When is curettage and cautery recommended for milia?

Milia are small, firm, keratin-filled cysts that commonly appear as white or skin-coloured bumps, including around the eyes. They are often harmless and may not need treatment. A clinician may use a sterile opening and gentle removal; curettage and cautery can be selected when a raised cyst needs controlled removal or when bleeding from the treatment site needs managing. The thin skin around the eyes requires particular care, and a bump that looks unusual may need a different assessment.

Arrange an examination if the bumps persist, recur, rub against clothing, or concern you cosmetically. Avoid needles, squeezing and strong acids at home, particularly near the eyelids. Tell the clinician about eczema, previous colour changes after skin injury and any products used on the area. Ask about cleansing, sun protection and whether a simple extraction would be more suitable than cautery for your individual milia.

Seek review if a supposed milium becomes red, painful, swollen, drains, affects vision or changes rapidly. These signs can indicate irritation, infection or a different lesion. After removal, contact the clinic if swelling continues to increase, the wound becomes increasingly painful, discharge appears or the treated area affects the eye.

Ask whether the bump is definitely milia, which removal method is safest at its location, and how close treatment can be placed to the eyelid. Discuss crusting, pigment change, scar care and what to do if a similar bump returns.