Milia Explained: A Doctor’s Guide

Treating and Preventing Those Stubborn White Bumps

Those tiny white bumps that sit under the skin — often around the eyes, cheeks or nose — are among the most misunderstood skin concerns. They don’t behave like spots, won’t respond to exfoliating acids or cleansers, and seem determined to stay put no matter what you apply.

Often mistaken for whiteheads, these bumps are actually milia: small keratin-filled cysts trapped beneath the skin’s surface. While harmless, they can be persistent and frustrating from a cosmetic point of view.

To separate fact from fiction, cosmetic doctor Dr Ross Perry, founder of Cosmedics, shared his advice in the Daily Mail on what milia really are, why they develop, and what genuinely works to remove them safely.

What are milia — and why do they appear?

Milia are small white or yellowish cysts that form just under the skin. They most commonly show up around the eyes, cheeks and nose, although they can develop anywhere on the face.

As Dr Perry explains:

“Milia are caused when keratin — a protein naturally found in the skin — becomes trapped beneath the surface. This can happen when skin cell turnover is slow, after skin trauma, sun damage, or from regular use of thick, occlusive skincare products.”

Unlike acne, milia are not caused by bacteria, excess oil or poor hygiene. They also cannot be “popped” or cleared using traditional spot treatments.

Reassuringly, they pose no medical risk. As Dr Perry notes, they are “completely harmless from a health perspective,” though many patients understandably seek treatment for cosmetic reasons.

Why milia don’t respond to skincare products

One of the biggest frustrations with milia is that they are resistant to most over-the-counter treatments. Exfoliating acids, retinoids, scrubs and pore strips simply cannot penetrate deeply enough to release the trapped keratin.

This misunderstanding often leads people to spend heavily on unsuitable products — and sometimes to make matters worse by picking or squeezing.

Dr Perry cautions:

“Trying to extract milia at home can lead to scarring, irritation or infection. They don’t behave like spots and shouldn’t be treated as such.”

What triggers milia in adults?

While milia are common in newborns, adults frequently develop them later in life — often in small clusters around the eyes or cheeks.

Several factors increase the likelihood of milia forming, including:

• Use of heavy or oil-based creams, particularly around the eye area
• Skin trauma such as burns, rashes, cuts or cosmetic procedures
• Sun damage, which thickens the skin
• Slower skin cell turnover with age
• Certain medications, autoimmune conditions or highly reactive skin types

However, Dr Perry highlights one major contributor above all others:

“The biggest culprits are rich, occlusive skincare products. Even on otherwise healthy skin, frequent use of thick creams can trap keratin just beneath the surface.”

Do certain skin types or tones get milia more often?

Milia can affect all skin types and tones, and no group is immune. However, some people may be more prone than others.

Those with thicker skin may trap keratin more easily, while people with dry skin who rely on heavier moisturisers may inadvertently increase their risk.

In terms of visibility, Dr Perry notes that milia often appear more obvious on lighter skin tones due to the contrast, whereas on darker skin they may look slightly yellow or flesh-coloured and blend in more.

What actually works to remove milia?

When it comes to treatment, there is one clear answer: professional removal.

Dr Perry is direct on this point:

“Milia do not respond to creams or exfoliants. The only reliable way to treat them is safe extraction by a trained clinician.”

In a clinical setting, the skin is gently opened using a sterile needle or fine blade, allowing the keratin cyst to be removed cleanly. In some cases — particularly for stubborn or recurrent milia — laser treatment or electrocautery may be used.

Once removed, milia do not usually return in the same spot, although new ones can develop elsewhere if triggers remain.

How to prevent milia from coming back

After treatment, prevention is key.

Dr Perry advises keeping skincare simple and breathable:

“The single most important step in preventing milia is avoiding heavy, occlusive creams around the eyes and cheeks.”

Instead, opt for lightweight, non-comedogenic products, use gentle exfoliation to support natural cell turnover, and be cautious with rich formulations — especially if you have a history of milia.

Read More

Find the original article in the Daily Mail at https://www.dailymail.co.uk/lifestyle/beauty/article-15155733/How-rid-unsightly-white-bumps-skin-cosmetic-doctor-reveals-fail-safe-ways-banish-milia-spots-youve-suffered-childhood.html.

The takeaway

Milia may be small, but they’re notoriously stubborn. The good news is that they are easily treated when approached correctly — and safely — by a trained professional.

If you’ve been battling white bumps that won’t budge despite your best skincare efforts, chances are the solution isn’t another product, but expert assessment and targeted removal.

Understanding what milia are — and what they’re not — is the first step to finally getting rid of them.

Treatment for Milia

Professional milia removal is available with doctors at Skin Surgery Laser Clinic. We offer a variety of techniques to tackle milia including medical options:

• Cryotherapy (freezing)
• Laser (with the latest technology)

Skin Surgery Laser Clinics

Dr Ross Perry is a qualified and experienced London GP, who founded Cosmedics Skin Clinics in 2003, an independent company specialising in skin treatments such as removal of lesions/blemishes.

Cosmedics’ Skin Surgery Laser Clinic offer private mole removal at a selection of clinics based in London and Bristol. Moles are removed using the latest surgical techniques including laser mole removal; with trained doctors and surgeons.

Our team of qualified and experienced doctors and surgeons also treat other skin blemishes, including sebaceous cysts, skin tags, warts and lipoma using  freezing, laser or surgical techniques.

For ultimate peace of mind, Cosmedics Skin Surgery Laser Clinic offer a thorough top to toe mole check carried out by their trained and experienced doctors.

For more information or to book a consultation, please complete the form on this web page or call 020 7386 0464.