Quick answer. Milia (often called “milk spots”) are tiny, firm, white or yellowish bumps just under the skin surface. Each is a small cyst filled with keratin (a normal skin protein) that has become trapped – not a blocked oily pore. They are extremely common and completely harmless: a large proportion of newborns get them on the face, and they also appear in older children and adults. In babies they clear on their own within weeks to months and need no treatment. The single most important rule – for babies and adults alike – is do not squeeze or pick them, because there is no pore to empty, and picking only risks scarring or infection.
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The reassurance most people need: milia are not acne, not contagious and not a sign of poor hygiene – they’re trapped keratin, and in babies they simply disappear with time.
What milia are
A milium (the plural is milia) is a small cyst that contains keratin, the structural protein of skin, hair and nails. Milia look like tiny, firm, pearly-white or yellowish bumps sitting just beneath the surface of the skin. They are benign (non-cancerous) and non-inflammatory, which means there is usually no redness, no swelling and no pain around them. Because they sit so close to the surface, they are easy to see but often barely raised to the touch.
Milia are frequently confused with whiteheads, but the two are not the same thing. A milium is a closed pocket of trapped keratin with no opening onto the skin; it is not a blocked oily pore and it is not acne. That difference matters a great deal, because it explains why milia cannot simply be squeezed out the way people sometimes try to deal with a whitehead. Despite the “milk spot” nickname, milia have nothing to do with milk, feeding or diet.
Where they appear and in whom
Milia most often turn up on the face, especially around the eyes and on the eyelids, and also on the cheeks, the nose and the forehead. They can occasionally appear elsewhere on the body, but the face is by far the most common site.
They are seen across all ages. Milia are one of the most familiar skin findings in newborn babies, where they appear on the face in the early weeks of life and clear on their own. They also occur in older children and in adults. In other words, milia are not a “children’s” problem or an “adults’” problem – they are simply common, and most people who notice them have nothing to worry about.
Milia in newborns
Milia are among the commonest newborn skin findings. They typically appear on a baby’s face in the first weeks of life and clear by themselves as the baby’s skin naturally sheds and matures, usually over weeks to a couple of months. No treatment is needed. Parents should simply keep the skin clean with plain water and gentle care – there is no need for special creams, scrubbing or any attempt to squeeze the bumps. Milia are sometimes mistaken for baby acne, but they are different: milia are firm keratin cysts rather than inflamed red spots, and they settle on their own.
Types of milia
In older children and adults, milia are usually grouped into two broad types:
- Primary milia – these arise on their own, from keratin that becomes trapped without any obvious trigger. They are commonly seen around the eyes and on the cheeks.
- Secondary milia – these develop after something has damaged or disturbed the skin. Recognised triggers include burns, blistering and blistering skin conditions, sun damage, some skin diseases, certain skin treatments, and heavy or occlusive skincare products that trap keratin at the surface.
Symptoms
Milia usually cause no symptoms at all beyond their appearance. They are small, painless bumps that do not normally itch or hurt, and they do not weep, crust or bleed. Because they are non-inflammatory, they lack the redness and tenderness of an infected spot. For many people they are simply a cosmetic concern – noticeable, especially around the eyes, but otherwise harmless and easy to leave alone.
What causes them
Milia form when keratin becomes trapped in a small pocket just under the surface of the skin, forming a tiny cyst with no opening. In newborns this is part of normal skin development, as the very young skin is still maturing and shedding – which is why baby milia clear on their own and need nothing done to them.
In adults, some milia arise for no clear reason, while others are linked with things that damage or occlude the skin: chronic sun damage, skin injury such as burns or blistering, and heavy or occlusive skincare products that trap keratin near the surface in people who are prone to them. Milia are not caused by poor hygiene, and they are not contagious.
Milia are not acne
This distinction reassures many people, so it is worth stating plainly. A whitehead or pimple is a pore blocked with oil and dead cells; it is often soft, sometimes inflamed, and it can be squeezed. A milium, by contrast, is a closed keratin cyst with no opening onto the skin. It stays firm, pearly and non-inflamed, and it cannot be popped. Because there is no pore to empty, trying to squeeze a milium simply breaks the surrounding skin and risks a mark or an infection where none existed before.
How milia are diagnosed
Most milia are diagnosed simply by looking at them, because their appearance – small, firm, pearly bumps just under the surface – is quite typical. A GP or a dermatologist can confirm that a bump is a milium and tell it apart from a whitehead or other harmless skin bumps. Tests are not usually needed. That confirmation is most useful when you are unsure what a bump is, or when a spot looks different from the others.
Treatment: reassurance first
The most important message is that milia often need no treatment at all. In babies they clear on their own, and in adults they frequently settle over weeks to months without anything being done. Because they are harmless, leaving them alone is a perfectly reasonable choice.
Just as important is what not to do: milia should not be squeezed, scratched or picked at home. There is no pore to empty, so home attempts do not remove the keratin cyst – they only break the skin and can lead to scarring or infection, particularly around the delicate skin near the eyes. Sterile needles, comedone tools and “at-home extraction” kits are best avoided.
Options for milia that bother you
If milia are persistent or you would simply like them gone, a doctor or dermatologist can remove them safely under clean, sterile conditions. A common, straightforward method is to make a tiny nick with a sterile tool and gently release and lift out the trapped keratin. For numerous or stubborn milia, a clinician may consider other minor procedures. The key point is that all of this should be done by a trained professional – not dug out at home.
Alongside removal, reviewing your skincare can help some people who are prone to milia. Switching to lighter, non-occlusive products instead of thick, greasy creams, and using gentle exfoliation if advised, may reduce the tendency for keratin to become trapped. Any change is best made gradually and gently, especially on facial skin.
Can you prevent them?
There is no guaranteed way to prevent milia, but for people who are prone to them a few sensible habits can help. Use gentle skincare and avoid thick, greasy, occlusive products that can trap keratin at the surface; keep up gentle cleansing and, if advised, mild exfoliation; and protect the skin against sun damage, since long-term ultraviolet exposure thickens the outer skin and is linked with milia. Broad-spectrum sun protection is sensible year-round in Singapore’s consistently high-UV climate. Reliable general information on sun protection and skin care is also available through HealthHub.
When to see a doctor
Milia are harmless, so most do not need medical attention. It is worth seeing a doctor if you are unsure whether a bump is really a milium, if a spot changes, grows, or becomes red or painful, or if you simply want persistent milia removed safely. A GP or a dermatologist can confirm the diagnosis and treat them cleanly. As a general rule, any new, changing, non-healing, bleeding or growing skin lesion or mole should be checked promptly, so that anything more serious is picked up early.
Related skin & dermatology topics
- Basal cell carcinoma
- Squamous cell carcinoma
- Sun damage & photoaging
- Sunburn
- Prickly heat (heat rash)
- Intertrigo (skin-fold rash)
- Ingrown hairs
- Lichen planus
- Dry skin (xerosis)
- Skin cancer
- Eczema
- Dermatologists in Singapore
Sources
- DermNet — Milium / milia: keratin cysts, appearance, clearance over time, professional removal options.
- Cleveland Clinic — Milia (milk spots): primary versus secondary, newborn occurrence, harmless nature, do not squeeze.
- StatPearls (NCBI) — Milia: newborn involvement, spontaneous resolution, extraction technique.
- Journal of the American Academy of Dermatology — classification of primary and secondary milia.