Milia (Bumps) under the eyes: causes, diagnosis, treatment, prevention:

Small bumps under your eyes also called milia. Milia are developed due to the accumulation of keratin under the skin. They often happen around or under your eyes. Health experts don’t know the exact reason behind its formation, but the use of steroid creams or trauma may cause milia.  

Overview:

Milia are the small yellowish or white bumps under or around your eyes, developed as keratine (a protein) trapped under the skin.

Milia often occur in children and newborns, but adults may be affected by it. Most people puzzle Milia with skin tags or acne spots. They may go away on their own, but sometimes removal (either by medical treatment or by home remedies) is needed to get clear skin and prevent damaging vision.

This article provides comprehensive information about Milia, including their causes, diagnosis, possible treatments, and home remedies.

What is Milia?

Milia are tiny, yellowish, or white bumps that typically appear on the face or other parts of your skin. They are caused by the accumulation of keratin, a protein, underneath the skin's surface. Milia can develop in people of all ages, including newborns, and are usually not harmful.

How common are bumps under the eyes?

Milia or bumps under your eyes are very common and usually not dangerous. Some individuals named them “milk spots”, and mistake them for pimples or acne blemishes.

A study showed Milia is more common in older women¹.

Can Milia develop in other areas of my body?

Bumps under the eyes or Milia can appear in other areas of your body, but adults may be around the forehead, cheeks, eyes, and genitals²

How does Milia develop?

Milia are a tiny collection of rapt Keratin. Keratin is a protein, which provides strength to your nails, hair, and skin cells. When these skin cells die off and drop within pores, the keratin may collect and become trapped in the pore, developing a little milium, or cyst.

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Can Milia damage my eyes?

When Milia develop very close to your eye, your healthcare provider may refer you to an opthalmologist to treat the abrasions. But if they find them at a safe distance from the eye, they may feel comfortable performing treatment to remove them. 

Causes:

What causes bumps under my eyes?

Bumps under the eyes could be due to a variety of reasons including:

1. Milia:

One common cause of bumps under the eyes is Milia, which are small, white, or yellowish bumps caused by trapped keratin beneath the skin's surface.

2. Syringomas:

Another possibility is that they could be syringomas, which are harmless sweat duct tumors.

3. Certain cosmetic procedures or trauma:

Some individuals get bumps under the eyes, which may be from undergoing cosmetic procedures or trauma. However, there is no obvious reason why some individuals develop them while others don’t. 

4. Use of steroids:

In rare cases, an individual may get bumps under the eyes after using a topical medication, such as corticosteroids³.

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Diagnosis:

How Milia is diagnosed?

If you go to your healthcare provider, they may refer you to a dermatologist or opthalmologist. Physical examination is typically enough for your doctor to be able to diagnose Milia.

If you have a lot of bumps, your healthcare provider may also need to check for underlying conditions that could be causing multiple Milia.

A condition that your healthcare provider will reveal during the diagnosis of Milia includes inherited genetic skin disorders, such as genodermatosis. They may also investigate conditions that don’t lead to Milia but can give a similar appearance, including⁴:

Idiopathic calcinosis cutis

• Sebaceous hyperplasia
• Flat warts
• Comedonal acne

Treatment:

How Milia is Treated?

Some cases of milia clear up without any treatment within a few months. Most people who had milia on their faces as infants no longer have any.

However, this is not always the case, and there is no set standard for treatment. Although the bumps are not harmful, many people have cosmetic concerns about milia under the eyes and on the face.

Never press a milium as they would a pimple. This will irritate your skin and may damage your sensitive skin in the area.

Your healthcare provider  may suggest you following treatment options including:

Over-the-counter treatment:

Chemical peels:

To remove the top layer of the skin chemical peels are applied. They can improve the appearance of wrinkles, uneven skin tone, acne scars, fine lines, and other skin issues.

Remember, over-the-counter exfoliative chemicals are not likely to remove milia under the eyes.

A chemical peel has these common ingredients such as:

• Glycolic acid
• Lactic acid
• Salicylic acid 

Remember, your under-eye area is very sensitive, so it’s crucial to take extra care while using chemical peel. Don’t use chemical peel until your dermatologist will recommend it.

Professional options:

Here are some professional treatment options your dermatologist may perform to remove milia in their clinic, including:

1. Laser ablation:

Laser ablation is a treatment that removes the top layer of your skin and heats the deeper layer, which helps stimulate the growth of collagen. This makes the skin under your eyes firmer and smoother as the top layer of skin heals and grows back.

Collagen is a protein that makes your skin feel smoother and firmer.

During laser ablation, your dermatologist will use a small laser to target the milium directly, opening the pore.

2. Extraction:

Milium extraction is a common procedure where your dermatologists will use a small scalpel or needle to take off a part of the skin covering the cyst. By opening the pore in this manner, they can gently remove the keratin. After this, you will need to take preventive measures to stop the milia from returning.

3. Cryotherapy:

Cryotherapy is a procedure in which your dermatologist will use very cold temperatures to remove or freeze the bumps under your eyes. This treatment will be done using liquid nitrogen or maybe other freezing agents.

In some cases, cryotherapy can help get rid of milia. But, because the skin under the eyes is delicate, cryotherapy might not be the best choice for treating milia in that area. It could hurt and leave scars or change the skin color.

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Prevention:

How can I prevent Milia? 

Not all cases of Milia are preventable, as some people may be more liable for them than others.

However, you can follow these general preventive measures to prevent Milia including:

• Using a prescription or topical retinoids
• Avoid trauma to the skin
• Maintaining a good skincare routine such  as gentle cleansing cleansing

Home remedies:

Most treatments you can do at home for milia involve gently removing dead skin or using special chemicals. But, it's important to talk to a doctor before trying these methods, especially near your eyes. A doctor might also be able to remove the milia in their office.

Why do I get Milia under my eyes?

You get Milia under your eyes due to taking certain medications (such as corticosteroids) or skin trauma. The second reason for having Mila is an inherited genetic skin disorder⁵.

How do I get rid of Milia under my eyes naturally?

Unreliable evidence suggests the following may help a person to get rid of milia under their eyes naturally:

It can be helpful to use a manuka honey face mask when dealing with Milia, as research has found anti-inflammatory properties in honey. Additionally, it's important to avoid picking or poking milia bumps, as this can slow down the healing process. Instead, try gently exfoliating and steaming the skin to help bring trapped keratin to the surface. Milia occurs due to an excess of keratin, so this method may be effective in helping to resolve the issue.

How can I get rid of Milia myself?

You can try gentle exfoliation at home. Be careful while scrubbing or exfoliation as it can hurt your under eye skin.

By exfoliation, your Milia will resolve within one month to even one year depending on your skin condition.

Conclusion:

Milia are small cysts that form under the skin, caused by the buildup of keratin. They are often found on the face, and around or under the eyes. It is important to keep in mind that milia are not pimples, and squeezing them can lead to further damage to the skin, inflammation, and scarring. Clearing the built-up keratin from the pores is necessary for the milia to disappear.

If you notice deeper milia or milia around sensitive areas such as your eyes, it is best to seek professional treatment. Your dermatologist can help diagnose and suggest treatment options if you experience recurring milia in the same area.