What to Know About Milia

What’s Causing White Spots on My Face and How Can I Treat Them?

Skin discolorations are common, especially on the face. Some people develop red acne patches, and others may develop dark age spots. But one particular skin discoloration might have you scratching your head.

You may notice white spots speckled across your cheeks or elsewhere on your face. Sometimes, these spots can cover a large surface area and may even extend to other parts of your body.

A number of conditions can cause white spots to form on your face, and they generally aren’t cause for concern. Here’s a look at the most common causes and how to handle them.

Milia develops when keratin gets trapped under the skin. Keratin is a protein that makes up the outer layer of skin. This causes the formation of tiny white-colored cysts on the skin. This condition most often occurs in children and adults, but it’s also seen in newborn babies.

When white spots are caused by entrapped keratin, it’s called primary milia. However, these tiny white cysts can also form on skin as the result of a burn, sun damage, or poison ivy. Cysts may also develop after a skin resurfacing procedure or after using a topical steroid cream.

Milia can develop on the cheeks, nose, forehead, and around the eyes. Some people also form cysts in their mouths. These bumps usually aren’t painful or itchy, and the condition typically resolves itself without treatment within a few weeks.

If your condition doesn’t improve within a few months, your doctor may prescribe a topical retinoid cream or recommend microdermabrasion or an acid peel to repair damaged skin. Your doctor can also use a special tool to extract the bumps.

Pityriasis alba is a type of eczema that causes a flaky, oval patch of discolored white skin to appear. This skin disorder affects about 5 percent of children around the world, primarily between the ages of 3 and 16.

The exact cause of this condition is unknown. It’s usually seen in the setting of atopic dermatitis. It may be connected to sun exposure or a yeast that causes hypopigmentation.

Pityriasis alba often clears on its own within a few months, although discoloration can last up to three years.

If you’re experiencing symptoms, apply moisturizing cream on any dry spots and use an over-the-counter (OTC) topical steroid, such as hydrocortisone, to relieve any itchiness or redness.

Vitiligo is a skin disorder caused by loss of pigmentation. These patches of depigmented skin can form anywhere on the body. This includes your:

These patches may be small in size initially and gradually increase until white areas cover a large percentage of the body. However, widespread white spots don’t occur in all cases.

This condition can develop at any age, although most people don’t show symptoms of the disease until their 20s. Your risk for vitiligo increases if there’s a family history of the disease.

Treatment depends on the severity of the condition. Your doctor may recommend topical creams, ultraviolet light therapy, or oral medication to help restore skin color and stop the spread of white patches.

Skin grafts are also effective for getting rid of small patches of white skin. To do this, your doctor will remove skin from one part of your body and attach it to another part of your body.

Tinea versicolor, also known as pityriasis versicolor, is a skin disorder caused by an overgrowth of yeast. Yeast is a common type of fungus on the skin, but in some it can cause a rash. Tinea versicolor spots can appear scaly or dry and vary in color.

Some people with this condition develop pink, red, or brown spots, and others develop white spots. If you have lighter skin, white spots may be unnoticeable until your skin tans.

This skin disorder can occur in people of all ages, but it commonly affects people who live in humid climates, as well as people who have oily skin or a compromised immune system.

Because tinea vesicular is caused by an overgrowth of yeast, antifungal medications are the primary line of defense. Talk to your doctor about OTC or prescription antifungal products. This includes shampoos, soaps, and creams. Apply as directed until white spots improve.

Your doctor can also prescribe an oral antifungal medication, such as fluconazole, to stop and prevent the overgrowth of yeast.

White patches typically disappear once the fungus is under control. It can take weeks or months for skin to return to its normal color. Without consistent treatment with topicals, it often recurs.

Tinea versicolor and pregnancy

Your body goes through a lot of changes during pregnancy, including skin changes. In addition to developing dark spots, stretch marks, and acne, some expecting women develop tinea versicolor. This generally isn’t a cause for concern. Skin color usually returns once hormone levels return to normal.

If you want to more quickly fade any spots you may be experiencing, talk to your doctor about antifungal treatments that are safe to use during pregnancy.

Idiopathic guttate hypomelanosis, or sun spots, are white spots that form on the skin as a result of long-term UV exposure. The number and size of white spots vary, but they’re generally round, flat, and between 2 and 5 millimeters.

These spots can develop on different parts of the body including your:

This condition is more evident in people with fair skin, and your risk for sun spots increases with age. Women often develop spots at an earlier age than men.

Because these white spots are caused by UV exposure, you should use sun protection to prevent sun spots from worsening. This may help prevent new ones from forming.

Different treatments can reduce the appearance of white spots and restore color. Options include topical steroids to reduce skin inflammation and retinoids to stimulate cell growth and hyperpigmentation.

Most white spots on the skin aren’t a major cause for concern. Still, it’s important to see a doctor or dermatologist for a diagnosis, especially if the white spots spread or don’t respond to home treatment after a couple of weeks.

You might shrug off a white spot that doesn’t itch or hurt, but continue to monitor your skin. With early intervention, your doctor can recommend products to possibly restore pigmentation.

Last medically reviewed on May 25, 2017

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Idiopathic guttate hypomelanosis. (n.d.).
  aocd.org/?page=IdiopathicGuttateH
• Mayo Clinic Staff. (2015). Milia: Definition.
  mayoclinic.org/diseases-conditions/milia/basics/definition/con-20033921
• Mayo Clinic Staff. (2015). Milia: Symptoms.
  mayoclinic.org/diseases-conditions/milia/basics/symptoms/con-20033921
• Tinea versicolor. (n.d.).
  uclahealth.org/dermatology/tinea-versicolor
• Pityriasis alba. (2016).
  dermnetnz.org/topics/pityriasis-alba/
• What is vitiligo? (2014).
  niams.nih.gov/health_info/vitiligo/vitiligo_ff.asp
• Zampino MR, et al. (2007). Prevalence of pityriasis versicolor in a group of Italian pregnant women. DOI:
  10.1111/j.1468-3083.2007.02253.x

What to Know About Milia

Milia are patches of white bumps on your face. Not much is known about these little white bumps, but they aren’t dangerous and don’t need treatment.

What Are Milia?

Milia are tiny white bumps (pimples or cysts) on your skin. They most often happen on infants’ faces. But anyone can get them on any part of the body.

You may hear milia (one is a milium) referred to as milk spots or oil seeds. It’s a common blemish that affects 40% to 50% of newborns.

Symptoms of Milia

Milia look like small white bumps on the cheeks, chin, or nose. They can also be on the body, especially the trunk and limbs.

A similar condition called Epstein pearls is marked by milia on your gums or the roof of the mouth. Epstein pearls are very common in newborns.

Milia don’t cause problems. They aren’t painful or itchy. Worsening symptoms such as inflammation, pain, or leakage may be signs of acne.

Causes and Risk Factors of Milia

Your body sheds dead skin cells to make way for fresh new ones.

Milia happen when the dead skin cells don’t slough away. Instead, they get caught under the new skin, harden, and form a milium.

Milia can also happen because of:

• Skin damage from something like a rash, an injury, or sun exposure
• Long-term use of steroid medications
• Your genes
• An autoimmune condition‌

Babies are most likely to get milia. Because their skin is still learning how to replace itself, they sometimes have milia and baby acne.

You’re also at higher risk if you:

• Don’t follow proper skin care
• Use cosmetics or makeup that clogs your pores
• Don’t get enough sleep
• Have skin conditions like dandruff, rosacea, or eczema

Treating Milia

It’s fine to let milia be. They’ll go away on their own after a few weeks or months.

You may be tempted to pick at or pop the milia. This irritation may only make it worse and cause complications. Picking at the skin around the milia can lead to scarring or an infection.

If you’re worried about how milia look, you can take a few steps to help the treatment process. An over-the-counter exfoliating cosmetic with salicylic acid, alpha hydroxy acid, or a retinoid can help remove the dead skin cells.

Baby skin is too delicate for lotions, oils, or other cosmetics. Wash your baby’s face with warm water and baby soap daily and then pat the skin dry. Wait for the milia to clear.

If your milia don’t clear up on their own or with the help of over-the-counter exfoliation treatment, your doctor can find a treatment plan. A dermatologist can do a simple procedure to surgically remove the milia.

Preventing Milia

Milia can’t totally be prevented. For adults, good skin care can help prevent milia and other conditions.

Use sunscreen and moisturizer. Milia tends to happen when you have too much sun exposure. Your skin becomes leathery, making it harder for the dead cells to fall off.

Sunscreen and moisturizer will keep your skin soft and flexible so it can replace itself the way it should. Use sunscreen, even during the winter and when you’re indoors near windows for long periods of time.

Avoid thick creams or ointments. These can irritate your skin and clog your pores, preventing natural exfoliation.

Keep your face clean. Dirt and sweat will build up and clog your pores. This can lead to acne and skin problems.

Removing the daily grime from your face will allow your skin to exfoliate. Keep your face clean to help your skin shed the dead cells.

Start early. If you and your child are prone to milia breakouts, teach them the importance of protecting their skin. As they get older, show them how to protect themselves from the sun’s rays, including using sunscreen and wearing hats and other protective clothing.

Show Sources

Photo Credit (inset, face): Biophoto Associates / Science Source

Photo Credit (inset, close-up: ©DermNet NZ / www.dermnetnz.org 2022

American Academy of Ophthalmology: “What Are Milia?”

Cleveland Clinic: “Does Your Skin Have Tiny White Bumps? Leave Them Alone,” “Milia.”
Mayo Clinic: “Milia.”

USF (University of South Florida) Health: “What Are Milia—And How Do You Get Rid Of Them?”
The Well by Northwell: “How To Really Take Care Of Your Skin.”

Cleveland Clinic – Photo Caption

Mayo Clinic – Photo Caption

An Overview of Milia

Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University.

Table of Contents
Table of Contents

Milia are small cysts that form on the skin. They are also known as “milk cysts.” Milia form when a protein called keratin gets trapped under the skin. The tiny bumps look like whiteheads, but they are not acne. Unlike acne, they don’t develop in a pore and are not red or inflamed.

This article discusses the causes and diagnosis of milia. It also covers treatment and offers tips for prevention.

Symptoms of Milia

Milia are hard, raised cysts that form under the outer layer of skin. They are white to yellowish in color. They can look like a grain of sand or a hard, milky capsule.

Milia are usually small, around 1 to 2 millimeters in diameter. Some can grow larger. Milia won’t pop and can take a long time to go away.

Milia can show up anywhere, but they are most common on the face. They may appear around the eyes and cheeks, nose, and forehead. Milia don’t hurt or itch. They are annoying but harmless.

Milia usually last longer than pimples. Pimples heal within a few days, but milia can last for weeks or months.

An aggressive form of milia exists, but it is rare. It is called “multiple eruptive milia.” Eruptive milia form on the head, neck, and trunk. They may last for weeks or months. Unlike other kinds of milia, eruptive milia are usually inflamed.

Recap

Milia look like acne, but they are not the same. They are common on the face. Milia can last a long time, but they are harmless.

What Causes Milia?

Milia form when keratin becomes trapped just under the skin. Keratin is the protein that gives skin its structure. It can become trapped when the skin doesn’t exfoliate, or shed dead cells.

Milia are often confused with acne, but they are not the same. Acne comedones , or blemishes, form when pores are blocked. Milia don’t form within pores. They form just under the top layer of skin.

Milia are very common. They can happen at any age. Even babies can have milia. In fact, up to 50% of healthy newborns develop milia. In newborns, milia usually go away within a few weeks.

Most cases of milia have no clear cause. Some people, though, are more prone to getting them. If you have acne and blackheads, you probably also have milia. But milia can form even if your skin is clear.

Healthcare providers think multiple eruptive milia are genetic. People with rare genetic skin disorders like Gardner syndrome often have eruptive milia.

Milia can also form after skin injuries like:

• Burns
• Sunburns
• Blistering rashes

Some medications can cause milia, especially:

• Topical corticosteroids
• The chemotherapy drug 5- fluorouracil

Certain procedures like Fraxel laser treatments can also cause milia.

When milia happen on their own, they are called “primary milia.” Milia that form after disease or injury are called “secondary milia.”

How Milia are Diagnosed

Healthcare providers can often diagnose milia based on how they look. But there are other causes of small, white skin bumps. If the cause isn’t clear, a dermatologist can remove a cyst and look at it under a microscope. This can help with diagnosis.

Basal cell carcinoma, a type of skin cancer, can also look like a pearly white bump. If you have a bump that does not go away and you aren’t sure what it is, call your healthcare provider.

Is There a Treatment for Milia?

Milia usually go away on their own. Sometimes it can take months or years. If you don’t want to wait, talk to your healthcare provider. Medications like retinoids and glycolic acid can help your skin shed and replace cells faster.

You can also have the bumps extracted. The process is simple and you will see results right away.

Don’t try to extract milia yourself at home. To remove milia, a healthcare provider makes tiny incisions on your skin. The healthcare provider removes the plugs with tweezers and a magnifying glass. Dried cells might be removed beforehand. This is done with a topical exfoliant.

Your healthcare provider or dermatologist can help you decide on the best way to treat your milia.

Can Milia Be Prevented?

There is nothing you can do to completely prevent milia. You can decrease your chance of getting them, though. If you are prone to milia, it might be because of what you put on your skin. Thick, heavy moisturizers and eye creams can trigger milia.

It might be a good idea to change your skincare routine. Look for products labeled “oil-free” or “non-comedogenic.” These products are less likely to clog your pores. They are also less likely to trigger keratin overgrowth.

Summary

Milia can be annoying, but they are harmless. You can decrease your chances of getting milia by changing your skin routine. You can also have them removed. Talk to your healthcare provide about the different treatment options for milia.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Yahya H. Idiopathic multiple eruptive milia: Report of a case in a Nigerian woman. Niger J Clin Pract. 2018;21(3):395-6. doi:10.4103/njcp.njcp_43_17
2. Kutlubay Z, Tanakol A, Engýn B, et al. Newborn skin: common skin problems. Maedica (Buchar). 2017;12(1):42-7.
3. Cho E, Cho SH, Lee JD. Idiopathic multiple eruptive milia occurred in unusual sites. Ann Dermatol. 2010;22(4):465-7. doi:10.5021/ad.2010.22.4.465
4. Ghosh S, Sangal S. Congenital milia en plaque on scalp. Indian J Dermatol. 2015;60(1):105. doi:10.4103/0019-5154.147871
5. Hinen HB, Gathings RM, Shuler M, Wine lee L. Successful treatment of facial milia in an infant with orofaciodigital syndrome type 1. Pediatr Dermatol. 2018;35(1):e88-e89. doi:10.1111/pde.13350

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.

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