When milia do not go away

Milia are tiny keratin cysts, not loose surface debris that can always be washed away. A bump may stay firm and unchanged even with a careful skincare routine. Persistent facial bumps can also be something else, including a whitehead or another type of cyst, so lack of improvement does not prove the diagnosis. Location, texture, colour, and symptoms help a clinician decide what it is.

Use gentle cleansing, avoid abrasive scrubs, and stop picking or squeezing. Review heavy products with a clinician if the bumps started after a change in skincare. When treatment is wanted, options may include a prescribed topical retinoid or careful removal with curettage and cautery. These choices should be matched to the area, particularly around the eyes, and discussed with attention to irritation and post-inflammatory colour changes.

Arrange an assessment if a bump has remained despite sensible care, keeps recurring, or is making you alter your routine. Seek earlier advice for pain, warmth, pus, bleeding, crusting, rapid change, or swelling near the eye. A review is also useful when several bumps are appearing and you are unsure whether they are milia or another condition.

How confident are you that this is milia? What could explain its persistence? Would leaving it alone be preferable to treatment? If removal is appropriate, what healing and colour changes should I expect? How can I prevent irritation while the area heals?