Why you should never break out those tiny, hard bumps on your face

You look in the mirror and see them: a bunch of tiny, hard white spots on your face, maybe with a faint blue tint. They don’t look or feel like typical acne or whiteheads, so what could they be? The most likely are the so-called thousandsor tiny pockets of dead skin.

“Milia are made of keratin,” he says Farah Moustafa, MD, dermatologist and director of lasers and cosmetics at Tufts Medical Center in Boston. They usually develop on the cheeks, eyelids and nose. As your skin naturally sloughs off old cells to allow new ones to grow, the cells can become trapped, harden, and become cystic—these are milia. “Think of them as pimples with nowhere to go,” he says Joshua Zeichner, MDdermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York.

These benign cysts — sometimes called “milk spots” — are very common in infants; about 50% of babies have them at birth, according to Cleveland Clinic. But they can appear on anyone at any age.

What causes milia in adults?

According to Dermatological consultant, there are different types of milia, including neonatal milia, the types that appear on the skin of infants. The most common type in adults is primary milia; there are two other types that are less common, one that appears in clusters on your skin and another that is caused by trauma to the skin.

In addition to the process of entrapment of skin cells during the natural peeling process, milia can also appear due to other factors. “They can be the result of sun damage or heavy skin care products,” says Dr. Zeichner. Oil-based makeup or detergents can be the culprit if they clog your pores.

Skin damage caused by injury or rash or long-term use corticosteroids, can also be a possible cause. In addition, certain medical conditions can cause milia to form. “Milia can be a secondary symptom of a blistering skin condition, such as a burn,” explains Dr. Moustafa. “They can also happen because of autoimmune disease or a genetic condition.” You can also get milia if you don’t cleanse your skin regularly, and you may be more prone to developing them if you do rosacea or dandruff.

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The first thing you might wonder is whether you should see a doctor if you have milia. Most often, there is no need. “Milia are completely harmless and purely a cosmetic problem,” says Dr. Zeichner.

Often they will just go away on their own. But if yours stick around and bother you, don’t try any of the “milia removers” you see online—they’re completely ineffective, experts say.

How to get rid of and prevent milia:

Do not try to remove them yourself.

It’s never a good idea to try popping milia like pimples (you shouldn’t pop your pimples either!). “Never poke or prod milia,” advises Dr. Moustafa. “And avoid scrubbing the milia with any type of scrub.”

Focus on gentle cleansing.

Here is the best daily remedy you can try: “Gentle skin care“, says Dr. Moustafa. Wash your face the right wayfollowing advice from American Academy of Dermatology: Use gentle cleanser and fingertips, wash with lukewarm water, avoiding rubbing and rinse with lukewarm water and dry with a soft towel. Also, make sure your skin has a chance to breathe and be makeup free from time to time.

Try a topical retinoid cream.

If you have a predisposition to milia, your dermatologist may recommend that you try topical retinoid if you have a relapse. “This can help by removing cells in the outer layer of skin, encouraging the eventual release of milia from your skin,” says Dr. Illustrator.

Always wear sunscreen.

This is a golden rule even if you don’t have milia, but sunburns and damage can be common triggers. Be sure to apply it properly at least SPF 30 sunscreen on the skin 30 minutes before going out. Birnur K. Aral, Ph.D.executive director of the Laboratory for Beauty, Health and Sustainability of the Good Housekeeping Institute, suggests applying a nickel-sized piece to your face. For sprays, she suggests spritzing sunscreen all over your skin, then rubbing it in.

See a dermatologist for professional removal.

Yes actually remove thousands, you have to get them out of your skin. “This means that the dermatologist physically makes an opening with a needle or scalpel blade,” says Dr. Zeichner. “Never do this yourself. Trying to remove milia the wrong way can lead to infections or scarring.” And he adds: “It is especially difficult to get rid of milia around the eyes because of their proximity to the eyeball.”

The actual process of milia removal is called removing the roof. The dermatologist uses a needle to remove the flap that holds the keratin in your skin and take out the keratin itself. However, the procedure is not covered by insurance and can be expensive, averaging between $200 and $500.

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