Milia treatment: what to know

Milia are tiny cysts containing keratin beneath the outer layer of skin. They are not the same as acne whiteheads, even though both can look pale and raised. The treatment plan changes with the area involved, the thickness of the cyst, skin sensitivity and whether there are many lesions.

Some milia settle without intervention, while others remain visible. A clinician may examine the surface closely before choosing treatment, particularly around the eyes or on irritated skin. Strong exfoliation and acne products can inflame the area without opening the cyst.

Use a gentle cleanser, avoid picking and protect treated skin from rubbing. Do not attempt to pierce a bump with a needle or use a household tool. These actions can cause infection, prolonged redness or a mark.

A dermatologist may use sterile extraction, curettage and cautery, or another suitable technique. A topical retinoid may help reduce the build-up of cells for selected patients, but it can irritate skin and is not appropriate for everyone. Follow the prescribed amount and placement exactly, and report persistent burning or scaling.

Book an assessment when a bump is persistent, recurrent, clustered, close to the eye or difficult to distinguish from a whitehead. Seek prompt medical attention if the area becomes hot, swollen, increasingly painful, drains fluid or is accompanied by fever. Those changes are not typical reasons to self-treat as milia.

How confident are you that these are milia? Could my cleanser, cream or medication be contributing? Is observation reasonable for this location? Which removal method suits my skin, and what aftercare should I follow? If a retinoid is prescribed, where should I apply it and what irritation should prompt a call?