skin disorders

Milia Under the Eyes: Causes & Solutions!

Milia around the eyes can be frustrating and difficult to get rid of. In this article, we reveal their common causes and effective treatments (and explain whether or not your eye cream may be to blame).

In This Article:

Milia is the technical term for small, hard, white bumps that are rarely swollen or inflamed. They don’t change much once they show up—mostly on the face—and can happen to just about anyone, including infants, teens, and adults. These frustrating yet benign bumps can last for weeks, months, or sometimes even longer.

The undereye area is a common location where many people notice (or are bothered by) milia, and these bumps tend to be extra-stubborn. Let’s find out what causes them, the best ways to treat them (and keep them from coming back), and if your favorite eye cream is making matters worse.

 

What Causes Milia Under the Eyes?

Milia occur when dead skin cells clump together, becoming trapped under the skin’s surface, forming small, hard cysts. These bumps can be unsightly, but they’re not painful nor do they cause permanent scarring such as can occur from certain types of acne. [1]

Adults can get two forms of milia: primary and secondary. Primary milia is the most common, and the same type seen in babies and adults, caused by dead skin cells that build up in the pore lining because they are unable to shed properly.

Secondary milia occur when a skin condition or infection (such as herpes) that leads to blistering actually damages the pore lining. Skin trauma, such as burns or even some types of laser treatments, can also cause milia to form.

Sun damage can be a contributing factor to milia because it makes skin rough and leathery, so it’s more difficult for dead cells to rise to the skin’s surface and shed normally. The resulting clogs can trigger milia formation—and they’ll stick around unless steps are taken to unclog the pore(s).

 

How to Treat Milia Under the Eyes

Milia under the eyes often go away on their own without treatment, so being patient and waiting it out is an option—but waiting is definitely not for everyone! Because milia form when the skin’s natural exfoliation process malfunctions, using a targeted exfoliating treatment with salicylic acid (BHA) on a regular basis will immediately improve what’s become a faulty process.

It may also allow the bump to dissolve on its own (relatively quickly, too) and prevent new ones from forming.

We suggest beginning with a 2% concentration of salicylic acid, such as Paula’s Choice SKIN PERFECTING 2% BHA Liquid. You can use a cotton swab to dab this liquid directly onto the bumps under the eyes, taking care to avoid getting the product near the tear duct or in the eye itself. Follow this routine on cleansed skin for at least a month, twice daily, before you determine if it’s working for you (recall that undereye milia can be extra-stubborn). It’s OK to apply a serum, eye cream, or other eye-area product over this exfoliant; you don’t need to wait for it to absorb.

If using a leave-on 2% BHA exfoliant for a month or longer doesn’t help, then you can try a stronger salicylic acid exfoliant, such as Paula’s Choice RESIST BHA 9 (a 9%, time-released concentration of salicylic acid). Apply BHA 9 to cleansed skin once per day (morning or evening), using a cotton swab to dab the treatment directly on the milia. It’s fine to use a lower-strength BHA exfoliant in the morning and alternate it with BHA 9 at night.

Bumps still there after a month or so of the above treatment options? Consider seeing a dermatologist who can remove them right there in the office using a needle or a tiny lancing utensil and, sometimes, a comedone extractor. [2]

This in-office procedure is fast, painless (numbing cream may be applied) and heals quickly for most people. Going forward, adding a BHA exfoliant product to your daily skincare routine should help keep milia from popping up under the eyes again—or at least minimize how many you get!

Another treatment option to consider is applying an over-the-counter or prescription retinoid product. Because both retinol and prescription versions like tretinoin can change how new skin cells are formed and how they move through the pore lining to skin’s surface, they can play a role in reducing the tendency for the pores around the eyes to become clogged, leading to fewer (possibly no) undereye milia!

Chemical peels using AHA (glycolic acid) or BHA (salicylic acid) at concentrations of 30% or greater may also help, but these can be tricky to use around the eyes, as the risk of irritation and lingering side effects is more significant compared to peeling other areas of the face. Still, this is one more option to discuss with your physician.

 

Can Eye Creams Make Milia Worse?

Many people believe eye creams, foundations, eyeliner pencils, or creamy concealers applied around the eyes cause milia under the eyes, but that’s highly unlikely. Given that 50% of all babies get milia, and men do as well, it clearly isn’t related to skincare or makeup products. [1] Of course, if you’re still concerned, you can experiment with changing your product selection or application method to see what works for you.

Try switching from a thicker, heavier eye cream to one with a thinner gel-cream or lotion texture. Such formulas aren’t as moisturizing as creams, so if your eye area is dry you may find layering a facial moisturizer over a lighter-weight eye-area moisturizer (or face oil) works well without causing milia to show up again.

If you apply a thicker tinted moisturizer, heavier foundation, or creamy concealer under the eyes, experiment with lighter-weight, thinner textures of any or all of those products and see if your undereye milia improve.

 

Are The Bumps Milia, or Something Else?

If you have yellowish, slight to obvious bumps without a depressed center around your eyes and/or on your eyelids, they aren’t milia (which typically are a translucent flesh to white color). Instead, you may be dealing with a skin growth known as xanthoma.

These bumps are common in people who have high cholesterol or high triglyceride levels. See your health care provider for a lipid panel, a test that involves drawing blood to analyze it for the amount of cholesterol and triglycerides that may be causing the bumps. Reducing the health problems associated with xanthoma can reduce the number and size of the bumps.

Xanthomas can occur right alongside milia under the eyes, so you may find you’re dealing with both concerns, only one of which has potential to respond favorably to topical treatments.

References Cited

  1. Berk D, Bayliss S. Milia: a review and classification. J Am Acad Dermatol. 2008;59(6):1050–63.
  2. Gurvinder P, et. al. Surgical pearl: enucleation of milia with a disposable hypodermic needle. J Am Acad Dermatol. 2002;47(4):602–603.
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