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 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?
Most milia in adults are random and doesn’t have an underlying condition; milia with no cause are known as primary milia. Secondary milia, however, can be caused by skin conditions or damage. We’re talking sun damage, some medications, dermabrasion, blistering, burns, rashes, and even tattoos. These things can block the skin’s ability to exfoliate dead skin cells and sebum like it’s supposed to.
Milia occur when keratin—a protein that gives your skin a protective barrier and contributes to skin firmness—gets trapped under the skin’s surface with dead skin cells and sebum. This cluster forms tiny white bumps. They’re often found around the eyes and eyelids but can also occur on the cheeks, forehead, and nose.
Which kind you have doesn’t really matter; you can treat primary and secondary milia the same way.
White bumps on the skin can be related to other conditions as well, including clogged pores or overgrown oil glands. So if you’re not sure, schedule a check-up with your derm to rule out other possibilities.
Milia treatment is pretty simple. Use these derm-approved tips to reduce milia and prevent them from coming back.
1. Avoid picking at them or trying to pop them
The last thing you want to do is make your milia worse or create more skin problems to deal with. Besides being an ineffective way to get these keratin clusters out of the skin, picking at your milia will just cause irritation. It’ll make your skin red, sensitive, and can result in scars or spawn more milia. Any physical extraction should be left to your derm.
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 (a prescription-grade retinoid) for milia.
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.
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.
Other in-office milia removal treatments include freezing milia off with cryotherapy, destroying them with extreme heat, or using laser treatments. 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.
4. Stock up on sunscreen
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. Use a broad spectrum sunscreen with an SPF of 30 or higher every day before going out in the sun. Re-apply every two hours as long as you’re exposed to the sun.
Invest in a derm-grade retinoid for milia removal
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. 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—a dermatologist-formulated retinoid serum tailored to your skin—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.
Sensitive skin or retinoid newbie? 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 2, so it shows results faster.
Questions? We’re always happy to chat skincare. Feel free to reach out at firstname.lastname@example.org.
- Poljšak, B., & Dahmane, R. (2012, February 29). Free radicals and extrinsic skin aging. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299230/
- Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: An overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/