During and after high school, I always had a few small, white bumps on my face, particularly around my eye area. They kinda looked like pimples, but they were smaller, a little bit lighter in color, and they wouldn't go away, no matter how hard I scrubbed. I would try squeezing them and prodding them (probably doing damage to my skin in the process), but to no avail. I came to accept these bumps as just part of my facial landscape; after all, no one has "perfect" skin anyway, right?
Fast forward more than a decade: I've left adolescence behind and am firmly an Adult with a capital A. A little over a year ago, I switched over to using a thick, oily makeup remover rather than my usual Cetaphil lotion, which, up to that point, I'd used to wipe away my eyeliner, shadow, and foundation at the end of each day since I started wearing makeup as a pre-teen. No big deal, I thought to myself. But as the months went by, I noticed more and more of the little white bumps starting to congregate — mostly below my eyes, though there were also a couple close to my eyelids. They seemed to be getting bigger and growing more prominent, almost like little tiny whiteheads that just wouldn't go away no matter how much I washed and scrubbed. What was going on?
It took a visit to dermatologist Dr. David Colbert, MD, of New York Dermatology Group, to learn that those little bumps growing on my face are actually something called milia.
As Dr. Colbert explained to me, milia may look similar to whiteheads in that they are both small bumps that appear on the skin. But they’re not the same: whiteheads are actually “closed comedones,” which are essentially clogged pores that are closed by skin, and can be addressed at home (follow these tips for doing so in the best way.) Milia, on the other hand, are actually little tiny cysts and can’t be removed at home, and there are two kinds: The first, called primary milia, occur when dead skin builds up in the pores of the skin, becoming tiny cysts. Secondary milia, on the other hand, occur from a — you guessed it — secondary cause, like an infection or blistering skin.
Primary milia, "can be from when your skin doesn't self-exfoliate; some people's skin doesn't do it as well," he tells Teen Vogue. "Or, if your pores get clogged." While Dr. Colbert couldn't say for sure that my change in makeup remover was 100% the culprit, he did say that using a thicker, oilier product on my skin day in and day out could have certainly contributed to the clogging of my pores — and the milia.
To be clear, milia aren't dangerous or harmful, but some people might choose to get rid of them. If you do have them and want to remove them, don't do it at home, Dr. Colbert says — make sure you go to a dermatologist.
Dr. Colbert removed my milia at his NYC offices using an extraction technique that involved making a small incision over the top of each milia, and then delicately squeezing out the white lesion inside with Q-tips. The sensation wasn't exactly pleasant, but the process was over before I knew it — just a few seconds for each one. After the procedure, there were tiny red spots where the milia used to be on my face, but they faded away just a week or so later.
When I came back to Dr. Colbert's office for a follow-up, there were a couple of bumps that were still around, which Dr. Colbert informed me were actually small, benign tumors called syringomas. Those are caused by cell overgrowth from the sweat glands — and not milia, like originally expected. They were removed quickly by Dr. Colbert via laser, leaving a tiny scab in their place that also disappeared within days.
So what's the moral of the story? If you spot milia on your face, don't squeeze or pick — it'll only irritate the skin. If you really want them removed, Dr. Colbert says to use Differin Gel (which is now available over the counter) or prescription Retin-A, or schedule an appointment with a dermatologist, who can safely get rid of them through extraction. And to prevent primary milia from happening in the first place, “exfoliation is key,” Dr. Colbert says. Using gentle microdermabrasion scrubs, retinals, and other exfoliation-boosting products can help prevent them, as does avoiding using heavy creams and makeup.
Related: What Cystic Acne Is, and How to Get Rid of It
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