Milia are the small, hard, white bumps that appear around the eyes, on the cheeks, and sometimes the forehead, and that make people reach for the same three things that never work: squeezing, scrubbing, and spot treatments. They are not pimples. They are tiny cysts of keratin, the protein that makes up the skin’s surface, sealed under an intact layer of skin with no opening. Nothing applied from outside reaches them, and pressure only bruises the skin around them.
Removal is simple and quick. Prevention is a routine.
Why they form
Milia develop when keratin gets trapped instead of shedding. In adults the common triggers are heavy or occlusive creams around the eyes, sun damage that thickens the skin, a healed burn, blister, or rash, long-term use of steroid creams, and skin that simply turns over slowly. They are entirely harmless, do not spread, and do not signal anything wrong. They also, in adults, rarely resolve on their own.
How they are removed
A provider cleans the area, makes a tiny opening in the skin over each milium with a sterile needle or a fine blade, and expresses the keratin pearl with gentle pressure. Each one takes seconds. There is no anesthetic needed for most, no bleeding beyond a pinpoint, and no scar; the site is a faint pink dot for a day or two. A cluster of milia is handled in one visit. Some clinics use a light electrocautery for stubborn ones, and milia very close to the lash line are removed by providers comfortable working near the eye.
Keeping them from coming back
Removal clears what exists. For people who keep getting milia, the fix is turnover. A series of light chemical peels speeds shedding so keratin stops getting trapped. A gentle retinoid at night does the same over time. HydraFacial and dermaplaning reduce the surface buildup that contributes. And around the eyes, switching from heavy creams to lighter, gel-based products often ends the cycle on its own.
What it costs
Milia extraction is usually priced per visit, often folded into a facial or charged as a small standalone fee, commonly $50 to $200 depending on how many there are. It is a cosmetic treatment and not covered by insurance.
How to choose a provider
Ask whether they extract milia specifically, since not every facial provider does. Ask what they use to open them, and whether they are comfortable treating close to the eye if yours are there. If you get milia repeatedly, ask what they recommend to prevent them, because a provider who only extracts is treating half the problem.
Browse the clinics below. Skip the eye cream for a day before your visit so the provider can see the bumps clearly.