Milia: Pesky White Bumps Around the Eyes

Today, I made one of my patients very happy by extracting one of these little ‘friends’ (the name I give to innocuous   skin acquisitions as opposed to their more sinister counterparts, the ‘foes’). She had the unsightly bump for more than 2 years and it took precisely 2 seconds to remove it with the help of a teensy yellow needle, a couple of cotton buds and some magnification. So satisfying.

Now, these develop most commonly around the eye and are essentially tiny cysts, formed from the lining of the hair follicle. This basically means its a tiny ball made up of a layer of skin cells folded back in on themselves, under the skin. And dead skin cells accumulate within the ball because they have nowhere to go, giving them their characteristic, pearly white colour. They are often mistaken for whiteheaded spots (called pustules) or closed comedones-but when squeezed, nothing happens.

Why they form isn’t fully understood, but comedogenic (or clogging) skincare formulations and sun damage are likely to be contributory. Using topical steroids can also predispose to them, so they are sometimes seen in eczema sufferers. They are also very common in new-born babies, in whom they tend to resolve spontaneously. Unfortunately, this tends not to be the case in adults. So what to do to prevent them?

In truth, not an awful lot works. I advocate the use of non-comedogenic skincare as a general rule, and I think this is a good beginning if you’re prone to milia.

Topical retinoids are beneficial in some patients and certainly make them easier to extract. Over-the counter products containing retinol or retinaldehyde are good alternatives to prescription products, but always introduce this group of ‘actives’ gradually when using them in the delicate eye area.And of course, this step necessitates the use of a broad-spectrum sunscreen, which again should be non-comedogenic (loving Vichy Mattifying Face Fluid Dry Touch SF 50 right now).

If you have milia,you can choose to a) do nothing-they’re harmless. Or b) have them extracted. The commonest method is with a sterile needle followed by manual extraction. A good way to make your dermatologist’s day.

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  1. I had one on my upper left eyelid. At first i thought it was a zit so tried squeezing it but nothing happened. It was there for a few months and was driving me nuts! I hated it being there. Looking back, i think i know the cause. I rarely wear eye make-up but had started using eye shadow frequently. It must’ve clogged up a pore or hair follicle or something. I was going to consult with a dermatologist about it, but being the impatient person I am who also has affinity for removing crusty things from skin (scabs, zits, boyfriend’s dandruff), I removed it myself…with a good ol’ fashioned fingernail. I had been picking at it since the day before and being beyond fed-up, i ripped the obnoxious thing off! I could scarcely believe it! I washed my hands and face before hand and sterilized the area afterward with hydrogen peroxide, witch hazel and neosporin. I currently have a circular bandaide over it. I hope it doesn’t get infected. :/

    • lunanoir
    • January 6th, 2013

    Hi, mine is right on my eyelid, between the lashes in the outside corner of my left eye and getting in there is not very easy. It’s been with me for more than a year, and I would’ve let it be if the boyfriend didn’t notice it and told me to try to take care of it. I can cover it in make-up, but I seldom wear make-up these days… So i guess that is what changed. Just wearing moisturiser with spf 15 and only washing my face once a day as i didn’t need to remove make-up.

    6 Months ago I read somewhere that the Oil Cleaning Method would take away the small white dots around the eyes, and I always had a few of those, but they never bothered me, but I thought this might take care of the thing in my eye if I were to clean my eyes with the oils. It takes make-up off beautifully, but if you get it too close to your eye, it actually gets in there and you have scummy vision that no amount of eye rubbing gets rid off! It doesn’t hurt, it just makes your eyeballs oily haha. It did notthing for my whatchacallit? Millia?

    I guess I could try slashing it with a sterilised pin or blade, but it really is very close to my eyeball and I could blink and disaster could ensue.. hmm need to try something less dangerous I guess… for now, I can cover it with eyeliner and ignore it. Anybody have any ideas?

    • I’m not a fan of oil cleansing generally, and especially in those with oily skin-types and those who are prone to clogging. Applying oil does dissolve surface oil on the skin-but you still need to emulsify it to get it off ie you still need to use a cleanser containing surfactants….which kind of renders the oil step pointless, and potentially exacerbates breakout and milia. My advice would be to see a dermatologist for assessment-these should only be removed with sterile technique using a needle, if its anywhere on the eyelid.

  2. The only safe way to extract these is with sterile technique and a needle. Best done by a professional, especially in this delicate area. And avoid oil-based eye make-up remover going forward. Hope that helps.

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  6. I think I have one of these, but just under my lower lid. Tonight, I tried squeezing it (thinking it was just a pimple that wouldn’t go away) and some white stuff came out but it’s mostly still there. I put a tiny dab of Neosporin on a Q-Tip and cleaned the area after my “surgery”. Should I go to the dermatologist to have it removed? Thank you, in advance!

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