Milia (milium – singular) are tiny white, keratin-filled cysts most commonly found near the eyes, nose, cheeks, and forehead, although they can appear anywhere. They look like tiny white seeds and sit just below your skin’s surface and are generally 1-2 mm in diameter.
Primary milia are common in newborns although they can appear in children or young adults.
Secondary milia are milia that occur due to some form of skin damage – sun exposure, burns, dermabrasion or from using harsh skin care products or too much heavy moisturizer.
Milia will usually go away without any treatment given enough time. But although they aren’t painful and they don’t itch, their appearance can be embarrassing especially if you have more than one or two, which leads people understandably to want to find a way to remove them. Some people find that milia are a long-term problem, with new milia erupting regularly.
The first thing that people do when they notice one of these cysts is to assume it’s a white head and try to pop it. But that doesn’t work because milia aren’t conventional spots! The content of these little bumps is not liquid so no amount of squeezing will get it out. With a spot, you have an inflamed pore, filled with cellular debris and pus and a gentle squeeze is enough to cause the thin layer of skin over the spot to rupture and allow the fluid to flow out smoothly.
Milia, on the other hand, are small solid lumps. Milia are plugs of dead skin cells and oil trapped just below the skin’s surface. They’re set deeper than spots, and there is no opening in the skin (pore) to allow them to come out even if they were liquid. All squeezing will accomplish is sore, inflamed skin around the milia which will make them even more noticeable than they were before.
Milia also hang around for a much longer time than whiteheads, taking weeks or sometimes months to disappear.
Dermatologists or aestheticians will excise (cut and remove) milia, but that can get expensive and time-consuming. You can extract milia yourself if you are very, very careful, (see the end of this post), but there are other ways to deal with the problem which, although they take a little longer to get results, aren’t invasive at all.
Excising milia doesn’t do anything to tackle the reasons that the bumps formed in the first place, so while it’s a quick fix, you still need to take better care of your skin to prevent more episodes.
We’ll look at the different ways to tackle your milia at home a little later on, as well as steps that you can take to prevent any more milia appearing. But first, let’s learn a bit more about milia and what causes them.
What Causes Milia?
Milia are very common. When skin doesn’t shed dead cells properly those cells build up and absorb oil, becoming hard bumps.
Your body produces new skin cells on a continual basis deep within the dermal matrix. As they mature skin cells move upward toward the surface. These cells begin life as squamous epithelial cells. Once mature some of these cells undergo a process called keratinization, which eventually leads to cell death. It’s the keratinized 25-30 layers of dead skin cells which make up the outer, protective layer of your skin.
The uppermost layers of dead skin cells are naturally and regularly sloughed off, but if something interferes with this process and dead cells are not removed from the surface quickly enough, they can lead to clogged pores, spots, and acne, as well as a dull, roughened complexion. These skin cells can also become the hard lumps which are the topic of this post.
As you age your rate of natural skin cell turnover slows down. In babies the turnover takes 2 weeks, this increases to 3 or 4 weeks for teens, and beyond that and into middle age it usually renews once a month. After the age of 50, skin renewal really slows down taking from 45 to 90 days.
The ultra-fast cell renewal in newborns is why their milia disappear so soon. And the older you are, the longer they take to resolve on their own.
Good skin care practices and a supportive diet can help to shed dead skin cells more quickly and help to prevent a lot of common skin problems.
Optimal skin health – and optimal skin cell renewal – requires the ready availability of vitamins, minerals, and other micronutrients. If these essential substances aren’t present in sufficient quantities, then your skin won’t be able to function properly. It will slow down its renewal mechanism and be less efficient at shedding the dead cells. And don’t forget that your skin is an organ, the largest one in your body, so it’s a good idea to feed it well.
You can get the nutrients that your skin needs by eating plenty of fruits and vegetables, quality proteins, and omega 3 from fatty fish like salmon and mackerel.
One vitamin that has been linked to skin cell renewal is vitamin A or retinol. Milia may be related to vitamin A deficiency, with individuals reporting that their recurring milia stopped once they increased their vitamin A intake. The source of your dietary vitamin A is important, so read on for more details, no skipping!
A product that dermatologists sometimes prescribe for milia and which has good results (but side effects) is Differin Cream or adapalene (generic name) which is a retinoid-like compound. A synthetic form of retinol (vitamin A).
I think it’s safe to say that vitamin A has a role to play in the development of milia. To prevent milia, it would be wise to ensure an adequate intake of vitamin A and assist your skin’s renewal process, allowing it to exfoliate the dead skin cells that it’s having trouble shedding by itself.
Vitamin A is found in two forms, active Vitamin A, and beta-carotene. Active Vitamin A comes only from animal-sourced foods and is called retinol. This type of Vitamin A is in a ready-to-use form, and the body can use it right away. The other type of vitamin A comes from plant sources, but it can’t be used by the body until it has been converted, and there’s a problem with that.
Dr Michelle Kmiec says that to effectively convert plant sources of beta-carotene into the form of Vitamin A that your body can use, you need to eat at least 12 servings of fruits and vegetables a day, be in perfect health, without any digestive issues, eat real fat, never eat processed or fast foods and have no stress in your life. She goes onto say that if you don’t tick all of those boxes, then you should get your vitamin A from animal sources, with the most natural source being cod liver oil.
Another superb source of Vitamin A is beef liver. One serving has 20,000 IU. Imagine how well that much natural vitamin A is going to feed your skin! If eating liver doesn’t sound very appealing to you, just slice it thinly and add it to a beef stir-fry, you’ll hardly know that it’s there. Or add it to a bowl of soup before blending.
***Caution! Current guidelines recommend that pregnant women should not consume liver.***
If you’re vegetarian or vegan and not in supremely good health, I suggest that you take a quality supplement to make sure that you’re getting the vitamin A that you need.
What about Topical Vitamin A – Retinol?
Retinol has been used as a skin care treatment for decades and has been extensively clinically tested with a slew of successful results.
Retinol has been shown to:
- increase the rate of cellular turnover
- help restore even skin tone
- stimulate the production of collagen
- manage acne and psoriasis with its exfoliating effects
- be an excellent cell-communicating ingredient
Retinol has to be converted by your skin into retinoic acid before it can begin to work, so it isn’t as strong as the retinoids used in prescription medications, which contain the already converted retinoic acids. But stronger isn’t always better, and retinoids can cause side effects such as:
Skin irritation including dryness, flakiness, and redness thinning of the skin (if overused), and sun sensitivity.
Prescription retinoids use filler ingredients like stearic acid, isopropyl myristate, polyoxyl 40 stearate, stearyl alcohol, and butylated hydroxytoluene which you probably don’t want to put on your skin. And they can’t be used during pregnancy, nor are they suitable for sensitive skin, or those with eczema or rosacea.
A retinoid cream might be effective treatment for milia, but I wouldn’t want to put anything like that on my skin. I think it’s a much better idea to use a natural and safe form of retinol and wait a little longer for it to work.
So, let’s look at some natural source of retinol that you can apply to your skin to help increase its rate of exfoliation and speed up the expulsion of the milia.
Rosehip seed oil is high in all-trans retinoic acid – a vitamin A acid that retinol converts to – the potent antioxidants lycopene and beta-carotene, and omega fatty acids. With the addition of carrot seed oil which also stimulates the rejuvenation of skin cells, you can help your skin to lose its dead cells and lose those milia.
To make a rejuvenating serum, you’ll need
- 1 tablespoon organic Rosehip Seed oil
- ½ tablespoon jojoba oil
- ½ tablespoon pomegranate seed oil
- 10 drops vitamin E oil
- 10 drops lavender essential oil
- 3 drops helichrysum (St. John’s Wort) essential oil
- 2 drops organic carrot seed oil
- Combine all of the ingredients in a small, clean bottle and shake to mix. Use this twice a day.
Cod Liver Oil – A tablespoon of Cod liver oil contains 13,600 IU of retinol. You can apply cod liver oil straight to your skin. It will smell for a few minutes, but that will quickly fade. Apply a tiny amount to the problem areas daily.
Vitamin C (or ascorbic acid) is a powerful antioxidant that increases skin cell turnover and has a long history of use in dermatology to brighten skin and improve the appearance of acne, age spots, and hyperpigmentation. A vitamin C serum is easy and inexpensive to make.
You should be able to find ascorbic acid at your local health food store or pharmacy. Otherwise purchase some online. You’ll also need some glycerin.
Add 1 teaspoon of vitamin C powder and 2 teaspoons vegetable glycerin to ¼ cup of water. Mix it well and apply to your skin. Store your serum in a dark bottle in the refrigerator for up to one month.
We’ve searched for the best Vitamin A products on the market to share with you. Click the LEARN MORE button to find out more.
In addition to ensuring that you have reasonable levels of vitamin A circulating in your body allowing your skin to shed its cells effectively, you can also help to remove skin cells with gentle exfoliation.
Add three tablespoons of oatmeal and one tablespoon of sugar to 1 tablespoon of honey. Gently massage the mixture over your skin and leave on for 15 minutes before rinsing off. You can use this twice a week.
Bentonite Clay Mask
Bentonite clay is a natural exfoliator and will remove dead skin cells and absorb excess oil. So, it will help to speed up the removal of skin cells and expose existing milia while helping to prevent new ones from forming.
- 1 teaspoon bentonite clay
- 1 teaspoon water or apple cider vinegar
Mix the two ingredients together in your hand until you have a thin paste and then use your fingers to smear onto your skin. You can just spot treat the milia if you want to, but a bentonite clay mask is so beneficial for your skin that it would be a shame to deprive the rest of your face.
Leave the clay mask on your face for half an hour. As it dries, it will tighten on your skin. If you have sensitive skin this tightening can be uncomfortable, so wash the clay off when it gets too much.
To remove the mask, use warm water and your fingers to rub the clay off, you can also use a washcloth dipped in warm water. Give your skin a final rinse in clean, cold water.
Our top picks for the best Bentonite Clay Mask products on the market. Click the LEARN MORE button to find out more.
Twice Weekly Facial Steam With Tea Tree Essential Oil
Steam treatments offer several benefits when you’re trying to deal with milia.
The hot steam increases the blood supply to your skin. Increased blood flow allows more oxygen and nutrients to be delivered, assisting your skin to renew itself properly. Plus, the heat causes your skin to sweat, and the sweat removes dead skin cells which will help to bring the milia to the surface more quickly. Steam treatments will also help to prevent more milia forming in the future.
Tea tree oil will help to remove excess oil from your skin.
Bring a pan of water to a boil then remove it from the heat and add 5 drops of tea tree essential oil. Close your eyes and lean over the steam while draping a towel over your head to concentrate the steam in one area.
Here is an excellent list of Tea Tree Oil products out on the marketing right now.
Salicylic acid is a beta-hydroxy acid with mildly exfoliating properties. It increases cell turnover which is something we need to encourage to allow the skin to release milia. A natural source of salicylic acid is fruit. Here’s a list with the best sources.
- Raspberries – just mash up and apply to skin.
- Granny Smith Apples – mash or juice an apple and apply.
- Cucumber -Juice or mash it up and apply generously
- Cantaloupe – juice it or blend it then apply to skin.
Strawberries – Strawberries are extra great for milia because the seeds will help to exfoliate along with the salicylic acid. Mash some up and rub them onto your skin.
Tomatoes – Just rub a slice of tomato over your skin
Leave the fruits on your skin for 10 minutes before rinsing thoroughly. For the granny smith apple, you should only leave it on for about 5 minutes due to its acidity. Green apple is one of the most effective salicylic acid fruit remedies, so you can apply its juice directly to the milia with a cotton tip and leave it on for longer.
There are also some essential oils that contain salicylic acid
- Black Willow Bark
- Violet Leaf
Here are the best Salicylic Acid products on the market right now.
Another essential oil that you can use is Frankincense. Individuals have found that using one drop of the oil on milia for two days in a row, has caused the milia to form a scab which can be lifted away taking the milia with it.
Finally, if you’re impatient and willing to risk scarring or infection, I’ll tell you how to excise or “deroof” milia.
Your skin, including your hands, must be clean and disinfected before you start. Your needle and tweezers must be sterile! Your tweezers need to be the kind that ends in sharp points, flat ends will not work.
Place a sewing needle and a pair of tweezers into a small cup of rubbing alcohol.
Wash your face and disinfect the skin around the milia you will be working on, then pat dry.
Take the sterile needle and wipe it dry with a clean piece of gauze. Pierce the skin over the milia. You should make the smallest break in the skin possible, don’t saw away at your skin.
Next, take the sterile tweezers and wipe them dry with gauze. Use the tweezers to remove the milia through the small hole that you made with the needle.
Do not use this procedure on any milia close to your eyes.
Once you have finished, wash with warm soap and water, pat dry, and place one of the ingredients like salicylic acid on the area you just tweezed.
This process may work better if you have done a steam facial with tea tree oil first.
If you have steady hands, buy flat, individual razor blades, and after cleansing, gently scrape your skin in a downward motion. This helps remove superficial dead cells. When you run across an area of milia, you can angle one corner of the razor blade—into the center of the spot. This may work better than poking a needle into it. After deroofing the milia, gently scrape over the area and remove the debris. Finish off with a disinfectant.
Updated: September 8, 2018 by Dr. Kimberly Langdon M.D. All medical facts and points stated on this page are correct as of this date. Please be aware that new content and additional references were added in this last update. All the content and media has been uploaded by Lily Greene our webmaster, who is also in charge of page design.