How to Get Rid of Milia: Aesthetician-Approved Removal Methods

Milia, those tiny, pearly white bumps often mistaken for stubborn whiteheads, can be a persistent source of frustration. Unlike typical acne, milia are not caused by clogged pores in the traditional sense, but rather by trapped keratin flakes beneath the skin’s surface. While harmless, their appearance can detract from an otherwise clear complexion. This comprehensive guide, crafted with an aesthetician’s insights, will walk you through definitive, actionable methods for their removal and prevention, ensuring a smoother, more radiant skin.

Understanding Milia: A Quick Primer (Before We Dive Into Removal)

Before we delve into the how-to, a brief understanding of milia types is helpful.

• Primary Milia: These develop directly from sweat glands or hair follicles. They can appear at any age and are most common around the eyes, cheeks, and forehead.

• Secondary Milia: These form due to skin trauma, such as burns, blistering, or even aggressive exfoliation, as the skin heals over a trapped keratin plug.

• Milia En Plaque: A rarer form where multiple milia are clustered on an inflamed, raised patch of skin.

• Multiple Eruptive Milia: Characterized by numerous milia appearing in crops over a period of weeks or months.

Regardless of the type, the core issue remains the same: keratin trapped beneath the skin. Our focus will be on the practical steps to address this, particularly for primary and secondary milia, which are the most common concerns.

Aesthetician-Approved In-Office Milia Removal Methods

For persistent or numerous milia, professional removal is often the safest and most effective approach. An experienced aesthetician or dermatologist possesses the tools and expertise to extract milia without damaging the surrounding skin or causing scarring.

1. Manual Extraction (The Cornerstone Method)

This is the most common and effective in-office method for individual milia.

What it is: A sterile lancet or a specialized milia extractor is used to create a tiny incision or puncture over the milium, allowing the trapped keratin to be gently expressed.

How it’s done (Aesthetician’s Perspective):

• Preparation: The skin is thoroughly cleansed and disinfected to prevent infection. In some cases, a warm compress may be applied to soften the skin and make extraction easier.

• Precision Puncture: Using a sterile, single-use lancet (typically a 30-gauge needle or a specialized milia needle), the aesthetician carefully creates a microscopic opening directly on top of the milium. The incision is just deep enough to penetrate the superficial layer of skin covering the keratin plug, not to go deep into the dermis.

  • Concrete Example: Imagine a tiny white dot on your cheek. The aesthetician will lightly stretch the skin around it, and with a steady hand, a swift, controlled prick will be made directly into the center of the milium.
• Gentle Expression: After the tiny opening is made, gentle pressure is applied around the milium with the fingers, cotton swabs, or a comedone extractor. The goal is to carefully push out the hard, pearly keratin plug.
  • Concrete Example: Picture the aesthetician using the pads of their index fingers, wrapped in gauze, to apply opposing pressure on either side of the milium, much like gently squeezing a tiny bead out of a fabric. The keratin plug should pop out cleanly.
• Post-Extraction Care: A soothing antiseptic solution or a calming balm may be applied to the area to prevent infection and aid in healing.
  • Concrete Example: After extraction, a small dab of a salicylic acid or tea tree oil-based spot treatment might be applied to the area to ensure it stays clean and heals quickly.

Why it’s effective: It directly removes the trapped keratin, providing immediate results.

What to expect: Minimal discomfort, usually a slight prick. Redness and a tiny pinprick mark may be visible for a few hours to a day, but typically heal without a trace.

Crucial Advice: Never attempt manual extraction at home with unsterilized tools. This can lead to infection, scarring, and further skin damage.

2. Microdermabrasion

While not a direct removal method for individual milia, microdermabrasion can be beneficial as a preparatory step or for addressing widespread, superficial milia.

What it is: A non-invasive procedure that uses a specialized device to gently abrade the outermost layer of skin, removing dead skin cells and encouraging cellular turnover.

How it’s done (Aesthetician’s Perspective):

• Preparation: The skin is cleansed thoroughly.

• Exfoliation: A handheld device with a diamond-tipped wand or fine crystals is passed over the skin, gently buffing away the superficial layers. This action helps to loosen the keratin plugs in very superficial milia and can make subsequent manual extraction easier for deeper ones.

  • Concrete Example: The aesthetician moves the microdermabrasion wand across your face in a systematic pattern, feeling like a gentle suction and exfoliation combined. For areas with milia, they might focus a bit more to encourage the top layer of skin to shed.
• Post-Treatment: A hydrating and soothing serum is applied.

Why it’s effective: It can help to slough off the superficial layer of skin that is trapping the keratin, making it easier for milia to naturally resolve or be extracted. It also improves overall skin texture and tone.

What to expect: Mild redness, similar to a light sunburn, immediately after the treatment. Skin will feel smoother. Multiple sessions may be required for noticeable improvement in milia.

3. Chemical Peels (Superficial to Medium Depth)

Similar to microdermabrasion, chemical peels can be a supportive treatment, particularly for widespread, small milia, by promoting skin cell turnover.

What it is: The application of a chemical solution (e.g., alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), or trichloroacetic acid (TCA)) to the skin to exfoliate the top layers and stimulate new cell growth.

How it’s done (Aesthetician’s Perspective):

• Preparation: The skin is cleansed and degreased to ensure even penetration of the peel solution.

• Application: The chosen peel solution is applied to the skin for a specific duration, depending on the type and strength of the peel. Superficial peels are often applied for minutes.

  • Concrete Example: For a mild AHA peel, the aesthetician might brush a glycolic acid solution onto your face. You might feel a slight tingling sensation as it works.
• Neutralization/Removal: The peel is then neutralized or rinsed off, depending on the type.

• Post-Treatment: A calming and hydrating serum or moisturizer is applied, along with strict sun protection.

Why it’s effective: By accelerating skin cell turnover, chemical peels can help to bring trapped keratin to the surface and prevent new milia from forming. They are particularly useful for preventing recurrent milia and for improving overall skin texture.

What to expect: Depending on the peel’s strength, you may experience mild tingling, redness, and some flaking or peeling of the skin for a few days post-treatment.

Important Note: Chemical peels should only be performed by a qualified aesthetician or dermatologist to ensure safety and efficacy.

4. Laser Ablation

For very stubborn or numerous milia, especially in delicate areas, laser ablation can be an option.

What it is: A concentrated beam of light is used to vaporize the milium, precisely targeting the trapped keratin. CO2 lasers are often used for this purpose.

How it’s done (Dermatologist/Aesthetician’s Perspective):

• Preparation: The skin is cleansed, and protective eyewear is provided. A topical anesthetic may be applied for comfort.

• Targeted Vaporization: The laser is precisely aimed at each individual milium. The energy from the laser instantly vaporizes the keratin plug.

  • Concrete Example: The aesthetician uses a handheld laser device, pointing a tiny red dot onto each milium. With a quick flash, the milium seems to disappear.
• Post-Treatment: A soothing balm and sun protection are applied.

Why it’s effective: Provides precise and often immediate removal with minimal surrounding tissue damage.

What to expect: A snapping sensation during the procedure. Post-treatment, there may be tiny scabs that heal within a few days to a week. Risk of hyperpigmentation is a consideration, especially for darker skin tones.

At-Home Strategies for Preventing and Managing Milia (After Professional Removal)

While professional removal is the most direct solution for existing milia, consistent at-home care is crucial for preventing new ones and maintaining clear skin. These strategies focus on promoting healthy skin cell turnover and preventing keratin buildup.

1. Gentle Exfoliation (Key to Prevention)

Regular, gentle exfoliation is paramount to preventing keratin buildup.

How to do it:

• Chemical Exfoliants (Preferred): Incorporate products containing AHAs (glycolic acid, lactic acid) or BHAs (salicylic acid) into your routine. These acids gently dissolve the bonds between dead skin cells, promoting their shedding.
  • Concrete Example: After cleansing your face in the evening, apply a toner or serum containing 5-10% glycolic acid a few times a week. Start with a lower concentration and less frequent use, then gradually increase as your skin tolerates it.
• Physical Exfoliants (Use with Caution): If you prefer physical exfoliation, opt for very fine-grained scrubs and use them sparingly (once or twice a week at most). Harsh scrubbing can irritate the skin and potentially cause secondary milia.
  • Concrete Example: If using a scrub, choose one with very fine, smooth particles (like jojoba beads, not jagged nut shells). Gently massage it onto damp skin in small, circular motions for no more than 30 seconds, then rinse thoroughly. Focus on areas prone to milia.

Actionable Tip: Don’t over-exfoliate. Excessive exfoliation can disrupt the skin barrier, leading to irritation and potentially worsening the problem. Listen to your skin and adjust frequency as needed.

2. Retinoids (The Gold Standard for Cell Turnover)

Topical retinoids (vitamin A derivatives) are highly effective in regulating cell turnover and preventing clogged pores, which indirectly helps prevent milia.

How to use them:

• Over-the-Counter Retinols: Start with a low concentration (0.25% to 0.5%) and apply a pea-sized amount to clean, dry skin every other night. Gradually increase frequency as your skin adapts.
  • Concrete Example: After cleansing and applying any hydrating serums, take a tiny dot of your retinol cream and gently spread it over your entire face, avoiding immediate eye contact (unless the product is specifically formulated for that area).
• Prescription Retinoids: For more stubborn cases, a dermatologist can prescribe stronger retinoids like tretinoin. These are more potent and require careful introduction to avoid irritation.

Actionable Tip: Always apply retinoids in the evening as they can increase sun sensitivity. Use a broad-spectrum sunscreen with an SPF of 30 or higher every morning.

3. Non-Comedogenic Skincare Products

Heavy, occlusive products can trap dead skin cells and oil, potentially contributing to milia formation.

How to choose:

• Look for “Non-Comedogenic” or “Non-Acnegenic”: These terms indicate that the product is formulated not to clog pores.
  • Concrete Example: When buying moisturizer, check the label for “non-comedogenic” or “won’t clog pores.” This is especially important for products you apply around your eyes.
• Opt for Lighter Formulations: Gels, gel-creams, and oil-free lotions are generally less likely to contribute to milia than rich creams or balms, especially if you’re prone to them.
  • Concrete Example: If you have oily or combination skin, switch your heavy night cream for a lightweight gel moisturizer, particularly during warmer months.

Actionable Tip: Pay close attention to makeup, especially concealers and foundations used around the eyes, as these are common culprits.

4. Eye Cream Considerations

The delicate skin around the eyes is a common area for milia due to its thinness and the potential for heavy eye creams.

How to manage:

• Choose Lightweight Eye Creams: Opt for gel-based or very light lotion formulations specifically designed for the eye area.
  • Concrete Example: Instead of a thick, emollient eye cream, try one with hyaluronic acid or a light serum texture. A product that comes in a pump or tube is often less likely to be contaminated than a jar.
• Apply Sparingly: A tiny amount is sufficient for the entire eye area.
  • Concrete Example: Use only a half-pea-sized amount of eye cream for both eyes, gently dabbing it along the orbital bone rather than directly on the eyelid.
• Avoid Over-Application: Resist the urge to layer multiple eye products if you’re prone to milia in this area.

Actionable Tip: If you notice milia forming around your eyes, consider temporarily pausing your eye cream or switching to an even lighter alternative to see if it makes a difference.

5. Sun Protection (Indirect but Important)

Sun damage can weaken the skin’s barrier and impair its natural exfoliation process, potentially contributing to milia.

How to protect:

• Daily SPF: Apply a broad-spectrum sunscreen with an SPF of 30 or higher every single day, rain or shine.
  • Concrete Example: Make applying a quarter-sized amount of SPF 50 sunscreen the last step in your morning skincare routine, even if you’re just staying indoors.
• Physical Sunscreens: Zinc oxide and titanium dioxide-based sunscreens are generally well-tolerated and less likely to cause irritation for sensitive skin.

Actionable Tip: Reapply sunscreen every two hours when exposed to direct sunlight, or more frequently if swimming or sweating.

6. Healthy Lifestyle Habits

While not direct milia removers, these habits contribute to overall skin health and can indirectly help prevent their formation.

How to implement:

• Hydration: Drink plenty of water throughout the day to support healthy skin function.
  • Concrete Example: Keep a water bottle with you and aim to refill it several times a day.
• Balanced Diet: A diet rich in antioxidants (fruits, vegetables) and healthy fats can promote skin health.
  • Concrete Example: Incorporate berries, leafy greens, and omega-3 rich foods like salmon into your weekly meals.
• Avoid Excessive Sweating with Occlusive Products: If you’re exercising intensely, avoid heavy makeup or creams that might trap sweat and dead skin cells, especially around the face.
  • Concrete Example: Before a workout, remove your makeup and cleanse your face. After, cleanse your face again to remove sweat and impurities.

Actionable Tip: Pay attention to how your skin reacts to different foods or habits. Sometimes, an underlying inflammation or dietary factor can subtly impact skin health.

When to Seek Professional Help (and Not Attempt DIY)

While at-home prevention is vital, certain situations warrant a visit to an aesthetician or dermatologist:

• Stubborn Milia: If milia don’t respond to consistent at-home efforts.

• Deep-Seated Milia: Milia that are large or feel deeply embedded in the skin are best handled by a professional.

• Numerous Milia: If you have a large cluster or widespread milia, professional extraction will be more efficient and safer.

• Milia En Plaque or Multiple Eruptive Milia: These rarer forms require professional diagnosis and treatment.

• Milia Around the Eyes: The delicate skin here makes self-extraction risky.

• Uncertainty: If you’re unsure if a bump is milia or something else, always consult a professional.

Concrete Example: If you’ve been consistently using a gentle AHA exfoliant for 6-8 weeks and a particular milium hasn’t budged, or if new ones keep appearing rapidly, it’s time to book an appointment with a skin professional.

Debunking Common Milia Myths and What NOT to Do

To ensure you’re on the right track, let’s clarify some common misconceptions and dangerous practices:

• Myth: Milia are acne.
  • Reality: They are not. Milia are keratin cysts, not pimples, and therefore don’t respond to typical acne treatments like benzoyl peroxide in the same way.
• Myth: You can pop milia like a pimple.
  • Reality: This is a dangerous misconception. Attempting to “pop” a milium without proper tools and technique will likely lead to skin trauma, infection, scarring, and frustration, as the keratin plug is encapsulated and cannot be simply squeezed out.
• What NOT to Do:
  • Don’t use harsh scrubs: They can irritate the skin and potentially worsen the problem or create secondary milia.

  • Don’t try to extract at home with needles or tweezers: This dramatically increases the risk of infection, scarring, and hyperpigmentation.

  • Don’t pick or scratch: This can lead to inflammation, infection, and post-inflammatory hyperpigmentation.

Concrete Example: If you find yourself instinctively trying to squeeze a milium with your fingernails, immediately stop. Instead, cleanse the area and remind yourself that this approach will only make things worse. Make a mental note to schedule a professional extraction if it’s bothering you.

Conclusion

Getting rid of milia requires a two-pronged approach: strategic professional intervention for existing bumps and consistent, gentle at-home care for prevention. By understanding the nature of these tiny keratin cysts and adhering to aesthetician-approved methods, you can effectively clear your complexion and maintain smooth, healthy skin. Remember, patience and consistency are key. When in doubt, always seek the guidance of a qualified skincare professional. Your skin will thank you.