How to Treat Milia on Face | Options That Actually Work

Those tiny white bumps under your eyes or across your cheeks are milia — small keratin-filled cysts that sit just beneath the skin’s surface. Unlike whiteheads, they have no opening to the surface, which is exactly why squeezing them does nothing but damage skin. Here’s what works, what doesn’t, and when to see a professional.

Can You Remove Milia at Home?

Do not squeeze or pick milia at home. Manual extraction is done in-office by a clinician using a sterile needle or blade to open the lesion and express the keratin plug. Trying this yourself risks scarring, infection, and post-inflammatory hyperpigmentation that takes months to fade.

What you can do at home safely is limited to prevention and gentle care: mild cleansing, light exfoliation, and daily sunscreen. Cleveland Clinic notes that gentle exfoliation may help keep skin clear, but harsh scrubs and over-exfoliating make the problem worse by irritating the skin barrier.

Professional Removal Options

If your milia persist beyond a few months or bother you cosmetically, a dermatologist can remove them quickly and safely. The most common in-office options include:

• Manual extraction — a sterile needle or blade opens the lesion so the keratin plug can be expressed
• Cryotherapy — freezing the milium with liquid nitrogen causes it to fall off within days
• Curettage or electrodesiccation — scraping or burning the lesion for stubborn, recurring cases
• Chemical peels or laser ablation — better for widespread milia, though usually reserved for persistent cases

Per the National Center for Biotechnology Information, milia en plaque — a rarer inflammatory form — may respond to oral minocycline in some reports. Most milia, however, don’t need that level of intervention.

Topical Retinoids for Widespread Milia

For milia spread across a larger area, topical retinoids like adapalene (available OTC) and tretinoin (prescription) help speed skin cell turnover, which pushes the keratin plugs out over time. Expect results in several weeks to months, not overnight.

Two critical caveats: retinoids increase sun sensitivity, so daily sunscreen is non-negotiable while using them. And per one review source, topical retinoids are not safe for people who are or may become pregnant — if that applies to you, discuss alternatives with your doctor.

For Babies, Hands Off

Baby milia are common and completely harmless. They generally need no treatment and should not be aggressively handled. Gentle washing with warm water and patting dry is all that’s needed — they typically clear on their own within a few weeks.

Knowing what to expect helps. If you’re unsure whether a product is worth trying for your specific skin, our tested roundup of milia creams covers what’s actually in the formulas and who they suit. One rule applies across every approach: patience beats aggression every time with milia.