How To Treat Milia

Milia, those pearly bumps that are sometimes called whiteheads, are very common noninflamed blemishes.  Even if you aren't prone to inflammatory acne, you can still develop milia.

Honestly, there's generally no medical reason to treat milia.  So, if they aren't really bugging you, no need to worry about them.

Still, most people are annoyed by them enough to want to get rid of them.  If you're done with those pesky white bumps and want them gone, there are things you can do to banish milia.

Never, ever try to pop milia.

Woman squeezing a blemish.
Photo: John Rensten / Getty Images

First things first, don't ever try popping or squeezing a milium.  Milium is the singular of milia.  So, you have one milium or many milia.

The contents of milia are not fluid like the contents of a pustule.  Pustules, those other whiteheads that are your typical pimple, are filled with cellular debris and, you guessed it, pus.  So, when you put pressure on a pustule, the fluid contents often easily flows from the pore.  (For the record, you really shouldn't be popping pustules either!)

Unlike a pustule, little white lump that makes up a milium is very hard.  It's made up of dead skin cells and oil, which becomes trapped just below the surface of the skin. 

Try as you might, squeezing at milia will get you nowhere.  That little bump is simply too hard, and there is no opening in the skin by which the plug could escape.  You'll just end up with a sore, red spot and quite possibly damaged skin.  And milia will still be there.

Grab an OTC exfoliating product.

Instead of trying to (unsuccessfully) pop out a milium, you can start off with an over-the-counter salicylic acid or glycolic acid product.  These products help exfoliate the skin.  If you have just a few little bumps here and there, an OTC product may be all you need to get the results you're looking for.

Still, treating with OTC products can take loads of time to see any improvement. 

If you have lots of milia, if they've been around for ages even with OTC treatment, or if they're in a spot that's difficult for you to treat with OTC products (like the top eyelid) then the next step would be to see a dermatologist.

Topical retinoids are a prescription option.

If you're prone to developing milia, and some people just are, your dermatologist may recommend you use a topical retinoid.

Topical retinoids help the skin to exfoliate effectively.  Since milia are plugs of dead skin cells that become trapped just beneath the skin's surface, keeping those skin cells exfoliated can help keep milia from forming.

Get manual extractions done by a pro.

The absolute best treatment for milia is manual extraction, done by a professional.  It's the most effective and the results are immediate.

During the procedure, a tiny opening is made in the surface of the skin with a small surgical blade called a lancet.  The hard plug of material that makes up the milium is gently pushed out through the opening with the technician's fingers or a tool called a comedone extractor.   

Although it sounds horrid, it's truly not that painful.  No anesthetic is needed, at worst you'll feel a prick. 

Most often, milia extractions are done at the dermatologist's office.  In some cases, milia extractions may also be done by an esthetician at a salons or skin spa.  Some states don't allow estheticians to pierce the skin, though, so legally they can't remove milia.

A quick word or warning -- don't try to self-extract milia.  You could do some serious damage to your skin, and end up with permanent scarring.  

You have plenty of treatment options available.  Remember, if you need help or have any questions, your dermatologist is a great resource. 

Source: "Milia." MedlinePlus Medical Encyclopedia. U.S National Library of Medicine. National Institutes of Health, 10 May 2013. Web. 19 May 2015.

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