Milia
Milia are small, white or yellowish bumps that appear just beneath the surface of the skin. They are tiny cysts filled with keratin, a protein found in the outer layer of the skin.
These bumps are harmless and commonly appear on the face, particularly around the eyes, cheeks and nose.
Milia can affect people of all ages, from newborn babies to adults, and are often a cosmetic concern rather than a medical issue.
At The London Skin and Hair Clinic, Consultant Dermatologists assess milia to confirm the diagnosis and advise on appropriate management. Patients seeking specialist dermatology advice in London can access expert assessment and guidance.
Milia are sometimes called mil spots in babies or children
Neonatal milia affects 40-50% of babies of all ethnicities and gender
Dermatologists tend to advise not treating milia in babies
Dermatologists ‘de-roof’ milia in adults with a hypodermic needle
What causes Milia?
Milia develop when keratin becomes trapped beneath the surface of the skin.
They can be classified as either primary or secondary:
- Primary milia occur spontaneously, often due to blocked hair follicles
- Secondary milia develop following skin damage or inflammation
Common causes of milia include:
- skin trauma such as burns or blistering conditions
- use of heavy or occlusive skincare products
- long-term sun damage
Neonatal milia are very common in newborns and occur due to immature skin structures. These usually resolve on their own without treatment.
Who is at risk of Milia?
Milia can affect people of all ages.
Newborn babies are commonly affected, with a large proportion developing milia shortly after birth.
In adults, milia are more likely to occur:
- on the face, particularly around the eyes
- in individuals using heavy skincare products
- following skin injury or inflammation
Certain rare forms of milia may be associated with underlying skin conditions.
What are the symptoms of Milia?
Milia appear as small, firm, white or yellowish bumps beneath the skin.
They are typically:
- smooth and dome-shaped
- painless and non-itchy
- found in clusters
Primary milia most commonly occur on the face, particularly around the eyelids, cheeks and nose.
Secondary milia appear at the site of previous skin damage and may occur anywhere on the body.
Milia symptoms are usually limited to their appearance, although in rare cases certain types may cause mild irritation or itching.
Images of Milia
These images are kindly provided by DermNetNZ.org for non-commercial use, for the purpose of education and information. The images have not been modified and DermNetNZ do not endorse The London Skin and Hair Clinic. You can find a copy of the license at http://creativecommons.org/licenses/by-nc-nd/3.0/nz/.
How does a dermatologist diagnose Milia?
A dermatologist will usually diagnose milia through clinical examination.
The appearance of milia is typically distinctive and allows for a straightforward diagnosis.
In rare cases, particularly if the diagnosis is uncertain, a skin biopsy may be performed to confirm the condition.
How is Milia treated and managed?
Milia are harmless and do not always require treatment, particularly in babies where they often resolve spontaneously.
In adults, treatment may be considered for cosmetic reasons.
Management options may include:
- manual extraction (often referred to as de-roofing)
- use of fine needle or specialised techniques to remove the cyst
- other dermatological procedures where appropriate
Milia cannot usually be removed using standard comedone extraction techniques, as they sit deeper within the skin.
Professional treatment by a dermatologist is recommended to minimise skin trauma and achieve the best cosmetic outcome.