Milia are tiny sealed cysts of hardened keratin trapped just under the skin, while whiteheads are closed pores clogged with oil and dead skin cells. A dermatologist can extract both, but each needs a different opening technique because only whiteheads sit in a pore. MedlinePlus states milia are not a true form of acne, according to the MedlinePlus encyclopedia entry. They often appear as pearly-white bumps on eyelids and cheeks.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What is inside each bump?
- Where do they form?
- How does in-office extraction differ?
- Can you remove them at home?
What is inside each bump?
A milium is a small cyst containing keratin. DermNet describes these cysts as tiny pearly-white bumps just under the skin, according to the DermNet milium page.
A whitehead is a closed comedone. That means a plugged follicular opening forms an uninflamed skin-colored papule. It holds oil and dead skin, not a sealed keratin ball.
Where do they form?
Milia develop in very small hair follicles or sweat ducts rather than pores. Trapped keratin hardens under new skin and creates a firm closed cyst.
Whiteheads form when a pore clogs with oil and dead skin cells. Water's Edge Dermatology explains this pore-versus-duct difference in its dermatologist-reviewed guide to milia removal. The location matters because it decides how the bump can be opened.
How does in-office extraction differ?
For persistent milia, a dermatologist uses de-roofing. The doctor cuts a tiny opening in the cyst top with a lancet, then pushes out the keratin plug with a comedone extractor.
For whiteheads, the doctor first punctures or incises the closed surface with a sterile needle or blade, then applies gentle pressure. The practical difference is small but important:.
- milia need a cut through cyst skin to release a solid plug
- whiteheads need a puncture through the closed pore surface to release softer clogged material
Can you remove them at home?
Squeezing a milium does not work because the cyst has no opening. Trying to pop it can cause bleeding, scabbing, and permanent scarring.
Milia are harmless and require no treatment. They affect 40-50 percent of newborns and usually clear within weeks, while adults have them removed only to improve appearance.