Medically reviewed by Dr Sin Yong · Last reviewed · 3 min read
Published 13 October 2026 · Reviewed by Dr Sin Yong
Milia (singular milium; 'milia seeds' in Singapore usage) are tiny cysts of keratin, 1 to 2 mm, firm and pearl-white, sealed beneath intact epidermis with no opening to the surface. They are not whiteheads and not trapped oil, which is why squeezing fails: there is no exit. Primary milia arise spontaneously, most often around the eyes; secondary milia form as skin heals after blistering, resurfacing or prolonged steroid creams. Removal is a sterile needle-point opening and expression of the pearl.
Key facts
ICD-10
L72.0
What's inside
Keratin, the compacted protein of the skin's surface layer; not sebum or pus
Primary vs secondary
Primary arise spontaneously at any age, including newborns; secondary follow blistering, resurfacing, burns or prolonged steroid creams
Removal
Sterile micro-opening and expression, seconds per lesion; fine RF or laser tips for numerous or recurrent milia
Where it fits
A comedone has an exit; a milium does not. Squeezing a lesion with no opening drives pressure into the surrounding dermis, and in Asian skin that inflammation often deposits a brown mark that outlasts the milium by months; home needling adds infection and scarring, millimetres from the eyelid margin. Milia are not a hygiene problem, do not respond to acne treatment and can sit unchanged for years. Heavy, waxy eye creams are a soft contributor in milia-prone people. Full page: milia and white bumps; the removal guide on milia seeds removal; the look-alike on syringoma.
Frequently Asked Questions
Because there is no opening. A milium is a keratin pearl sealed under an intact roof of epidermis, so pressure has nowhere to push the contents. In clinic a sterile fine point creates a precise opening first, and the pearl is then expressed whole.
No. Primary milia are a quirk of skin turnover with a preference for thin skin around the eyes; secondary milia follow a disruption such as blistering or resurfacing. Scrubbing accomplishes nothing but irritation.
