Adult milk spots: what to know about milia

They often appear as pearly white or cream bumps around the eyes, cheeks or forehead. A clinician can confirm the diagnosis if the appearance is unclear, especially when bumps are new, widespread or changing.

Milia form when keratin, a protein found in the outer layer of skin, becomes trapped beneath the surface. They are not caused by poor hygiene and are not contagious. In adults, they may arise without an obvious trigger or follow skin irritation, injury, burns, or the use of heavy products that trap material near the surface.

Unlike whiteheads, milia are typically firm, lack an inflamed red base and do not have an opening that releases acne material. Other skin bumps can look similar, so appearance alone may not settle the diagnosis.

Leave the bumps intact and use a gentle cleanser, light moisturiser and daily sun protection. Avoid needles, scraping and forceful squeezing; these can damage delicate skin, introduce infection or leave discoloration and scarring, particularly near the eyelids.

Some milia clear without treatment. Persistent or bothersome lesions can be assessed by a dermatologist, who may open and extract them with sterile equipment. A topical retinoid may be considered for suitable areas or repeated milia, but it can irritate skin and requires professional guidance. Treatment around the eyes needs particular care.

Book a routine skin assessment if the bumps persist, multiply, return after removal, or do not resemble typical firm white cysts. Seek earlier care for pain, marked redness, warmth, swelling, bleeding, crusting or discharge, because these features are not typical of uncomplicated milia.

A bump on an eyelid that affects vision, causes substantial swelling or makes it difficult to open the eye deserves prompt assessment. Sudden widespread bumps after a burn, blistering rash or new medicine also need a clinician to identify the cause before treatment.

Ask whether the bumps are milia or another condition, whether any skincare product may be contributing, and which removal method suits their location. If a retinoid is discussed, ask where to apply it, how to limit irritation and which products or circumstances make it unsuitable.