Different types of milia

Primary milia form when skin cells become trapped and are common on the eyelids, cheeks and other facial areas. Secondary milia develop after skin has been irritated or injured, such as after a blister, rash or procedure; they may occur where the skin healed. Multiple milia can appear in clusters, while milia in newborns usually settle without treatment.

Milia look like firm white or pearly bumps, but they are not the same as acne whiteheads. A diagnosis is usually based on appearance, although an unusual, inflamed or changing bump may need a closer examination.

Do not pierce, scrape or squeeze a bump near the eye or elsewhere on the face. This can injure the skin and introduce infection. Use a gentle cleanser, avoid harsh scrubs and mention heavy creams or new products at review. A clinician may remove a persistent lesion with a sterile opening and extraction, or discuss curettage and cautery. Topical retinoids may be considered for some patterns, but they can irritate skin and are not suitable for everyone.

For visual comparison, see [Milia](/conditions/milia/), [Skin Bumps](/symptoms/skin-bumps/) and [Whiteheads](/symptoms/whiteheads/).

Arrange a dermatology review if a bump is painful, red, bleeding, rapidly changing, affecting vision or not clearly typical of milia. Seek prompt care for spreading redness, warmth, pus or fever after attempting removal. A cluster that appears after a burn, blister or procedure may be secondary milia and can benefit from an examination.

Does this bump look like milia or a whitehead? Is it primary or secondary milia? Would observation, a topical retinoid or in-clinic removal be most suitable? How can I protect the area and reduce irritation after treatment?