White Bumps Under Skin (Milia): Causes & Treatment

Milia are small white bumps that can develop all over the body, but they are most common on the face, specifically under and around the eyes. Although they resemble tiny pimples, milia are caused by dead skin cells being trapped underneath new healthy skin, resulting in the small bumps. 

People of any age can develop milia, but they are most common in infants. 

These white bumps are harmless and can go away on their own. However, there are also several treatments and home remedies available and easy ways to prevent them altogether. 

What Are the White Bumps Under the Skin?

Commonly confused with tiny pimples, milia are actually small benign cysts that are made up of either dead skin or keratin that is trapped underneath the newly formed skin. 

Damage to the skin can also form a type of milia known as secondary milia. Additionally, there are rarer forms of the affliction that can be inherited, but the most common types of milia are neonatal and primary.

Neonatal Milia

Neonatal milia only appear on the face of an infant soon after birth. 

Oil glands in a baby’s skin are still developing and sometimes are unable to slough off dead skin properly. Instead, the skin remains stuck underneath new healthy skin, resulting in bumps. Neonatal milia occurs in about 40 to 50 percent of all newborn babies. 

Primary Milia

Both children and adults can develop primary milia. These tiny bumps form the same way as neonatal milia, with dead skin being trapped underneath new skin that results in a small white bump. Typically, primary milia forms around the eyes and can occur on the eyelids.

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Causes of Milia

Milia are caused by dead skin cells that don’t slough off normally like they should. Healthy human skin is able to produce new skin and get rid of older dead skin during a skin cycle. 

However, certain types of skin (especially in infants) can’t always dispose of dead epidermis, and it gets caught under the newer skin. This will cause a cluster of white bumps.

Secondary milia is caused by harm to the outer layers of the skin. This can include burns, rashes, and too much exposure to direct sunlight.

Removal & Treatment: How Do You Get Rid of the White Bumps Under the Skin?

Milia in newborn babies almost always goes away on its own and does not require treatment. This also holds true for adults with milia, but the bumps can be persistent in some cases, and remedies are needed. 

There are several treatments and home remedies that will also help speed up the natural process of eradicating milia. 

Home Remedies

• Clean the affected area at least once a day with non-irritating soap. There are also over-the-counter and prescription cleansers that are specially made for combatting milia.
• Exfoliating the skin on a daily basis removes dead skin cells on the uppermost layer of skin and will help remove milia.
• Opening the pores on the face by standing over boiling water or sitting next to a hot shower will create more room for dead skin to be released.

Medical Treatments

• Milia can be frozen during cryotherapy, and it will then disappear within days.
• A process known as de-roofing can be performed where incisions are made to physically remove the small bumps. 
• Taking oral antibiotics such as minocycline can help the skin eradicate milia.
• An erbium laser can be used to quickly remove milium, which also helps halt their recurrence.
• Chemical peels can burn away milia in extreme cases.

What Not to Do

Since a milium looks so much like a small pimple, many people try popping, poking at, or picking their milia. These methods will not help with milia and can lead to bleeding and scarring. 

If the small white bumps are present on the eyelid, potential damage can also occur to the eye itself. Do not pick or squeeze milia.

Prevention of Milia

The best ways to prevent neonatal and primary milia are proper hygiene and a skin care regime. Keeping the areas under and around the eyes clean will further the chances of dead skin being trapped. 

There are several methods of preventing secondary milia, such as these: 

• Avoid overexposure to direct sunlight.
• Use sunscreen.
• Moisturize your skin daily.
• Avoid thick creams or ointments that can clog pores.
• Exfoliate your skin regularly.

Milia FAQs

Are milia painful?

Milia are not painful. The only time pain is associated with milia is when a person attempts to pick at the tiny bumps. Do not squeeze or pick them ever.

Are milia contagious?

Milia are not contagious and will not spread to other parts of the body or other people after contact with the affected area.

Can you pop milia?

No, you should not attempt to pop or squeeze milia at home. A dermatologist may be able to cut away milia, but you should not attempt to do so yourself. If you do so on your own at home, you can seriously damage the skin and cause scarring. 

How long does milia last if left untreated?

This depends on the person, but milia usually only lasts for a few weeks in newborn babies. Milia can last up to a couple of months in adults before they naturally go away.

When should you see a doctor for milia?

Since milia are benign, there is no need to see a dermatologist. However, people who are concerned about their appearance and want milia removed quickly can seek medical treatment. The doctor may recommend treatment that will help to mitigate milia and prevent future occurrences.

References

1. Clinical Practice Trends in Cryosurgery: A Retrospective Study of Cutaneous Lesions. (February 2015). Advances in Dermatology and Allergology.

2. Epidermis and Its Renewal by Stem Cells. (2002). Molecular Biology of the Cell, 4th Edition.

3. Hygiene and Emollient Interventions for Maintaining Skin Integrity in Older People in Hospital and Residential Care Settings. (December 2014). Cochrane Library.

4. Idiopathic Multiple Eruptive Milia Occurred in Unusual Sites. (November 2010). Annals of Dermatology.

5. Milia. (January 2022). StatPearls.

6. Milia May Originate From the Outermost Layers of the Hair Bulge of the Outer Root Sheath: A Case Report. (November 2016). Oncology Letters.

7. Multiple Milia Formation in Blistering Diseases. (September 2019). International Journal of Women’s Dermatology.

8. Newborn Skin: Common Skin Problems. (January 2017). Maedica: A Journal of Clinical Medicine.

9. Pronounced Secondary Milia Precipitated by a Superficial Traumatic Abrasion in a 4-Year-Old Boy. (January 2010). The Journal of Pediatrics.

10. Non-Surgical Removal of Milia: Treatment and Aftercare. (March 2021). Journal of Aesthetic Nursing.