What Causes Milia? Main Reasons and Prevention Explained

Quick Summary

• Milia are caused by the blockage of keratin underneath the skin. A natural protein called keratin is present in the skin, but if the dead cells do not shed effectively, small white or yellowish bumps may form.
• Milia can be caused by heavy skin care products. Thick eye cream, oily balm, rich moisturizers, and greasy suncreams will tend to promote buildup, especially around the eyes and cheeks.
• Milia can also occur when the skin is damaged. Secondary milia can occur when the skin heals after burns, blisters, rashes, sun damage, or laser treatments.
• Milia is not acne or [whiteheads](/blogs/what-are-milia-bumps). They are not caused by too much oil or bacteria; squeezing or using regular acne treatments will not clear them up.
• The key to prevention is to do gentle, regular skin care. Lightweight products, thorough cleansing, gentle exfoliation, daily use of a sunscreen, and refraining from picking and squeezing the bumps can all help.
• Milia are commonly small white or yellowish bumps resulting from trapped keratin, a natural protein in the skin, hair, and nails. If the dead skin cells do not shed properly, they can build up beneath the skin and cause small bump-like growths to develop.
• Although milia are generally harmless, they can be annoying as they may appear to be whiteheads and can be treated as acne. They are frequently seen around the eyes, cheeks, nose, forehead, and lips, and sometimes other parts of the body.
• The key to understanding milia is knowing what causes them, so you can take the best possible care of your skin to minimize the chance of milia occurring or recurring.

What Are Milia?

Milia are little cysts under the skin filled with keratin. Unlike pimples or clogged pores, or blackheads, that's why standard acne treatments have little effect on them.

A whitehead occurs when oil, bacteria and dead cells clog a pore. Milia are caused by keratin trapped under a thin layer of skin. They are generally not red, unless the surrounding skin is irritated, they are firm and white or pale yellow.

Babies, children and adults can all have milia. In new-borns they often clear up spontaneously. Their symptoms may last longer in adults and may return if the condition is not treated.

Milia are very common, with a study of inclusion cysts of the oral cavity and face revealing 31.4% of newborns had milia.

Main Causes of Milia

1. Trapped Dead Skin Cells

Usually, milia are caused by the failure to shed completely dead skin cells. Over time, the skin is replaced, but if old skin does not shed off, new skin can form over it, trapping keratin beneath, which results in a small, hard bump just under the skin's surface.

This is how milia often occur, especially in the thin and delicate skin around the eyes or on the cheeks.

The basic dermatology research has shown that the milia are small, cyst-like formations and are in relation to the skin appendages and not ordinary pimples.

2. Heavy or Occlusive Skincare Products

Some people may be more prone to developing milia, for example, from the use of thick creams, heavy moisturizers, oily balms, and rich eye creams. These products can be pore cloggers that can collect dead skin and keratin below the surface.

This does not imply that each moisturizer will result in the formation of milia. This can usually be a problem with the product being too heavy for the skin type or when applied too thickly in sensitive areas.

Some triggers that may be related to the product include:

• Thick eye creams
• Heavy facial oils
• Ointments or balms that are sticky or greasy
• Rich night creams
• Excessive sunscreen that isn't completely washed off thoroughly throughout the day.

Comedogenic makeup or concealer

If milia do present as part of a new product, it might be a factor to consider and reconsider.

3. Slow Skin Cell Turnover

Some people naturally exfoliate their dead skin at a slower pace. If this renewal process slows down, then the dead cells will sit on the surface for longer and are more likely to become trapped under new skin growth.

Slow turnover can be due to age, dry skin, genetics, lack of exfoliation, or use of products that don't encourage healthy skin turnover. This is why milia are common in adults, particularly around the eyes, cheeks, and forehead.

4. Skin Damage or Injury

Milia may occur after damage to the skin (secondary milia). They happen during the healing process of the skin when keratin gets trapped in the healing process.

Secondary milia may appear following:

• Burns or blisters
• Rashes or trauma to the skin
• Sun damage
• Laser or chemical peels
• Dermabrasion
• Prolonged skin irritation

Researchers studied 69 post-blistering milia in eight patients, of which 52 (75.4%) were related to eccrine sweat ducts, showing the strong association between milia formation and the healing process following dermatologic trauma.

5. Sun Damage

Any excess exposure to the sun will thicken, toughen, and reduce the skin's ability to shed dead skin efficiently. This causes conditions for keratins to become trapped under the surface over time.

Sun damage can also accentuate existing milia through a change in the general skin texture. Even when not directly caused by UV exposure alone, this is the reason why it is recommended to use sunscreen every day.

6. Using the Wrong Eye Cream

Milia around the eyes are especially prevalent, as this area of skin is thin and more prone to product accumulation. Sometimes, the thicker eye cream formulations may be too occlusive for this area.

If milia occur under the eyes, consider seeking a less heavy, oilier, or slower-absorbing eye cream. A non-comedogenic formula with light-weight consistency is better. Using small amounts and avoiding the use on the lash line can also help.

Another point to consider is that topical steroids have been recognized as a cause of milia. One case report of a 5-year-old girl who had localized milia on her ear after the use of topical steroids was published.

7. Lack of Gentle Exfoliation

If dead skin is not cleared away regularly, it can build up on the surface, increasing the likelihood of milia (especially if an individual is already predisposed to slower skin turnover).

Gently brushing off the skin on a regular basis can help to prevent premature skin loss. But if the scrubbing is too vigorous, it can make the situation even worse, irritating the skin and disrupting the skin barrier. Avoid rough towels, coarse scrubs, and harsh scrubs. It's not to try to take the bumps off, it's to stimulate healthy skin regrowth.

8. Genetics and Skin Type

Some people are just more susceptible to the development of milia. Even with the right skin care regimen, if you tend to accumulate keratin in your skin, there is a chance that you will get bumps.

Milia may be more visible in those with dry, sensitive, or thicker skin. Genetics may also be a factor, and if milia keeps recurring without any apparent cause.

9. Certain Skin Conditions

Sometimes, milia develops in conjunction with skin conditions that slow down healing, blisters, and cell turnover, and may be seen after inflammatory skin conditions, when the skin barrier is broken.

When milia suddenly appear in great numbers, spread quickly or are associated with other skin changes such as redness or pain, it is important to see a dermatologist as soon as possible.

10. Trying to Pop or Pick the Bumps

Unlike acne, milia does not have an open pore, so squeezing will never help, and it may actually lead to further issues. Scratching can lead to redness, dark marks, and further irritation, even more bumps may form nearby.

If the person tries to pull it out at home using needles or other sharp objects, there is a risk of infection and scarring. If the milia are not going away, it is always best to have them professionally removed by a trained dermatologist.

How Can You Prevent Milia?

You cannot always prevent milia completely, especially if you are naturally prone to them. However, the right skincare habits can reduce the chance of new bumps forming.

1. Use Lightweight Skincare Products

It's not always possible to avoid milia completely, especially if you're prone to them, but there are some skin care practices that can make a difference in your likelihood of new milia forming.

Use lightweight skin care products.

Opt for products that absorb well and won't leave a greasy film on the skin. Check the labels for:

• Non-comedogenic
• Oil-free
• Lightweight
• Gel-based
• Don't use fragrance if your skin is sensitive
• When using eye cream, use sparingly or a light cream; avoid heavy or sticky eye balms, especially for the eye area.

2. Cleanse Your Skin Properly

The deep cleanse helps to clear all sunscreen, makeup, oils, and product buildup that can mix with the dead skin cells and cause congestion.

Cleanse your skin one or two times a day with a mild cleanser, depending on your skin type. For those who wear foundation, sunscreen or other cosmetic products, double-cleaning at night can help make sure the skin is completely clear before sleeping.

It is to be noted that milia are most frequently seen on the face. A study of 1000 consecutive newborns revealed that 16.6% of babies had cutaneous milia, which were most common on the cheeks, chin, and forehead and were present during the first 3 days of life.

3. Exfoliate Gently

Regular gentle scrubbing will help to get rid of dead skin cells before they can get caught. While a physical scrub can cause friction damage, chemical exfoliants are usually more effective in evenly distributing the product over the skin's surface.

Some helpful ingredients might be:

• Lactic acid
• Glycolic acid
• Mandelic acid
• Polyhydroxy acids
• Salicylic acid, especially if you have oily or acne-prone skin
• Start gradually, such as once or twice a week. Excessive peeling can irritate the skin by breaking the barrier.

4. Consider Retinoids

Retinoids help maintain a healthy turnover of skin cells and can help prevent future milia in time if you have persistent milia in adulthood.

Retinoids may irritate the skin upon initial application, so consider beginning with the lowest strength option and applying only a couple of nights a week. Do not use highly active retinoids directly adjacent to the eye area without the dermatologist's counsel. Pregnant women or breastfeeding women should seek medical advice before using retinoids.

5. Wear Sunscreen Daily

Using a daily sunscreen will help prevent damage from the sun's UV rays, as well as changes to the texture of the skin and damage to the repair mechanisms that can be factors in milia development. Use a lightweight formula that isn't too heavy or greasy.

Make sure you remove all sun cream every night - sunscreen is often the cause of milia if it is left to build up overnight.

6. Avoid Heavy Products Around the Eyes

The eye area is one of the most affected regions for milia and should be taken into special consideration:

• Use just a rice-sized amount of eye cream.
• Don't apply heavy formulas too near the lash line
• Cleanse off concealer and sunscreen thoroughly every night.
• Use a lighter eyed product if they continue to form in this area.

7. Do Not Pick or Squeeze Milia

It is usually not possible to squeeze milia, since they are located beneath the skin without an open pore, and squeezing can lead to irritation, dark marks, and scarring.

When a bump is stubborn or a hassle, the proper action is to seek the counsel of a dermatologist or trained skincare professional to safely have a bump professionally removed.

8. Keep Your Routine Simple

It can be difficult to determine the cause of milia or what products may be irritating or aggravating it if too many products are used at the same time. A more streamlined process works better:

Afternoon: Oil-free powdered veil → Spot treatment (if necessary) → Cover-up powder

Morning: Gentle exfoliant or retinoid daily → Lightweight moisturizer

Don't apply too many rich creams, facial oils, and balms unless your skin type really needs them.

Can Milia Go Away on Their Own?

Milia may clear up on its own, especially in infants and young children. In adults, however, they can last for months if the trapped keratin does not come to the surface.

Surface-level milia may improve over time with simple exfoliation and good skin care. Stubborn or deeper milia, however, will usually need to be professionally extracted to be completely resolved.

When Should You See a Dermatologist?

It's a good idea to see a dermatologist if:

• The bumps are near the eyes
• They cause pain, are red, or swollen.
• Their growth rate is greater than anticipated
• You're not sure if they are milia or another type of lesion
• They won't go away even after you change your skin care products
• No improvement with at-home care
• You need a safe and professional removal without scarring issues

A dermatologist will be able to confirm the diagnosis and suggest the best and most effective treatment options for your case.

Final Thoughts

The main cause of milia is due to dead skin cells and trapped keratin underneath the skin's surface. Not a type of acne and cannot usually be solved by squeezing or popping.

Some of the most frequent causes of dry skin are due to slow turnover of skin cells, heavy or occlusive skin care products, sun damage, skin injury, and application of heavy cream around the eyes or other sensitive areas. Prevention involves careful washing, using light products, scrubbing lightly, sun protection, and avoiding picking or squeezing.

Professional removal is still the safest and sure bet should the milia not go away, or if in a sensitive area.

Frequently Asked Questions (FAQs): Causes of Milia

1. What actually causes milia?

The skin gets milia when the keratin stays in the skin, usually when there is a lack of shedding of dead skin, and the new skin growth traps the keratin.

2. Can heavy moisturizers cause milia?

Yes - in some people, especially people with milia-prone skin. Thick, greasy, or slow-absorbing formulas are the most likely to contribute. One of the first things to do is to change to light non-comedogenic alternatives.

3. Can Vaseline cause milia around the eyes?

However, whilst not directly causing milia in all, the highly occlusive nature of Vaseline can cause a buildup around the eyes in those prone to milia.

4. Why do I keep getting milia under my eyes?

Keratin can become trapped in the skin under the eyes, as it's that part of the skin that is very thin and delicate. Common causes are heavy eye cream, oily products, lack of proper eye cleaning, and slow cell turnover.

5. Are milia the same as whiteheads?

No. Whiteheads develop within pores as a result of the build-up of oil and dead skin cells. Unlike acne, milia do not react to squeezing techniques and are cysts filled with keratin, which are sealed below the surface of the skin.

6. Can retinol cause milia?

Retinol is mainly used in skin turnover, and with repeated application, it may prevent milia. But, at times, these bumps may look more noticeable as an initial reaction to a new retinol formulation. Start gradually and don't apply near the eye area.

7. Does exfoliation help prevent milia?

Yes, but gentle and regular exfoliation will help, as it will reduce the build-up of dead skin cells. Avoid using harsh physical scrubs, as this can damage the barrier and aggravate irritation.

8. Can sunscreen cause milia?

Some heavy or greasy sunscreen formulations can also help to cause milia if they aren't thoroughly cleaned off at the end of the day. This can be avoided by using a light sun cream and cleansing properly every night.

9. Can I pop milia at home?

No. Since milia are under the skin and do not have an open pore, squeezing them will not help and may lead to irritation, infection, dark marks, or permanent scarring.

10. Do pimple patches work on milia?

Pimple patches won't work on milia because milia is not an open lesion. They may serve as a physical deterrent and discourage picking, but they will not break down or remove the keratin that is trapped.

11. Can milia go away on their own?

Some do, although adult milia may last for months. For those that are recurring, stubborn, or close to the eyes, professional removal is the better and safer choice.

12. What skincare products should I avoid if I get milia?

Do not use extremely thick eye creams, facial oils, occlusive balms, or heavy moisturizers that lie on the skin. Instead, use lighter, non-comedogenic products.

13. What ingredients may help prevent milia?

Ingredients that promote healthy cell turnover, like gentle AHAs, BHAs, PHAs, and retinoids, may help prevent the occurrence of milia. Be careful and don't over-exfoliate.

14. Why did milia appear after changing my skincare routine?

You may have a skin type sensitive to a newly introduced product that is too heavy, occlusive, or irritating. If milia appeared after using a new cream, sunscreen, oil, or retinol, stop using it and keep an eye on the skin to help pinpoint the cause.

15. When should I see a dermatologist for milia?

If milia are growing or are near the eyes, or are painful or inflamed, or are not improving despite changing your skincare products, consult a doctor. A dermatologist is able to make the diagnosis and help to remove them safely.