What Are Those Tiny White Bumps?

Those little white bumps you get right below your eyes, on top of your cheekbones, or even on other parts of your face? Those pesky bumps are called Milia (pronounced mill-ee-a). Singular - plural, same word.  They're like tiny pearls underneath the first layer skin that won’t come out no matter how much you squeeze, unless you literally scratch the darn thing off your face. Please don't do that.

Whatever others might have told you, it’s not “calcium deposits” or acne breakouts. It doesn’t require two rounds of Retin-A or massive chemical peels (although there are those with a genetic propensity that do have luck with AHAs and some have even been helped with careful and monitored use of Retin-A). However I've seen way too many people with prescriptions renewed a thousand times before they've asked their doctor why it doesn't seem to be working.  

So what are these milia?

Photo by Dr. Alaa Saad via dermRounds

Milia are basically a response to excess rubbing and/or scratching.  A lot of the time, eye products, moisturizers, and/or makeup removers that are too rich for your skin can get stuck just outside of pores and in between microscopic tears in your skin.  Wash cloths or towels used to remove leftover makeup, or mascara remover wipes that are too textured for the delicate eye area, cause teeny-tiny tears that the skin has to repair.  Sometimes extreme dryness can cause microscopic tears as well.  The skin creates excess dead skin cells with fats and waxes in order to repair and prevent further damage.

Here's a great example of one of the crazy ways I've seen milia form.  I used to have a client whose skin had a very compromised natural barrier, making it extra vulnerable to water loss, on top of the fact that it produced very little oil.  When she first started coming to me for facials, the milia on her upper cheeks were extensive.  As we got to know each other I found out that she ran the Chicago Marathon almost every year, which meant a lot of running outside throughout the summer.  After not being able to pin down what was causing the problem, it finally dawned on me that while sweating with very little oil production, the salt from her sweat would crystalize invisibly on her upper cheeks.  All day long, as she was wiping away the sweat from her cheeks and under her eyes, she was scratching her skin with the salt of her sweat!

So, what to do about it?

• Be especially careful about how you remove your eye makeup! Use 100% cotton rounds with gentle, outward motions. In my skincare webshop, I carry a wonderful eye makeup removing sponge that is gentle enough even for people who wear contacts! The fact that it can be used with nothing but warm water to remove ALL non-waterproof makeup is really the best thing ever!

• The only people who should be using waterproof mascara are those who use eye drops 24/7, or who know they’re going to cry any second! If your mascara runs or smudges, it doesn’t mean you need waterproof, it just means you need to change brands to something that works! Keep your receipts and return what you don’t like.

• DO NOT use washcloths to wipe off makeup or even to wash your face! Washcloths are just way too rough.  Just use your good ol' hands.  If water dripping down your wrists and forearms drives you crazy, it's not crazy to wear terrycloth wrist bands while you wash.  Sure, they'll make you look like you're cos playing John McEnroe, but your skin will thank you, I promise.

• Milia can be removed only by puncturing, but please don’t do it yourself. Get a facial from a licensed esthetician or see a doctor.

In the meantime, if milia are a constant problem, we need to evaluate your eye creams, makeup removal techniques, and moisturizers. Please contact me so we can work together on your way to clear, radiant skin! :)

Like this post ?  Please share!