White spots under the eyes: what should you know?

Milia are usually firm, pearly and close to the skin surface. They are different from a pimple because they do not have the same inflamed follicle pattern and squeezing rarely helps. Irritation, thick eye products, blocked follicles and less common skin conditions can also create pale bumps.

The thin eyelid skin is easily injured. A clinician should distinguish a harmless surface cyst from a lesion involving the eyelid margin, especially when the bump is new, changing or associated with eye symptoms.

Cleanse gently, avoid rubbing, and pause heavy or fragranced products that touch the area. Do not pierce, squeeze, scrape or use strong acids near the eye. Choose products labelled for the eye area and keep applicators clean. If the bumps persist or bother you, a trained clinician can discuss safe removal after confirming what they are.

Take a close photograph without makeup and note whether the bumps itch, hurt, multiply or affect vision. This can help at an appointment.

Arrange review for a bump that bleeds, crusts, grows, changes colour, causes persistent swelling, or returns after removal. Seek urgent eye care for vision change, severe pain, marked redness, light sensitivity, or swelling that develops quickly. A baby or child with unusual eyelid lesions should be assessed by an appropriate clinician.

Ask whether the bumps are milia or another lesion, whether an eye-safe procedure is appropriate, which products could be contributing, and what symptoms would require an eye specialist.