Milia are tiny, hard, pearly-white bumps under the skin, usually around the eyes, eyelids, cheeks and nose. Each bump, often called a "milia seed" or "biji milia", is a small cyst filled with keratin, a skin protein that gets trapped under the surface. Milia are harmless, not acne and not contagious. They are very common in newborn babies and also affect adults. Most clear by themselves within weeks to months. Do not squeeze them: milia do not pop like pimples, and picking can scar the skin. If they bother you, a doctor can remove them safely in the clinic.
Ringkasan: Milia (bintik putih kecil di muka)
- Milia ialah bintik putih kecil yang keras di bawah kulit, biasanya di sekitar mata, kelopak mata, pipi dan hidung. Ramai menyebutnya biji milia.
- Ia bukan jerawat dan tidak berjangkit. Ia terbentuk apabila keratin (protein kulit) terperangkap di bawah permukaan kulit.
- Kira-kira 40%–50% bayi baru lahir ada milia. Ia hilang sendiri dalam beberapa minggu.
- Pada orang dewasa, milia boleh kekal beberapa minggu hingga beberapa bulan. Jangan picit sendiri kerana boleh meninggalkan parut atau jangkitan.
- Doktor boleh membuang milia dengan selamat di klinik. Jumpa doktor jika milia tidak hilang selepas beberapa bulan, tumbuh banyak dengan cepat, atau berada di atas kulit yang merah dan bengkak.
Sumber: DermNet, Cleveland Clinic, Patient.info, American Academy of Ophthalmology.
Apa itu milia? (What is milia?)
A milium (plural: milia) is a tiny cyst filled with keratin, the protein that makes up the outer layer of skin (DermNet). Milia usually appear in groups, which is why most people say "milia". They look like small, smooth, pearly-white or yellowish domes, each about 1 to 2 mm across (Patient.info; PCDS).
- Where: mostly on the face, especially the eyelids, under the eyes, cheeks, nose and forehead, but they can appear anywhere (DermNet).
- How they feel: firm, like a grain of sand under the skin. They are not usually itchy or painful (Cleveland Clinic).
- Who gets them: people of all ages and both sexes. They are most common in newborn babies (DermNet).
- Common names: milia seed, biji milia, oil seed or milk spot, although the bumps contain keratin, not oil or milk (Cleveland Clinic; Patient.info).
- Not contagious: milia do not spread from person to person (Cleveland Clinic).
Milia are often mistaken for jerawat (acne) whiteheads, but they are a different condition and acne spot treatments are not designed for them. For blackheads and whiteheads, see our blackhead (komedo) guide. See the comparison table below.
Jenis milia (types of milia)
Doctors group milia by who gets them and why. Most adults with a few bumps around the eyes have primary milia.
| Type | Who gets it | What it looks like |
|---|---|---|
| Neonatal milia (milia pada bayi) | About 40% to 50% of newborn babies | Tiny white bumps, often on the nose; sometimes on the gums or roof of the mouth (Epstein pearls). Clear by themselves within weeks |
| Primary milia | Children and adults, with no skin damage before | A few bumps around the eyelids, cheeks and forehead. May clear in weeks or last for months |
| Secondary (traumatic) milia | Anyone, after the skin has been damaged | Bumps that appear where skin is healing after a burn, blistering rash, dermabrasion or sun damage, or after some creams. Sometimes permanent |
| Milia en plaque | Rare; mostly women aged about 40 to 60 | Many milia on a raised, red or inflamed patch, usually on an eyelid, behind the ear, or on a cheek or jaw |
| Multiple eruptive milia | Rare | Crops of many milia appearing over weeks to months on the face, upper arms and upper body; can be itchy |
| Juvenile milia | Rare; linked to some inherited conditions | Present from birth or appear later in childhood |
Sources: DermNet; Cleveland Clinic; Patient.info; MedlinePlus.
Punca milia (what causes milia?)
Skin normally sheds dead cells to make room for new ones. When old cells do not shed properly, new skin can grow over them and trap them, and the trapped keratin hardens into a tiny cyst (Cleveland Clinic; American Academy of Ophthalmology). Things that can make milia more likely include:
- Skin damage: burns, blistering skin conditions, dermabrasion and other procedures that injure the skin; milia then form as the skin heals (DermNet; PCDS).
- Sun damage: too much sun exposure or sunburn (Cleveland Clinic; PCDS).
- Long-term steroid creams: using a steroid cream for longer than prescribed (Cleveland Clinic; Patient.info).
- Heavy creams and makeup: thick or oil-based skin care and makeup that clog the skin (American Academy of Ophthalmology; Cleveland Clinic).
- Some skin medicines: rarely, creams such as hydroquinone, phenol or 5-fluorouracil (DermNet).
In Malaysia, be careful with face creams bought from unknown sellers that promise fast whitening or "glowing" skin, because unregistered products may contain undeclared ingredients that can irritate or damage the skin. Our guide to spotting fake skin brightening products explains what to check.
Milia atau jerawat? Cara bezakan (milia vs whiteheads and other bumps)
Several small bumps around the eyes and face can look alike. A doctor can usually tell them apart just by looking (DermNet). These clues help:
| Bump | Colour and feel | Where | Key clue |
|---|---|---|---|
| Milia | Pearly-white or yellowish, firm, 1–2 mm, smooth dome | Around the eyes, eyelids, cheeks, nose | Not red or painful; no pore opening; does not pop |
| Whitehead (jerawat putih) | Skin-coloured or white, softer | Face, chest, back; often in oily areas | Part of acne; may turn red or inflamed and come and go with breakouts |
| Syringoma | Skin-coloured or yellowish, firm, 1–3 mm | Lower eyelids and cheeks, often in symmetrical clusters | A harmless growth from a sweat duct; more common in women |
| Xanthelasma | Yellowish, flat patches with clear edges | Upper and lower eyelids | May be linked to raised cholesterol; ask your doctor about a blood test |
| Baby acne | Small red bumps or pustules | Baby's face and scalp | Appears around 2 weeks after birth, while milia are present from birth |
Sources: Cleveland Clinic; DermNet; Nair 2016.
If a bump around the eye is soft and hangs off the skin, it may be a skin tag. A painful, red lump on the eyelid is more likely a ketumbit (stye). Any bump that keeps growing, bleeds or does not heal should be checked by a doctor (see our guide to kanser kulit).
Cara buang milia dengan selamat (how to get rid of milia safely)
Milia do not need treatment, because they are harmless and often clear by themselves within a few months (DermNet; Cleveland Clinic). If you want them gone sooner, these are the safe options.
What you can do at home
- Leave them alone. This is often the best first step, especially for new milia.
- Cleanse gently every day with warm water and a mild cleanser, then pat the skin dry (Cleveland Clinic).
- Exfoliate gently. Adults may try an over-the-counter exfoliating product, retinol or a mild facial peel; the American Academy of Ophthalmology suggests exfoliating 2 to 3 times a week and asking your doctor which product suits your skin.
- Ask about a retinoid. Cleveland Clinic lists adapalene gel or prescription tretinoin cream as treatments that can help. In Malaysia, ask a pharmacist or doctor which strength is right for you.
- Use sunscreen with at least SPF 30 every day (American Academy of Ophthalmology).
- Switch to lighter products if you use thick creams or oil-based makeup.
Do not squeeze, pick or scrape milia. Milia sit under a thin layer of skin and cannot be pushed out like a pimple. Squeezing or using needles at home can damage the skin and cause scarring or infection, especially around the eyes (Cleveland Clinic; American Academy of Ophthalmology; Patient.info).
Pregnant or breastfeeding? The Malaysian acne guideline says topical retinoids (such as adapalene and tretinoin) should be avoided in pregnancy. Check with your doctor or pharmacist before using any retinoid or peel.
Rawatan milia di klinik (treatment by a doctor)
If milia bother you, last for months, or are near the eyes, a GP or dermatologist can remove them. These treatments are done in the clinic and should not be copied at home:
| Clinic treatment | What happens | Used for |
|---|---|---|
| Removal (de-roofing) | A doctor makes a tiny opening in the skin over the milium with a sterile needle or blade and removes the keratin. No anaesthetic is usually needed | A few milia that do not go away |
| Cryotherapy | The milium is frozen so that it falls off | Single or a few milia |
| Diathermy (electrocautery) and curettage | A fine electric current or a small scraping tool destroys the cyst | Stubborn milia |
| Topical retinoid (adapalene or tretinoin) | A cream or gel used regularly to help the skin shed | Many small milia |
| Chemical peel, dermabrasion or laser | Removes the top layers of skin | Very widespread milia |
| Minocycline (an antibiotic tablet) | Taken by mouth for some weeks | Milia en plaque only |
Sources: DermNet; Cleveland Clinic; Patient.info; PCDS.
Treatment removes existing milia but does not stop new ones forming, so the prevention habits below are still worth keeping.
Milia di bawah mata dan kelopak mata (milia under the eyes)
The skin around the eyes is one of the most common places for milia (DermNet; PCDS). It is also the thinnest and most sensitive skin on the face, which is why Patient.info says it is especially important not to try to treat milia yourself there.
- do not squeeze or prick milia on the eyelids or under the eyes;
- keep strong exfoliating acids, scrubs and retinoids away from the eye area unless your doctor says otherwise;
- use a light eye moisturiser rather than a thick, greasy one;
- see a doctor if the milia are on a red, raised patch on the eyelid (this may be milia en plaque) or if you are not sure what the bumps are.
Yellowish, flat patches on the eyelids are not milia. They may be xanthelasma, which can be linked to raised cholesterol; see our guide to kolesterol tinggi and ask your doctor about a blood test (Nair 2016).
Milia pada bayi (milia in newborn babies)
Milia are so common in newborns that they are considered normal: about 40% to 50% of babies have them, usually on the nose, but also on the cheeks, chin, scalp or upper body (DermNet; Patient.info). Similar white bumps on the gums or roof of the mouth are called Epstein pearls and also go away by themselves (MedlinePlus).
- baby milia need no treatment and usually clear within a few weeks;
- wash your baby's face gently with warm water and pat it dry; a mild baby soap can be used if needed (American Academy of Ophthalmology);
- do not squeeze the bumps or use adult creams, oils or scrubs on your baby's skin (Cleveland Clinic);
- baby acne is different: it causes small red bumps that usually appear about 2 weeks after birth (Cleveland Clinic).
Talk to your baby's doctor if the milia have not gone after a few months. Newborns can also have tiny clear sweat blisters (see our guide to ruam panas) or yellow skin from kuning bayi (jaundice), which need a different approach.
Cara cegah milia (prevention)
Most milia, especially in babies, cannot be prevented. These habits may lower the chance of new milia in adults (Cleveland Clinic; Patient.info; American Academy of Ophthalmology):
- protect your skin from the sun with daily sunscreen (SPF 30 or more), a hat or a tudung that shades the face;
- use steroid creams only for as long as your doctor prescribes;
- cleanse daily and exfoliate gently 2 to 3 times a week;
- choose lighter, non-greasy moisturisers and makeup;
- treat burns and blistering rashes promptly, and follow aftercare advice after skin procedures.
Bila perlu jumpa doktor (when to see a doctor)
Milia are harmless, but see a GP or dermatologist if:
- your milia or your baby's milia have not improved after a few months (Cleveland Clinic);
- they bother you and you would like them removed;
- many new milia appear over a few weeks, or they are itchy (multiple eruptive milia);
- the bumps sit on a red, raised or inflamed patch of skin (milia en plaque);
- milia appear after a burn, a blistering skin condition or a skin procedure;
- you are not sure the bumps are milia, or a bump grows, bleeds or changes.
Frequently asked questions (FAQ)
Apa itu milia (what is milia)?
Milia are tiny, hard, pearly-white or yellowish bumps just under the surface of the skin, usually 1 to 2 mm across. Each one is a small cyst filled with keratin, the protein in skin (DermNet; Patient.info). They are most common on the face, especially around the eyes, eyelids, cheeks and nose. Milia are harmless, are not acne and are not contagious (Cleveland Clinic).
What is a milia seed (biji milia)?
"Milia seed" and "biji milia" are everyday names for milia, because each bump looks like a tiny white seed under the skin. Cleveland Clinic notes that a single milium is also called a milk spot or an oil seed. The bumps contain keratin, not oil or milk.
Apa beza milia dan jerawat putih (whitehead)?
A whitehead is a type of acne: a blocked pore that is often softer, may become red and inflamed, and usually comes and goes with breakouts. Milia are not acne (Cleveland Clinic). They are harder, pearly-white, do not have a pore opening, do not turn red or painful, and can stay the same for weeks or months.
Boleh picit milia sendiri (can I squeeze milia myself)?
No. Cleveland Clinic, the American Academy of Ophthalmology and Patient.info all advise against squeezing, picking or scraping milia at home. Milia sit under a thin layer of skin and do not pop like a pimple, so pressing on them can damage the skin and lead to scarring or infection, especially around the eyes. If they bother you, a doctor can remove them safely.
Berapa lama milia hilang sendiri (how long does milia last)?
In babies, milia usually clear within a few weeks, typically by about 12 weeks of age (Patient.info). In adults, milia may last a few weeks to a few months (Cleveland Clinic), and some last longer. Milia that form after skin damage are sometimes permanent (Patient.info). If they have not improved after a few months, see a doctor.
How do I get rid of milia under the eyes?
Milia under the eyes often clear by themselves. Do not squeeze them or use strong exfoliating products close to the eyes, because the skin there is thin and sensitive. A doctor, usually a dermatologist, can remove them with a sterile instrument, or use cryotherapy (freezing) or another clinic treatment (DermNet; Patient.info). Ask your doctor before using a retinoid product near the eyes.
Is milia on my baby's face normal?
Yes. About 40% to 50% of newborn babies have milia, often on the nose (DermNet). They are harmless, need no treatment and clear by themselves within a few weeks. Wash your baby's face gently with warm water and pat it dry; do not squeeze the bumps or use adult creams, oils or scrubs on your baby's skin (Cleveland Clinic; American Academy of Ophthalmology).
Why do I keep getting milia?
Some people simply get milia more easily. Things that can make them more likely include skin damage from burns, blistering rashes or sun damage, long-term use of steroid creams, and heavy or oil-based skin care or makeup (Cleveland Clinic; American Academy of Ophthalmology). Gentle regular exfoliation, daily sunscreen and avoiding unnecessary steroid creams can help reduce new ones.
Is milia a sign of high cholesterol?
No. Milia are not linked to cholesterol. Flat, soft, yellowish patches on the eyelids are a different condition called xanthelasma, which can be linked to raised cholesterol, so a doctor may suggest a blood cholesterol test if you have them (Nair 2016).
Is milia contagious?
No. Milia do not spread from person to person, and sharing a towel or touching someone with milia will not give them to you (Cleveland Clinic).
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor, dermatologist or pharmacist. Do not try to remove milia yourself.
References
- Milium (milia) — DermNet
- Milia — Cleveland Clinic
- Milia — Patient.info
- What are milia? — American Academy of Ophthalmology
- Milia — Primary Care Dermatology Society (PCDS)
- Milia — MedlinePlus, US National Library of Medicine
- Syringoma — DermNet
- Clinical Practice Guidelines: Management of Acne Vulgaris, Second Edition (2022) — Malaysian Health Technology Assessment Section (MaHTAS), Ministry of Health Malaysia
- Berk DR, Bayliss SJ. Milia: a review and classification. J Am Acad Dermatol. 2008;59(6):1050-63.
- Nair PA, et al. Xanthelasma palpebrarum with arcus cornea: a clinical and biochemical study. Indian J Dermatol. 2016;61(3):295-300.
