We asked top skin experts what exactly is milia and what you can do about these pesky bumps under your eyes.

By Melanie Rud
December 10, 2019

Whether you realize it or not, you probably have a few milia somewhere on your skin. These tiny, hard bumps can often be mistaken for a pimple, but make no mistake about it, milia are very different than standard blackheads and whiteheads. That means your treatment and extraction approach also needs to be different. (Spoiler alert: You can't just pop 'em.) Ahead, skin experts weigh in on what causes milia and how to get rid of milia.

What are milia?

"Milia are tiny white bumps of keratin, the protein that forms hair, skin, and nails, that is trapped under the skin," explains New York City dermatologist Marnie Nussbaum, M.D. "They're painless and look like acne, but are quite different. They can't be popped or squeezed and will never release any pus or blood." Unlike breakouts, there's also usually no redness or inflammation involved, just a flesh- or white-colored, small, hard bump. You'll often see milia clustered in groups, and they often pop up on the nose, cheeks, and especially around the eyes, adds Dr. Nussbaum. While milia are unsightly and annoying, they're not a health concern, adds Gretchen Frieling, M.D., a board-certified dermatopathologist in the Boston area. They most often pop up on your face, though milia can occur elsewhere on the body, particularly the chest, back, and arms.

How are milia different from other types of clogged pores?

Clogged pores are usually caused by excess oil, dirt, and bacteria becoming trapped inside a pore and creating a pimple or blackhead or whitehead; unlike milia, they're extractable and if you squeeze, all that gunk will come out of it. There may be oil trapped in milia as well (along with the keratin build-up), but it's trapped much deeper and covered by layers of dead skin, explains celebrity esthetician Elina Fedotova, founder of Elina Organics Spa and Skincare. That's why, no matter how hard you try, you won't be able to 'pop' milia. Milia also don't even have to necessarily occur within a pore; sometimes these bumps can form under the skin and not even inside a pore, says Dr. Frieling.

What causes milia?

It's still somewhat unclear what caused milia. Many times there's no specific reason why the keratin gets trapped, and milia often pop up without cause, says Dr. Nussbaum. Still, we do know that certain people have a genetic predisposition to form milia, adds Fedotova. "Usually these people have very dehydrated complexions and narrow pores which makes it hard for oil to exit and easier to be trapped inside," she explains. Your makeup routine may be a culprit, too. "Heavy, silicone-based concealers and foundations cover the skin with a thin film that traps oil in the pores. This is why you often see milia under the eyes because many people use concealers to cover up dark circles," says Fedotova.

How can you get rid of milia?

Here's the biggest, most important takeaway when it comes to getting rid of milia: Do not, we repeat, do not attempt to remove milia yourself.

While pimple-popping is never really advised, in the case of milia, it truly won't work. "Mila will not budge, no matter how much squeezing or pressure you apply, and will only cause scarring if you try," cautions Dr. Nussbaum. Bottom line: You need to see a professional for removal. Safe, professional extraction typically involves unroofing the bump with a sterile needle to remove the hard ball of keratin and old oil or using a heated needle to break apart the bump.

What you can do is implement a milia prevention plan, particularly if you know you're prone to them. There's no surefire way to keep milia at bay, but there are some things that can help, says Dr. Nussbaum.

Step one: Stick to non-comedogenic (AKA non-pore-clogging) makeup and skin care.

Step two: Use products with ingredients that will help promote cell turnover and exfoliate, to help clear out dead cells before they pile up and prevent bumps, advises Frieling. Retinoidsalpha-hydroxy acids, and beta-hydroxy acids are all good options.

Step three: Hydrate. Milia are also more likely to occur when the skin is dry and extra flakes build up, says Dr. Frieling. The trick is to choose products that contain lighter humectants, such as hyaluronic acid, rather than heavy oil and butter, notes Fedotova.

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