Scrub for Milia: Should You Use It or Avoid It? Quick Guide

Quick Summary

• Scrubs, however, are not effective for the removal of existing milia: Milia are small cysts filled with keratin and are not dirt on the skin, nor are they ordinary whiteheads.
• Avoid harsh physical scrubs, especially around the eyes, as they can irritate, dry, and damage the skin barrier with redness.
• A chemical peel that is gentle may help to prevent future development by encouraging healthy skin cell turnover, but it's best to start slowly and not peel aggressively.
• It can be dangerous to pick, squeeze, or scrape milia at home, as this can lead to scarring, dark marks, and infection.
• Stubborn milia or those in or around the eyes should be treated by a dermatologist, who can remove them safely with sterile instruments or suggest appropriate treatments like retinoids.
• True, milia can be quite annoying because they closely resemble small whiteheads, but are not the same as common pimples. Many people think that a face scrub will “dig out” the trapped substance, but this is not the case with milia.
• Although there may be a temporary improvement in the smoothness of the skin, the scrub won't actually eliminate the milia. In reality, scrubbing too hard can irritate the skin, break down the skin barrier, and make the skin more sensitive in the area scrubbed. The better way to do this is to treat the skin gently, gently exfoliate if necessary, and get professional removal if that bump persists.

What Are Milia?

Milia are small, white or yellowish bumps that are caused by the accumulation of keratin under the skin. Keratin is the naturally occurring protein in the skin, hair, and nails.

They are most frequently seen around the:

• Eyes
• Cheeks
• Nose
• Forehead
• Lips
• Chin

Most milia are harmless, but can be a cosmetic nuisance. They're not blackheads, whiteheads or acne, and that's why squeezing or scrubbing them typically isn't the solution.

Can a Scrub Remove Milia?

A scrub is not likely to help remove the existing milia as the trapped keratin is below the surface of the skin. While scrubs can only work on the top layer, they can remove dead skin cells; however, they cannot open up or remove a cyst safely if it exists under the top layer of skin.

• Milia may become aggravated by using an abrasive scrub.
• Redness and burning
• Dryness and flakiness
• Skin irritation
• Tears in the skin that are too small to be seen without a microscope
• Post-inflammatory dark marks
• Increased sensitivity, especially around the eyes

This is particularly important for milia on or around the eyelids or under the eyes, where the skin is very light and sensitive, and scrubs can aggravate the milia.

In one study of 561 full-term newborns, 31.4% of the babies were diagnosed with milia, a finding that supports the case that milia result from the keratin cyst structure embedded in the skin, and not from surface debris that can be scrubbed off.

Should You Use a Scrub for Milia or Avoid It?

Avoid harsh physical scrubs on milia, such as walnut shell, sugar crystals, apricot particles or coarse beads.

A mild buffing agent might over time clear away the accumulation of dead skin cells and facilitate healthier skin renewal; it can't be used too aggressively, though. Prevention and progressive improvement are the goals, not friction to bring out the milia.

The simple answer: If your skin can handle it, use gentle exfoliation, but never scrub milia aggressively and never scrub in a rough manner.

Why Scrubbing Milia Can Make Things Worse?

The secondary milia were examined under the microscope, and the results showed that, out of 69 milia arising after blistering, 52 lesions (75.4%) were identified as being connected to eccrine sweat ducts, and one lesion (1.5%) was identified as being connected to a hair follicle.

This is a good reminder that milia is not surface dirt! Caused by keratin trapped under the skin. Rubbing too hard can irritate the area around the bump but fail to affect the bump itself.

Over-scrubbing can also damage the skin barrier. If the barrier is broken, the skin may be dry, flaky, red, or inflamed. Many then use heavier creams to try to ease that dryness, and heavier cream can actually help to clog up even more, making milia look worse.

This leads to an irritating cycle: scrubs irritate skin → skin dries out → more cream is used to moisturize it → skin feels even thicker → milia become more prominent.

Can Gentle Scrubbing Ever Help Prevent Milia?

A human skin study reported that twice-daily application of a 4% glycolic acid formulation for 3 weeks was not enough to break open the barrier at that concentration, but did loosen the “glue” between the outer dead skin cells; transepidermal water loss was not altered.

However, although it cannot clear away existing milia, very gentle, regular exfoliation may help to decrease the risk of new milia developing, as it helps to promote the natural exfoliation of dead skin cells and prevent buildup on the surface.

The trick is to make it simple and non-irritating. If you choose to scrub, it is best to use very fine and smooth particles and do this no more than once a week, and not around the eye area.

If you have sensitive or easily irritated skin, it may be better to avoid physical scrubs altogether and choose mild chemical exfoliants instead. The ultimate aim is to promote good cell regeneration without causing inflammation or damaging the barrier.

Better Alternatives to Scrubs for Milia

Don't grab the hard scrub, here are some less abrasive and more effective options.

1. Use a Mild Cleanser

Wash face 1-2 times a day using a mild cleanser. Don't use strong scented products, stripping cleansers or harsh soaps. While normal skin allows for natural cell exfoliation, harsh exfoliation will not help the skin get rid of milia.

2. Try Gentle Chemical Exfoliation

Chemical exfoliants typically do not require friction, and are thus generally preferable to physical scrubs. Lactic acid, glycolic acid, or salicylic acid might soften the skin and gently exfoliate the epidermis over time.

Introduce them gradually (one or two times per week is a good amount to start) and don't apply two or more exfoliating acids at the same time.

In one clinical study, it was found that L-lactic acid stimulated the keratinocytes to produce 300% more ceramide, while D-lactic acid stimulated 100% more ceramide. L-lactic acid, when applied to living skin, also increased the level of ceramide in the stratum corneum by 48%, indicating that, in addition to its exfoliating effects, it is also of benefit for maintaining skin barrier function.

3. Consider Retinoids

Retinoids may help to regulate the rate at which skin cells grow and shed, and help decrease the conditions leading to plugging. Depending on your skin and the degree of concern, you can use an over-the-counter adapalene or a tretinoin that is prescribed by your dermatologist.

Retinoids should be introduced gradually, as they can initially cause dryness and irritation. They should also not be used in the eye area, unless a dermatologist has explicitly advised to do so.

A published pediatric case report reported that at the time of writing, there were only nine pediatric cases of milia en plaque reported. Of these, one seven-year-old boy with nasal milia en plaque was successfully treated topically with tretinoin, a testament to the versatility of retinoids even in more complicated presentations.

4. Choose Lightweight Moisturizers

Creams and balms that are too thick for the skin don't work for milia-prone skin, especially on the face. Use lightweight moisturizers that are non-comedogenic and will give sufficient moisturization without being greasy or occlusive.

5. Wear Sunscreen Daily

A thickened, rougher, and slower turnover in the skin may be caused by sun damage and may lead to milia. A daily sun protection cream helps maintain a healthy barrier function and is especially vital if you're using exfoliating acids or retinoids, which can make your skin more sensitive to the sun.

What Not to Do With Milia?

Here are some pitfalls to steer clear of with milia:

• Avoid hard scrubbing of the area
• Avoid picking, scratching, or irritating the bumps
• Do not squeeze them as you would a pimple
• NEVER try to remove at home with needles or sharp objects
• Avoid strong acids around or near the eyes
• Avoid mixing multiple actives in the same regimen.
• Not all small white bumps are milia; make sure to assess them first.

Trying to pick the milia on their own may result in scarring, infection, or permanent dark spots (especially on delicate skin).

When Should You See a Dermatologist?

If you notice any of the following, it is time to see a dermatologist:

• Milia are found close to or on the eyelids
• The bumps are spreading or are becoming more numerous
• They are painful, red, or obviously swollen
• You're not sure if the bumps are milia or not
• Despite months of consistent skin care, they haven't improved.
• Safe removal with no scarring, professionally done, is desired.

Milia can be removed by a dermatologist in a controlled environment with sterile instruments, which is much safer and more effective than the idea of trying to scrub or squeeze them at home.

Best Skincare Routine for Milia-Prone Skin

The best routine is a simple one:

• Morning
• Gentle cleanser
• Lightweight, non-comedogenic moisturizer
• Broad-spectrum sunscreen
• Night
• Gentle cleanser
• Effortless chemical peel or retinoid on designated nights
• Lightweight moisturizer

Exfoliating acids and retinoids shouldn't be used together on a nightly basis unless your skin is already acclimated to both and you've been instructed by your dermatologist.

Final Verdict: Should You Use a Scrub for Milia?

Scrubbing is not an effective remedy for milia. Avoid any harsh physical scrubs as they can irritate and inflame the skin, but won't make any real impact on the bumps.

Using gentle exfoliation is helpful in preventing further milia formation by diminishing dead skin cells, but it will not guarantee to remove existing milia. Professional milia removal by a dermatologist is the safest and best way to treat stubborn or persistent milia.

The only effective remedy is to be gentle, not to scrub excessively, to make sure to use light products, to use sunscreen every day, and to get the advice of a professional if the milia is not improving over time.

FAQs About Scrubs for Milia

1. Can a face scrub remove milia?

Unlikely. Milia are actually under the skin's surface and not on top of it, so scrubbing to remove the dead top layer of skin may help, but will not remove the trapped cyst beneath.

2. Is it okay to use a physical scrub on milia?

Hard physical scrubs are generally not recommended. Coarse particles may irritate the skin and make it red, and can disrupt the skin barrier, especially when located on the face or around the eyes.

3. Why do some people on Reddit say scrubs worked for their milia?

A few people have reported better results, as gentle rubbing over time can help remove surface buildup. However, rough scrubbing can actually be very irritating and is not an effective or safe cure for milia.

4. Is chemical exfoliation better than a scrub for milia?

Yes. In most cases, a gentle chemical exfoliation is preferable. Other ingredients such as lactic acid, glycolic acid, or salicylic acid can help promote skin cell turnover without the rubbing and micro-damages of a physical scrub.

5. Can I use glycolic acid for milia?

Over time, glycolic acid can help to prevent dead skin cells from building up and help to improve the texture of the skin. Use sparingly, just a few times a week, and not too near the eye area.

6. Can salicylic acid help with milia?

Though salicylic acid may benefit oily skin and acne, it's important to note that milia is not acne. It can possibly help to prevent future accumulations, but likely won't remove existing milia in a rapid and effective manner.

7. Should I scrub milia under my eyes?

No. The skin under and around the eyes is thin and sensitive. It is very easy to irritate, dry out, or harm this area through physical exfoliation, so that shouldn't be done.

8. Can heavy eye creams cause milia?

Thick or occlusive eye creams can help to build up the film that can lead to the formation of milia for some. When it comes to eye products, it's better to use a light product, or a gel product, or a non-comedogenic product if you tend to develop milia.

9. Can retinol help with milia?

Retinol or prescription retinoids might be helpful for this, as they speed up the turnover of skin cells and could be useful in prevention. They can be dry and irritating, especially around the eyes and should be introduced slowly and carefully.

10. Can I pop milia like a whitehead?

Because the milia are not connected to an open pore, squeezing will not help, and could lead to the development of inflammation, scarring, infection, or dark spots that do not go away.

11. How long does it take for milia to go away with exfoliation?

Some milia may not go away with skin care and can take several weeks to months. Any gentle exfoliation can help prevent new bumps from forming, but often, existing bumps are too stubborn to remove, and you will need to visit your professional for the job.

12. What is the safest way to remove milia?

Extraction by a dermatologist is the safest choice. A trained professional will be able to open and clear the milia using sterile equipment and with little risk of damage to the skin surrounding the milia.

13. Should I stop exfoliating if my milia gets worse?

Yes. If it causes the skin to become red, dry, tight, flaky, burning or more irritated, stop exfoliating and take it easy. However, it can make milia (and skin in general) more of an issue if it is over-exfoliated, which breaks down the barrier function of the skin.

14. What skincare routine is best for milia-prone skin?

A mild cleanser, light moisturizer, daily use of sunscreen, and mild exfoliation as needed. Don't use thick creams, rough scrubs, or apply many active ingredients at once.

15. When should I see a dermatologist for milia?

If milia are near the eyes, persist, or increase in number or fail to clear up with mild skin care after a few months, consult a healthcare provider. Professional extraction will always be safer and more reliable than a homemade extraction.