due to the potential risks and complications it can entail. Milia often occur beneath the skin's surface, and they require careful and precise extraction methods best performed by dermatologists. Trying to pick or squeeze milia at home may lead to skin irritation, inflammation, and an increased risk of infection. Additionally, improper extraction can cause scarring, hyperpigmentation, or further blockages in the pores, exacerbating the issue. It is crucial to exercise patience and seek professional guidance from a dermatologist for safe and effective removal of milia. Dermatologists have the expertise, sterile tools, and controlled environments necessary to perform extractions without compromising skin health.

2. USE A GENTLE EXFOLIATOR

Give skin that isn’t exfoliating like it’s supposed to a little help with a non-irritating exfoliant. Adding an exfoliant to your skincare routine can help usher out the buildup of keratin, dead skin cells, and oil while minimizing irritation.

Skip the facial scrub, though. According to dermatologist Dr. Sheila Krishna, physical exfoliation can be irritating, causing more oil production and scarring. A physical exfoliant only deals with the surface of the skin anyways. Instead, go for a gentle chemical exfoliant like AHAs, BHAs, or topical retinoids (aka vitamin A derivatives). There are many studies proving the efficacy of tretinoin for milia.

Chemical Exfoilants

Chemical exfoliants will penetrate the skin and draw out the buildup causing your milia. Now you might be thinking, “What if I have milia around my eyes? Aren’t I supposed to avoid these types of products around my eyes?” You’re right! Please avoid the delicate eye area when applying chemical exfoliants. But according to dermatologist Dr. Lana Kashlan, these products “will spread locally beyond the area of direct application.” So when you apply chemical exfoliants to the rest of your face, they’ll diffuse under the skin and work to minimize your milia.

Include chemical exfoliants as part of your regular skincare routine as well to prevent milia from coming back.

3. CONSIDER IN-OFFICE TREATMENTS FROM YOUR DERMATOLOGIST

If at-home treatment isn’t working to get rid of your milia, ask your dermatologist about the in-office treatments they offer. In-office treatments can be more expensive than at-home remedies, so keep that in mind to find the right balance of effectiveness, treatment speed, and budget for you. In-office treatments are also worth considering for milia on the eyelids or right next to your eyes. You don’t want to risk getting skincare products in your eyes.

Deroofing

Deroofing is a common extraction method for milia. It involves cutting the milium cyst (one milia) open with a sterile needle or knife and removing the cyst with an extraction tool. This procedure is easy for derms but can be dangerous to try at home, so don’t do it yourself.

Cryotherapy

Cryotherapy, a technique involving the application of extreme cold, is sometimes used for milia removal. Done by a dermo, the freezing process causes the milia to blister and eventually slough off, revealing smoother skin beneath. Cryotherapy is considered a quick and relatively non-invasive procedure. 

Laser Treatments

Laser treatment is another option for milia removal, particularly when other methods are ineffective or if the milia are persistent. Laser therapy for milia involves using a focused beam of light to target and break down the keratin deposits that make up the milia. The laser energy is absorbed by the milia, promoting their disintegration and eventual absorption by the body. This non-invasive procedure is generally well-tolerated and can be performed in a dermatologist's office. Multiple sessions may be required for optimal results, depending on the size and quantity of milia.

 

HOW TO USE TRETINOIN FOR MILIA

Now that you know your options, it’s up to you to decide which route to take to get rid of milia. If you opt for a topical retinoid, consider getting a dermatology-grade retinoid like Tretinoin or adapalene for milia. You can compare adapalene vs Tretinoin in our blog post.. Derm-grade retinoids are more potent than over-the-counter retinol. By getting a prescription, you can better tailor your skincare routine to your skin needs.

That’s where Dear Brightly comes in. After sharing your skin story, a board-certified provider will determine whether to prescribe you a retinoid serum and the right concentration for your skin. Then, you’ll be sent Night Shift—your dermatologist-formulated tretinoin prescription online —in the mail. It’s the ease of an online doctor’s consultation from the comfort of your home without the cost or bother of an in-person visit.


Tretinoin has emerged as an effective treatment for milia. It works by accelerating cell turnover, preventing the accumulation of dead skin cells, and promoting the shedding of keratin. When applied as directed by a dermatologist, Tretinoin not only aids in the removal of existing milia but also prevents repeat outbreaks.

Sensitive skin or retinoid rookie? Depending on your skin and skin history, your provider may start you on a lower strength retinoid serum before increasing to the concentration that’s ideal for your skin. This will minimize irritation and give your skin a chance to adapt to increased skin cell turnover.

Night Shift is formulated with Tretinoin, the only FDA-approved retinoid for photoaging and acne with over 50 years of research to prove its safety and efficacy. It’s 20 times more potent than over-the-counter retinol, so it shows results faster.