The 7 Best Milia Removal Techniques

Milia—the small, white bumps that form on the face when dead skin cells get trapped under the skin—often go away on their own in a few weeks or months. Treatment isn't necessary, but a few milia removal strategies can help if you don't like how they look:

• Manual extraction by a dermatologist
• Over-the-counter (OTC) exfoliating skincare products
• Prescription medications (antibiotics, retinoids)
• Chemical peels
• Curettage
• Cryotherapy 
• Laser ablation

This article explains the best and safest ways to get rid of milia if you want to.

Note that milia can be stubborn and may need to be treated for months. If you are treating suspected milia on your own without success, something else might be causing the bumps on your skin. See a healthcare provider.

Milia Removal at Home

If you have just a few little bumps of milia here and there, you may want to try an over-the-counter (OTC) product that helps exfoliate dead cells from the skin's surface first.

OTC milia removal products include:

• Salicylic acid products
• Glycolic acid products
• Differin (adapalene), an acne treatment

You’ll need to use these products for the long haul to see continued results.

If you have lots of milia, they’ve hung around even after using OTC treatments, or if they're in a spot that's hard for you to treat with such products (like your eyelid), it’s best to see a skin specialist (dermatologist).

Manual Extraction

The most effective treatment for milia is manual extraction done by a qualified provider.

A tiny opening is made on the surface of the skin with a small surgical blade (lancet). The hard plug of material is gently pushed out through the opening with the provider’s gloved fingers or a tool called a comedone extractor.

This may sound painful, but it's not. At worst, you'll feel a little prick. The results of manual extraction for milia are immediate.

The procedure, sometimes called deroofing, is usually done by a dermatologist. In some cases, milia extractions are done by a person who works at a salon or skin spa (esthetician). However, some states do not allow estheticians to pierce the skin, so not all of them can offer this service.

Prescription Medications

Some people are just more likely to get milia. If that’s you, your dermatologist may recommend using a prescription topical retinoid.

Topical retinoids exfoliate the skin more effectively than OTC products. They also loosen the keratin plug in milia, helping it come to the surface and go away.

The oral antibiotic Minocycline may be prescribed for a more severe version of the condition called milia en plaque.

Procedures

There are also some less common ways providers can try to treat milia. These techniques are more often used for other skin problems but might be used to try to treat milia if other options haven’t helped.

• Curettage is a kind of surgery that uses electricity to scrape off the skin. It’s mostly used to treat skin cancer, but some providers use it to treat stubborn milia. 
• Cryotherapy is a treatment that uses very cold temperatures from liquid nitrogen to “freeze off” skin.
• Laser ablation/resurfacing uses small lasers to remove the outer areas of the skin.

Preventing Milia

The following won't just help prevent milia, but improve the overall health of your skin:

• Cleansing and steaming: Regular, gentle cleansing of your face and body will help keep your skin healthy and prevent clogged pores. You may also find that steam treatments help keep your skin moisturized and pores open. 
• Using sun protection: Covering your skin with clothes and wearing sunscreen can help keep your skin protected from the sun. To prevent milia, look for a sunscreen that isn’t too heavy and won’t clog your pores. 
  

Summary

Milia are tiny cysts that form under the skin, usually on the face. Milia are just a cosmetic issue, so the choice to treat them or not is up to you.

If you do, there are several treatment options you can try, ranging from at-home exfoliating products to professional manual extraction, prescription medications, and procedures like laser resurfacing.

Never try to pop milia on your own. Not only will you be unsuccessful, but it can cause complications like a skin infection.