Hard Milia: What They Are and What to Do

Milia often look like pearly white or skin-coloured bumps with a smooth surface. Unlike a typical whitehead, the trapped keratin sits in a small cyst and may not release with gentle washing. They can occur on the face, eyelids, or other areas, sometimes after skin irritation or injury.

A firm bump is not automatically milia. A clinician can distinguish milia from other skin bumps by examining its colour, surface, depth, and distribution.

Use a gentle cleanser and non-scratching skincare. Avoid needles, extracting tools, harsh scrubs, and squeezing, which can cause infection or a lasting mark. Review heavy or irritating products if bumps began after a skincare change.

If removal is wanted, a trained clinician can open and extract a cyst using a clean technique. Topical retinoids may be considered for selected cases, while curettage and cautery are procedural options when appropriate. Treatment choice depends on location and skin sensitivity.

Book an assessment if bumps are spreading, itchy, inflamed, bleeding, changing, or not clearly typical of milia. Around the eyes, professional assessment is especially useful because delicate skin is easy to injure during home extraction.

Ask whether the bumps are milia, whether they may settle without treatment, which products to pause, and which removal method suits your skin and their location.