You wake up, glance in the mirror and see a small white bump near your eye or on your cheek. Of course, your initial instinct is to treat it as you would a pimple. You could attempt to squeeze it, thinking it may be a whitehead that’s yet to be cleared. But this bump is hard, stubborn — and it will not pop.
If that sounds like you, though, you probably do not have acne. You have milyom (the medical term is actually milia).
These tiny, pearly-white cysts can be very frequent. Although they are most commonly seen as a newborn — you may have heard them referred to as “milk spots” — these spots occur in people of all ages and skin types. While harmless, they can be a beauty annoyance as they don’t go away nearly as quickly as your typical blemish.
Knowing what causes these bumps — and how to safely cure them — is the cornerstone of achieving clear skin. Here’s what to know about telling milyom apart from acne, and how to get rid of them without damaging your skin.
What Exactly Is Milyom?
Milyom (singular: milium) are tender, benign cysts that form superficially beneath the skin. They are usually small white or yellow lumps 1-2 mm across. These little buggers can show up anywhere on the body, but they like growing best in our faces — eyelids, cheek, nose and chin.
To understand why they appear, you need to know how skin works. Dull skin is the result of your skin naturally shedding dead cells (keratin) to make room for new cells. Typically, these dead flakes get swept away or drop off unnoticed. But occasionally, that keratin becomes trapped beneath the skin’s surface. And when enough of it builds up, it hardens into a small lump, forming a cyst.
Milyom vs. Whiteheads
Milyom vs Whitehead: Having a hard time identifying the two? But their construction is very different.
Whiteheads (Closed Comedones): A type of acne that occurs when a pore becomes clogged with oil and dead skin cells, allowing bacteria to grow. Because they are soft and attached to a pore, material within can usually be expressed.
Milyom: These are unrelated to pore. They’re isolated pockets of protein (keratin) just beneath the skin. They don’t have a pore you can squeeze which is why squeezing them doesn’t work and usually just hurts.
The Different Types of Milia
Some milyom are more equal than others. Dermatologists have categorized them depending on why they appeared and who is developing them.
Neonatal Milia
This is what we see in around 40% to 50% of infants. It happens when the sweat glands are underdeveloped. The good news, however, is that neonatal milia is totally harmless and typically goes away on its own within a few weeks as baby’s skin matures.
Primary Milia
This is the type most frequently identified in older children and adults. It happens spontaneously, usually at the eyes, cheeks and forehead. Primary milia can all persist for weeks, months, or more time if not properly treated.
Secondary Milia
This type of milia, or traumatic milia, are those that form in damaged skin. Burns, blisters, rashes (such as from poison ivy) or aggressive skin treatments (like laser resurfacing or dermabrasion) can disrupt the mechanism by which cells shed, leaving them to build up dangerously fast. As the skin continues to heal, keratin becomes trapped and a cyst develops.
Milia En Plaque
This is less common, and the milia are close together on a raised, red patch of skin. It is usually seen in autoskin immune skin diseases It necessitates good medical treatment.
Common Causes and Triggers
For adults wading through primary milia, identifying the exact culprit can be difficult. Nevertheless, it is possible that a number of factors could facilitate the development of these:
Heavy Skincare Products
Heavy, occlusive creams — especially around the thin skin of the eyes — are a notorious culprit. If you’re using a product with heavy mineral oils, lanolin or petroleum; then the natural exfoliation of skin is blocked and keratin gets trapped in.
Sun Damage
The double-edged effect of the sunlight. It thickens the top layer of the skin (the epidermis), so that dead cells do not shed as easily. Because of this leather-like texture, it’s easier for keratin to get trapped from below.
Lack of Exfoliation
Although you should be encouraging your skin to slough off those dead cells daily with cleansing or a mild chemical exfoliant, if you are not, then that debris can have no choice but to stick around. Can build until it forms a milyom cyst.
How to Treat Milyom Safely
Before we get to home remedies, let’s be clear on the most important rule of milyom care: Don’t go around popping them.
Because the cyst is closed under the skin and has no opening, trying to squeeze it will only cause damage to the surrounding tissue. The result is redness, inflamation and in the worste case a permanent scar. Instead, try these methods.
The “Wait and See” Approach
Milia are not dangerous. They don’t itch (usually) and they don’t hurt. If you can wait (I know, easier said than done), they’ll come to a head and rise to the surface of your skin, where they’ll vanish as your skinContinue on naturally exfoliates. This can be a matter of weeks or months.
Gentle Chemical Exfoliation
You can use topical ingredients that promote cell turnover to speed the process.
Retinoids: Topical retinol or a prescription retinoid speeds up skin cell turnover to prevent keratin buildup and help milia to appear on the surface of your skin.
Alpha Hydroxy Acids (AHAs): Think glycolic acid and lactic acid, which help break apart the “glue” that holds dead skin cells together so they don’t accumulate on the surface of your skin.
Salicylic Acid (BHA): Most commonly known for treating acne, salicylic acid also helps keep skin’s texture smooth and refined.
Professional Extraction
If the bumps are near your eyes or just won’t budge, seeing a dermatologist or licensed esthetician is the way to go. They do a procedure known as “deroofing.”
The electrolysis professional then pierces the surface with a sterile needle or lancet. They use an extractor tool to apply gentle pressure as they push the hard, keratinous pearl out. It’s a quick, almost painless procedure that heals up with no scars.
Cryotherapy or Laser Ablation
If you have more stubborn or widespread milia, Dr. Palep says that dermatologists can offer treatments including cryotherapy (literally freezing cysts off) or lasers to open up the cysts. These are typically used in milia en plaque, or more severe cases.
Prevention Strategies
Once you’ve gotten rid of your skin bumps, you want to make sure they don’t come back.
Flick Your Eye Cream: If you’re prone to milia around the eyes, trade your heavy duty eye cream for a serum or gel texture option. Search for ones that are labeled “non-comedogenic.”
Incorporate Sunscreen: Sun damage = thicker skin and milia, so slathering on a broad-spectrum SPF 30+ every morning is non-negotiable.
Include Retinols: It’s also a good idea to incorporate a mild retinol in your nighttime routine- this is perhaps one of the best preventative measures. It keeps the skin cycle turning over, so keratin doesn’t have time to sit and brag.
Frequently Asked Questions
Are milyom contagious?
No, milia is not contagious. They are not the result of bacteria, viruses or fungi. You cannot catch them from someone else, and they do not spread from one part of your body to another through touch.
Can makeup cause milia?
Indirectly, yes. If you have been wearing heavy oil-based make up and fail to properly remove it at night, remaining makeup contributes towards dead skin build-up. Make sure to double-cleanse (first with an oil cleanser and then water-based) to keep your skin free of debris.
Is toothpaste an effective home remedy?
No. (Note: Though online tips often recommend toothpaste to dry out pimples, it will not work for milia.) It can irritate and lead to contact dermatitis, making the area look worse without actually extracting the cyst.
Patience is Key
You deal with milyom in another way than you would with acne. A pimple may appear and vanish in a week, but a milium is the marathoner of blemishes. It just involves having patience and giving them a little gentle care.
If you protect your skin from the sun, steer clear of those extra-heavy products, resist the urge to pick — hello smooth complexion. And if you can’t bear to live with the bumps, just skip the bathroom surgery and seek out a professional. Your skin will thank you.
