What should you know about large milia under the eye?

Milia are firm, pale bumps caused by trapped keratin near the surface of the skin. Under-eye skin is thin and moves with blinking, so a bump there should not be treated like a spot on the cheek. A clinician can distinguish milia from whiteheads, a blocked gland, irritation or another lesion by examining its surface and position.

Size does not by itself show whether a bump is serious. A lesion that is red, painful, rapidly changing or associated with eyelid swelling deserves a closer assessment. Avoid placing active products close to the eye unless a clinician has explained exactly where and how to apply them.

Do not squeeze, lance or scrape an under-eye milium. A slip can injure the eyelid or eye surface, and rough handling can leave inflammation or a mark. Use gentle cleansing and remove eye makeup without rubbing. Tell the clinician about contact lenses, eye disease, allergies and products used around the eyes.

A dermatologist may remove a suitable milium with sterile opening and extraction. Curettage and cautery may be discussed for selected lesions, while topical retinoids are not appropriate for every under-eye bump and can irritate this sensitive area. Follow the exact aftercare instructions and keep unapproved products away from the healing site.

Arrange medical review if the bump bleeds, crusts, grows quickly, becomes tender or is accompanied by persistent eyelid redness. Seek urgent care for vision changes, severe pain, marked swelling, light sensitivity or difficulty opening the eye. These symptoms can arise from several eye or skin problems and should not be managed with home extraction.

Ask whether the bump is truly milia, how close treatment can safely be to the eyelid margin, which method is planned, how to protect the eye during treatment, and when eye makeup, contact lenses and skincare can be resumed.