Milia are small, white, or yellowish cysts that appear on your face and body including on the eyelids and under the eyes. Milia are sometimes called “milk spots” or “oil seeds” and typically occur in clusters.
Milia are very prevalent in newborns which affects nearly 50% of all full-term newborn babies have at least a few facial milia. Teens and adults can also be affected by milia. These tiny skin bumps hardly become swollen but they can be annoying cosmetically especially when they occur on the eyelids.
Milia develop when dead skin cells or keratin build up under the surface of the skin, creating a raised “pinhead” bump that resembles a whitehead.
Milia are usually triggered by hormones but should not be mistaken to be acne.
Sun damage can also cause milia because it makes the skin rough and leathery which makes it more difficult for dead cells to rise to the surface of the skin and shed normally. Sometimes, milia disappear without treatment but they can also be persistent unless removed.
Milia removal and treatment
Milia and neonatal milia often disappear without treatment. However, primary milia that affect older children and adults can disappear within a few weeks, months, or even longer. Adults who find persistent milia especially on eyelids and under the eyes bothersome and unsightly often have them removed. A dermatologist or an ophthalmologist with cosmetic eye surgery specialization can remove milia surgically.
Chemical peels, cryotherapy (freezing), laser ablation, and diathermy (heat therapy) can also help remove milia. Facial milia occurring far from the eyes such as on the cheeks, chin, and nose can be safely removed at home through a sterilized needle, lancet, or comedone extractor.
Comedones are blocked, often infected oil glands which are also called blackheads and whiteheads. These are the primary signs of acne. A comedone extractor is a pencil-shaped hand-held skincare tool that has a sharp lancet on one end and a small spoon-shaped extractor on the other end to remove acne lesions and milia.
Always disinfect a comedone extractor with isopropyl alcohol before and after extraction of milia. Never share an extractor without clean and disinfecting it.
Though it may be safe to extract facial milia at home, never attempt to remove milia on your eyelids or under your eyes. Extraction of milia around the eyes should only be done by a medical professional.