Milia: You might not ever have heard of them, but we can almost guarantee you’ve seen them. Ever wondered why those pesky hard whiteheads won’t disappear? Well, chances are they're not whiteheads or any form of acne at all; they’re actually milia — sometimes referred to as milk spots.
While they most commonly crop up around the eye area — and can be so tiny you might not even have noticed them — they can actually appear in various places, including your body. You can have one or a few at a time, and they can give the appearance of an uneven texture to the skin.
Once there, milia can be seriously hard to eliminate, especially near the delicate eye area. Despite the fact they don’t really mean any harm, anything that sits on your face for months (years, even) without any sign of budging can be incredibly irritating.
Luckily, it turns out that preventing milia is actually relatively easy, provided you know what you’re doing. To help get navigate the world of these tiny but annoying spots, we’ve enlisted the help of a few experts to reveal exactly what milia are and what to do if you’re looking to get rid of them once and for all.
What are milia?
When it comes to getting to the bottom of any skin issue, it’s useful to know the problem inside out. Milia are small white or yellowish cysts that are made of keratin. “Keratin is a protein that’s contained in the outermost layer of the skin called the stratum corneum, and when debris is trapped beneath the surface of the skin, milia (keratin-filled cysts) are formed,” Dr Ash Soni plastic surgeon and founder of The Soni Clinic tells Glamour.
“Like tiny cysts, they are formed from debris such as sebum (the natural oil we produce to lubricate our skin) and accumulated dead cells becoming trapped in the pores,” adds Lesley Reynolds, co-founder of the Harley Street Skin Clinic.
Typically, you can expect them to appear near the eyes, cheeks and nose in small clusters. But “you can also find them on your lips; often the lipstick edge (called the vermillion border),” says Spirithoula Koukoufikis, senior medical aesthetician at Skinfluencer.
What causes milia?
The bad news is, unlike other forms of cysts and spots, milia have the ability to occur totally out of the blue. However, some people are more prone to milia than others. People with oilier skin types might be more prone to milia due to the overproduction of sebum. In addition to this, “the changes in skin that happen from years of chronic sun damage seem to promote milia formation for predisposed people — another good reason to use sunscreen,” explains Spirithoula.
Likewise, milia can occur in absolutely anyone and everyone. While they are known to appear a lot on the skin of babies, they can (and do) occur in adults of all ages, sexes, and skin colours.
Despite this, there are certain things that are known to spur milia on. Fans of thick, nourishing face and eye creams might want to consider lighter alternatives should they be prone to milia. Lesley reveals: “Milia can be caused or exacerbated by the regular use of thick face cream, which will initially clog the pores and provide a stick trap.” Spirithoula echoes this, adding “comedogenic creams and lotions may prevent the sloughing of dead epidermal skin cells,” which leads to these teeny tiny cysts forming.
Can stress cause milia?
Internal stress can certainly impact how your skin acts and behaves, but it won't cause milia per se. Stress to the skin could, though. “Certain individuals may experience milia as a result of skin trauma and in uncommon instances, they may occur following the application of topical medications like corticosteroids,” says Dr Vahe Karimyan, plastic surgeon and medical director.
How to get rid of milia
OK, let’s clear something up straight away. DO. NOT. TRY. THIS. AT. HOME. Milk spots are seriously stubborn little guys, and any attempts to get rid of milia at home could lead to infection, scarring or further issues. “I cannot stress enough that milia removal needs a professional, especially if they are located on an eyelid or near the eyes,” warns Lesley. “Do not attempt to remove them yourself. Go to a skin or aesthetic clinic where the practitioner knows what they are doing,” she adds.
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Removal in a clinic is quick and relatively painless; we’re talking lower or perhaps on the same level as skin extractions. Plus, it’s over and done with in minutes, depending on how many you have to treat. “Using a sterile needle, a dermatologist can “de-roof” the milia,” says Dr Soni. There is little to no downtime, but it’s advised to avoid long periods of direct exposure to the sun, wear SPF 30+ (which you should ideally be doing every day regardless), and avoid any acid-heavy skincare for a few days. If you have any questions or concerns, be sure to ask your practitioner.
Can you pop milia?
It's a hard no from us and a hard no from the experts. “You should avoid popping milia as doing so can lead to skin irritation and potential harm to the delicate skin in that region,” says Dr Vahe. The best advice is consult your doctor or dermatologist, and they can prescribe the best course of action.
How to prevent or avoid milia
“Unfortunately, nothing absolutely prevents milia from forming if you’re prone to them, but they can be treated quickly and easily”, explains Spirithoula.
Exfoliation is a key way to prevent milia. This can be tricky with the eye area, which obviously needs delicate care, however, if you have milia on the nose or cheek area, it is possible to use an acid treatment to hurry up the life cycle although have realistic expectations if you're doing this at home. “A dermatologist might suggest a chemical peel treatment but it's vital to note that non-prescription exfoliating products are unlikely to eliminate milia beneath the eyes,” explains Dr Vahe. “Typical active components in chemical peels comprise lactic acid, glycolic acid and salicylic acid and is why exercising extra caution is crucial since the under-eye region where milia often occur, is highly sensitive.”
A retinoid can also work to prevent and treat milia through a speed up in skin cell renewal. Although, again, there are sadly no products that can entirely promise to prevent milia and the only sure way of treatment is removal.
Something else you might want to consider if you’re prone to milia is your heavy moisturisers and eye creams. “Instead of using heavy moisturisers, look for lighter products that won't block pores. The main ingredient culprits in heavy creams are mineral oil and lanolin, which are both brilliant for dry skin but unhelpful for milia,” says Lesley.
If you’re particularly prone to milia, you may want to avoid any eye products that contain ingredients listed as the following: liquid paraffin, liquid petroleum, paraffin oil, liquid paraffin, petrolatum liquid, petroleum oil and lanolin, she adds.
Best skincare products for milia prevention
As mentioned before, “there’s no way of preventing milia from coming back entirely,” says Dr Soni, not even skincare. However, a skincare routine that includes regular exfoliation can reduce the chances of milia forming by gently removing the dead skin cells from the top layer of skin, and a lightweight cream gives all the moisture you need without running the risk of being pore-clogging.
“Using a glycolic treatment such as Neostrata Resurface Smooth Surface Daily Peel for several months can help to dissolve the dead skin debris and eventually cause the milia to flake away. However, make sure you do not do this on the eyelids or too close to the eyes,” says Lesley.
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Medik8 Press & Clear Exfoliating 2% BHA Tonic gently clarifies and decongests the skin without damaging your skin barrier, thanks to its blend of salicylic acid and polylysine. Super sensitive? Paula’s Choice Calm 1% BHA Sensitive Skin Exfoliant is an even more gentle version of its cult fave 2% BHA Exfoliant.
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Retinol helps with accelerating skin cell turnover, preventing keratin from building up and preventing milia from forming. Beauty Pie Super Retinol Anti-wrinkle Eye Cream and The Inkey List Retinol Serum are both gentle introductions to the ingredient, but as always, use with caution around the eye area, where the skin is thinnest and therefore, most sensitive.
Finally, a lightweight eye cream – like Avène Soothing Eye Contour Cream – is perfect for preventing milia by keeping the skin hydrated and decongested.
