Milia: everything you need to know about those little white bumps on your skin

Milia are those small white bumps that appear on the skin that could easily be mistaken for whiteheads. However, they are in fact small cysts containing the protein keratin. They develop when clumps of dead skin cells get trapped below the skin and form hard white balls. The light colour has given them the nickname ‘milk spots’, which you might be familiar with as you often find them on babies.

To understand a bit more about these little spots and what can be done to remove and prevent them, we spoke to Dr Anita Sturnham, a GP and skin expert.

What do Milia look like?

‘Milia are typically white lesions, but can be yellow and red when irritated and inflamed,’ says Dr Sturnham. ‘They’re typically 1-2 mm diameter, uniform and spherical protruding from just under the skin surface.’

Why do Milia appear?

‘Milia are commonly found in both children and adults, and there are different types,’ explains Dr Sturnham. ‘They can either appear spontaneously, as in there is no obvious reason or trigger for them appearing, or they can be triggered by any form of trauma to the skin. Clinical studies have identified Milia as being linked to some genetically triggered skin conditions too.’

Milia are normally grouped into three categories…

Primary Milia – those that appear for no obvious reason

‘Within this category there are congenital Milia, which occur in up to 50% of newborns on the face (especially the nose), scalp and upper body, says Dr Sturnham. ‘These are harmless and tend to resolve themselves within weeks without treatment.

‘There’s also Eruptive Milia, which are larger groups of Milia that appear slowly and are most commonly found in younger women and are thought to be triggered by UV exposure.

‘And finally, Milia en plaque, a rare form, which can appear on adult skin. It occurs on red, swollen and inflamed skin, usually around the ears and eye regions.’

Secondary Milia

Secondary Milia is caused by damage to the skin.

‘The trigger can be any mechanical trauma (things like a strong laser or abrasive skin treatment), which creates an abnormal healing process leading to accumulation of keratin under the skin,’ she says. ‘Rather than developing in the sebaceous, oil-producing glands they can appear in the sweat glands (also known as eccrine glands).’

How can you treat them?

‘When I assess adult skin with Milia I do a full review of their skincare products and take away any harsh formulations, mechanical scrubs and heavily silicone and fragrance loaded products,’ explains Dr Sturnham. ‘I then recommend a gentle Alpha Hydroxy Acid (AHA) and Beta Hydroxy Acid (BHA) Cleanser duo at night, and using cream or clay-based products with ingredients such as Lactic acid, glycolic acid and Salicylic acid. I’d also integrate a fruit acid and fruit enzyme mask once a week to reduce the build up of oil and keratin clogging the pores.’

In the clinic, we treat Milia with extractions, Hydrafacial and NDyag laser to help to eliminate them safely.

Can you pop a Milia?

‘No. I always tell my patients not to pop them, as this can make things so much worse.’ warns Dr Sturnham.

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