Milia – those annoying white bumps under the skin

Its amazing what you can learn at a medical conference.  At a lunchbreak at the recent Mount Sinai Derm meeting, I sat down next  to two young dermatologists.  They were  talking about milia, those little white bumps under the skin– sort of faux pimples. ( In the picture below my milia is under my eye). Milia are formed when a pore becomes blocked with dead skin cells.  They are more common as we get older,  the result of slower cell growth.  Unlike the garden variety pimple, they do not contain oil or bacteria  so they don’t become red and inflamed.   Milia  just sit there. Forever.

Another important difference, milia are actually  in the dermis and if you try to  remove them yourself, you  can do real  damage to the skin. Seriously, you can get infections and even  scar the area.  Case in point:  Even when I had my milia removed by a physician, I got a shiner! 

Sitting next to the derms I learned two new facts:

1) The best way to deal with milia is to exfoliate regularly with Retin A,  dermabrasion or glycolic peels.  Milia tend to come back in the same area but since I have been using Tri-luma  ( which conains Retin-A), I  have been milia-free.

2) Its an old wives tale  that  rich face creams promote milia.  Good to know  since I use a moisturizer under my eyes every night. 

I’d love to hear about  your experiences with milia.  Where  do they appear?  How do you handle them?

48 thoughts on “Milia – those annoying white bumps under the skin

  1. Thank you for this posting; I had no idea what those were and are getting a few around my eyes. I thought they were just stubborn pimples. I will pay more attention to exfoliating now.

    • I’m so glad that the post helped you identify them. You can’t really exfoliate around the eye. In this area they shouldbe removed by a dermatologist. THey go very deep, and as you can see in the second photo, I actually got a black eye when even a trained dermatologist removed it. Let me know how your are doing.

  2. I’ve removed these myself several times with a washcloth and some very gentle circular rubbing. And they are usually around my eyes where many people (me included) often avoid using a washcloth or exfoliating.

    A dermatologist actually told me to do it this way years ago! Not that I will advocate it to others but it did work in my case. It seems the trick is to catch them right away – while they are just very tiny bumps. I use a very high magnification mirror to see stuff like this.

    On this web site called Skinsight (searched for milia) they said topical retinoid cream or sometimes fruit acid peels are prescribed. I do use a fruit acid product quite regularly but usually avoid the eye area – the most common place for milia it seems.

    • THat’s an interesting trick with the washcloth. Exfoliation is certainly an excellent way to get rid of small milia. Dr Marmur suggested using scrubbing grains or alpha hydroxy cleansers if the milia are not under the eye. Retin A has also been used successfully to help the pores eliminate the milia. You can’t use regular Retin A under the eye, but in a combination formulation called Triluma it can be helpful. Tri-luma contains Retin A, a skin lightener and a steroid to keep things calm. It can provide enough boost to skin turnover to deal with milia.

  3. You always seem to write about what I’m experiencing! I just went to the dermatologist with a cluster of white bumps that suddenly appeared on my upper cheek – closer to the eye than the jaw line. Like you said, they weren’t large or inflamed. She removed them, but I didn’t have any bruising as you had. She recommended a face wash and cream that contains glycolic. Thanks for the informative article.

  4. Thank you for this. And better than a washcloth (well at least the terry towelling ones we have here as standard), is MUSLIN cloth. Thank you! J

  5. I have dozens of these around my eyes and I’m having a hard time finding a doctor to help me out with these. My dermatologist sent me to a plastic surgeon, because he didn’t have the time to deal with this many. My plastic surgeon will only take cash because the insurance company is a hassle. Now I’m going to try and go to an eye surgeon. We’ll see how that turns out. I tried using a mild scrubbing cream, but they just irritated my eyes and the milia have seemed to multiply! It’s a nightmare!

    • Oh, it sounds like you’ve been thru alot and have received very little help. Have you tried a very mild Retin A cream on the area? This can “deroof” the milia and allow for easier removal. I don’t know about the insurance coverage because it can be viewed as both a cosmetic as well as medical problem. I would suggest going to another dermatologist. I am constantly amazed at the range of different opinions. I really feel for you since I know that removing a single milia gave me a shiner. Please let me know how you are doing. I will ask my experts for their advice.

  6. I was told recently by the skincareorganics ltd people that I should only put the eye creams on the bone socket area of my eye as the heavenly eye complex would naturally travel inwards. They said that too much cream under the eye on the soft tissue would promote those White spots. Makes sense. The eye complex has certainly worked a treat and after using the skin polish glycolic treatment and following this new tip I can say it is definitely working. The bee venom mask if you haven’t tried it already is defo worth a go . Can be used to pulp out the lines also around the eye….. But not on that area just beneath.
    http://Www.Skincareorganics.co.uk will send out goods directly. My cousin buys from them or one of their salons and they send directly to me.

  7. Hi there, I’ve had milia under my eyes for quite a few years. Would it be okay to use retin a 0.1% mixed with some moisturizer directly under my eyes? I’ve read that you should never do this AND that it’s okay to do this. I also read that you can use it there and wait a half hour then apply a good eye cream. And of course, on another site I read that you should never exfoliate your face because it causes more harm than good and that the face is self cleaning oven and sheds on it’s own! I’m not sure what to do! Help!

    • Hi Christina,
      No, please don’t use Retin A in this way. In the delicate under eye area, you need to combine Retin A with a steroid to avoid irritation. You can get a prescription for this that can be filled by a compounding pharmacy. You can also get milia removed by a dermatologist.
      I am a huge fan of exfoliation. It should be a natural process but for most skins need al ittle extra help. And skin is definately not like a self cleaning oven! One of the reasons that men seem to age slower than women is their daily shave exfoliates the skin and encourages healthy skin growth. We don’t shave daily, so we need grains, peels or brushes. Let me know how you are doing.

  8. I have the white spots under my eyes too,I am 41 years of age I have seen them before and was able to use a wash towel but there they were again first I was thinking it was a white head well now they are there and will not go away.I think I will try some of the things you all have been talking about.

  9. Similar to Christina, could you tell me how and where to apply Retin A 0.05% to the entire eye area? I’ve also read conflicting opinions that you should never do this AND that it’s okay to do this. There are plenty of instructions on how to apply Retin A to the face as it was originally intended for acne but they never address the delicate eye area.
    Many thanks.

    • Tradional formulations of Retin A should NEVER be applied to the eye area. Its much too strong and can cause sever irritation on what is the thinnest skin on the body. However, you can apply Tri-luma which is a combination of Retin A, hydroquinone (for dark circles) and a steroid (to keep things calm) under, but not on the lids of the eyes. Tri-luma which is available only by perscription is hard to find these days. However you can get a prescription from your dermatologist to take to a pharmacy that compounds medications. Even some of the chain pharmacies will do that– and it actually costs less than Retin A. Let me know how it works for you.

  10. I’ve been fighting milia ever since I started using anti-age eye skincare, so, from my own experience, I would claim that rich creams do cause milia. I now use GEL eye treatments as opposed to cream ones, and I haven’t encountered any new milia so far. Unfortunately, I haven’t found an anti-age eye gel yet, so I’ve been using a plain moisturizing eye gel.
    I’ve read many people who were prone to milia claim that Clinique’s All About Eyes cream did not cause them any trouble. But still, it’s a moisturizer, as far as I know, and not an anti-age product I’m still looking for.

    • I’m so glad you made a case pointing to eye creams as a source of milia. Doctors insist that they are not the problem, but that just seems to go against everything we know about pores and moisturizers. The only products I use under my eye is a retin A and hydroquinone combo at night and a concealer with sunscreen during the day.

      • Thanks for sharing your information. I used a needle to pop one that I had. Left a horrible mark, but it came back. I hate them. Where can I get retin A and hydroqinone or glycol. I would love to know how to get rid of these pesky things. I will never remember this website so please e-mail at monica_aree@hotmail.com. Any information would be a joy. Again, thank you!!!

        • Glycolic Acid products are available in many products in drugstores and online. The Derm store carries a great line called aqua Glycolic that has 10% glycolic acid toners, and masks. Hydroquinone is for discolorations and cna also be found in sdrugstores. Retin A is avialalbe by perscription. There are also combinations of hydroquinone and Retin A by prescription thaat can lighten discoloration and help the skin get rid of milia. But before you try a do-it-yourself session, I would urge you to see a dermatologist for visit.

  11. I have had milia for over 15 years, I’m 30 years, I have them all over my face. Ive always had them but I’m hoping that someday they will stop coming up. I don’t know anyone who’s got as many as me. I have tried many creams and gels, the one the hospital is currently trying on me is retin-a gel 0.01 tretinoin. Surgery is not an option as they said it will produce to much scarring on my face. Patience is what’s needed when dealing with milia. It’s been interesting to see how other people deal with this. Xxx

  12. I have a cluster of white bumps under both eyes around the tear through. Went to one dermatologist who cut a very thing piece of skin off. He wanted to do more but i decided against it. I read online phyto-contour cream works. Ive been using that for 3 months with no luck. I’ve also tried extracting them with a needle. Not much luck with that either. I don’t know what else to do.

    • THe products that can actually help are way too strong to use around the eyes. Having them removed by a dermatologist is just about our only option. Many, but not experts feel that using eye creams and oily concealers in the area and INCREASE their appearance, so I am not surprised the phyto-cream was unhelpful. Try to keep the area as oil-free as possible with non-oily eye makeup removers, even if you don’t use eye-makeup.

      • follow-up on the acne cream. The bumps returned and the acne cream doesn’t have the same effect as before. When I first used the acne cream it seemed to dry them out and shrink them. Now its not having the same effect. It was really nice for about 4 days having them minimized.

          • 36. Top care acne cream. 10 benzoyl peroxide. When I first noticed the bumps I tried clearisal. Same results. They shrunk at first but after that, not as effective.

  13. I’ve had milia under my eyes for at least 8 years now. My doctor prescribed retin-A and it really helps to push them from deep under the skin into a clear protruding white bump (which I will then proceed to extract with the prick of a tiny needle)

    Interestingly, I have more diffused whitish patches under my eye which I always though were milia. Turned out after I visited a dermatologist that they are in fact syringomas – abnormally shaped sweat glands. These are often mistaken for milia. I had electrocautery to remove them, but the results were not perfect – I’d say a 50% improvement.

  14. OMG!!!! After reading all this I am more confused than ever. My dermatologist told me to go to the beauty dept. of Macy’s!!! Doesn’t sound right to me. I have tried many drugstore eye creams even Avon ones. The milias are all over the lid of my eyes and under both eyes too!!! Everyone tells me they can’t see them but they are there and getting worse. Sometimes my eyes itch on the lid….I see no one mentions itching which sometimes bothers me and I also have a clump of 2 right on the inner corner of my eye.
    PLEASE HELP!!!!!????

      • The dermatologist just told me to go there and let them see the milias around my eyes. No product recommended. I used to have dark circles around my eyes all the time and always used a concealer wondering if that has something to do with them?? I don’t use it anymore and haven’t for quite some time. I will attempt to send pics as I am frustrated as what to do???

  15. I’m 35 and have had milia every now and then close to the eye area, typically near the brow and eye lids. Lately I have developed a cluster of them.From reading the above posts, it seems that the rich moisturizer I have been using might be the culprit. I also think it might be the eye makeup remover I have been using since years. How do I know the exact strength of retinol I need? Somedays they appear to have shrunk and other days they seem bigger. Is there a permanent non surgical fix for them?

    • Retin A, microdermabrasion and glycolic peels work well on milia, but can be difficult to use near the eye. If there are just a few of tme ( less than 20) I would have a dermatologist remove them maually. The only Retin A forumlation that you can use near the eye is the mixed forumlation that also contains hydrocortisone which can be made up by a compounding pharmacist.
      While the jury is out on moisturizers as the culprit, I personally believe they are part of the problem. Oily eye make-up removers can also trigger pore blockage.
      T

    • I’m in the same boat as you. Mine have shunk at times.
      I see a demotalagist in a few weeks. I’m hoping there is
      An ointment he can prescribe. I’ll let you know what he says.

  16. I have had these white spots under my eyes for about 5 years now and it is becoming more and more they are under my eyes and are working their way down to the top of my cheek. I have been to the doctors about this several times and they have simply said it would go away or it is just blocked pores. Please could you tell me how to get rid of them. Is there another way instead of needles because I am terrified of needles.

    • The best way to clear individual milia is by extraction with a sharp needle. I hate needles too but I did not freak out ( too much) when my dermatologist used a needle to remove them.

  17. Hello I think I have milia on my cheeks, I get them now and then, and they seem to go away on their own, but now i have one on my tear duct. not sure what to do with that, its been there for a few months now.

    • The only really safe way to deal with a milia on a tear duct is to have it removed by a dermatologist. For the rest of the face, microdermabrasion, glycolic peels and Retin A can do the job.

  18. I found out that the little white bumps under my eyes are called syringoma. They are different than milia. Not a lot options to remove them. Deb, have to heard of any products for syringoma? Thanks

  19. Hi, please can someone who has had milia professionally extracted let me know if this has left a permanent mark or scar? Or if this mark/scar does go away, how long does it take?

    There are a lot of recommendations suggesting it is best to treat it by extraction by a dermatologist, but I have also read that extraction is really bad for the skin…
    http://theskiny.com/extractions-facials/

    Please can someone tell me the aftermath of the area after extraction.

    Thanks.

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