What should you know about tiny bumps under skin?

Firm, rough bumps around hair follicles may fit keratosis pilaris. Small itchy or inflamed bumps can occur with folliculitis or heat rash. Pearly, firm white bumps may be milia, which form when keratin becomes trapped near the skin surface. A clustered or persistently scaly area needs a closer look because lichen planus and other conditions can look different from ordinary blocked pores.

A clinician will consider when the bumps began, whether they are painful or itchy, and whether shaving, sweating, friction, cosmetics, or a new product preceded them. A photograph can help track change, but it cannot replace an examination.

Wash gently with lukewarm water, avoid squeezing or digging at the bumps, and pause products that sting or seem to trigger them. Choose loose, breathable clothing where heat or friction is involved. Do not use a strong exfoliant, steroid, or antibiotic product without advice, since the wrong treatment can irritate the skin or mask useful clues. If itching is the main problem, ask a pharmacist or clinician whether an antihistamine treatment is suitable for you.

Arrange a dermatology assessment if the bumps persist, spread, recur, become painful, crusted, or drain fluid, or if you cannot tell whether they are in the skin or deeper beneath it. Seek urgent help for rapidly spreading redness, severe pain, facial swelling, fever, breathing difficulty, or swelling of the lips or tongue.

Ask what pattern the bumps suggest, whether a medicine or product could be contributing, and which signs would change the diagnosis. You can also ask whether a skin examination is enough or whether a sample or treatment trial is needed.