Milia, Whiteheads and Skin Tags: What Are These Bumps?

Milia are tiny, hard, white or yellowish cysts filled with keratin that sit just under the skin, whiteheads are clogged pores that are a mild form of acne, and skin tags are soft, harmless growths that hang from the skin on a thin stalk. All three are usually harmless, but each is managed differently, and squeezing, cutting or tying them off at home often leads to infection, marks and scars.

These are among the most common reasons people in India message a dermatologist with a close up photo of a small bump. Here is how to tell them apart.

What are milia?

Milia (singular milium) are very small cysts, usually 1 to 2 millimetres, that form when keratin, the protein in the outer skin layer, gets trapped under the surface.

Typical features:

• Pearly white or yellowish, firm, dome shaped bumps
• Common around the eyes, eyelids, cheeks, nose and forehead
• Do not hurt or itch, and do not have a visible opening
• Very common in newborn babies, where they usually clear on their own within weeks

In adults, milia can appear on their own or after skin damage, such as:

• Sun damage over many years
• Burns, blisters or skin resurfacing procedures
• Long term use of steroid creams on the face
• Thick, occlusive creams used around the eyes in some people

What are whiteheads?

Whiteheads, or closed comedones, are pores blocked with oil (sebum) and dead skin cells. The opening of the pore is closed, so the plug stays white or skin coloured rather than turning dark like a blackhead.

Typical features:

• Small, skin coloured or white bumps, often many at once
• Common on the forehead, chin, jawline and nose
• Part of acne, and often seen alongside blackheads, pimples or oily skin
• Can become red, inflamed pimples if bacteria and inflammation develop

Whiteheads are encouraged by heavy, oily cosmetics and hair oils on the forehead, humid weather, and hormonal changes. Our guide to acne causes and treatment on Indian skin covers how acne is treated, and our article on fungal acne explains another lookalike that is common in Indian humidity.

What are skin tags?

Skin tags (acrochordons) are small, soft, flesh coloured or brown growths that hang from the skin, often on a narrow stalk.

Typical features:

• Soft, painless, movable growths, from a pinhead to a few millimetres or more
• Common on the neck, armpits, eyelids, under the breasts and groin
• Increase with age, weight gain and pregnancy
• Can be irritated by friction from collars, chains, bra straps or shaving

Skin tags are harmless and are not a form of cancer. They are more common in people with diabetes, insulin resistance and obesity, and in some families. If you also have darker, velvety skin on the neck or underarms, read our article on dark underarms and acanthosis nigricans, as the two often occur together.

How can I tell them apart?

Feature	Milia	Whiteheads	Skin tags
What it is	Keratin cyst	Clogged pore (acne)	Soft benign growth
Feel	Hard, like a grain of sand	Soft to slightly firm	Soft, floppy
Colour	Pearly white	White or skin coloured	Skin coloured to brown
Common sites	Around eyes, cheeks	Forehead, chin, nose	Neck, armpits, eyelids, folds
Can you squeeze it?	No, no opening	Should not, causes marks	No
Linked to	Sun damage, steroid creams, heavy creams	Oil, hormones, cosmetics	Age, weight, insulin resistance

Other bumps can look similar, including warts, molluscum, sebaceous hyperplasia and small moles. If you are unsure, see our guide to warts, molluscum and corns, or ask a dermatologist.

How are milia treated?

Milia in babies need no treatment. In adults, milia often persist for months, but some clear on their own.

Your dermatologist may consider:

• Extraction, where a tiny opening is made with a sterile needle or blade and the keratin is gently expressed
• Topical retinoids in some cases to help with multiple small milia, under supervision
• Light electrocautery or laser for multiple milia

At home, you can:

• Switch to lighter, non comedogenic moisturisers, especially around the eyes
• Use daily sunscreen to reduce sun damage
• Stop any steroid cream use on the face, with medical advice

Please do not try to dig out milia with pins or needles at home. The skin around the eyes is thin, and this can cause infection and scarring.

How are whiteheads treated?

Whiteheads are treated as part of acne. Your dermatologist may consider:

• Topical retinoids to normalise how skin cells shed and keep pores clear (our retinol and tretinoin guide explains how these work)
• Salicylic acid or other ingredients to help unclog pores
• Professional extraction or peels in selected cases
• Treatment of underlying hormonal factors if relevant

Daily habits that help include a gentle cleanser, oil free moisturiser and sunscreen, keeping hair oil away from the forehead, and removing makeup fully at night.

How are skin tags removed?

Skin tags do not need treatment unless they are irritated, bleeding, or bothering you cosmetically. Removal is usually quick. Your dermatologist may consider:

• Snipping with sterile instruments
• Electrocautery or radiofrequency
• Cryotherapy (freezing)

Tiny tags may leave little or no mark, though on brown skin there is a chance of a temporary dark or light spot. New skin tags can continue to appear over time, especially if the underlying tendency remains.

Why should I avoid home removal?

Common home methods in India, such as tying a thread around a skin tag, applying caustic pastes, cutting with nail clippers or burning with heated objects, can cause:

• Pain, bleeding and infection
• Scars and dark marks, which are more noticeable on Indian skin
• Missing a growth that is not actually a skin tag and needs a proper diagnosis

Can my skincare or makeup routine cause these bumps?

Sometimes, yes, at least for milia and whiteheads.

• Heavy eye creams and thick balms can contribute to milia around the eyes in some people. Lighter gel or lotion textures are usually better tolerated.
• Oily foundations, heavy sunscreens and hair oils that spread onto the forehead can clog pores and lead to whiteheads, especially in humid Indian summers. Look for products labelled non comedogenic, and keep oil on the scalp rather than the hairline.
• Sleeping in makeup traps oil and debris in the pores. A gentle cleanse every night helps.
• Over scrubbing does not prevent milia or whiteheads and can irritate the skin, leading to dark marks.

Skin tags are not caused by skincare, but they may be irritated by necklaces, collars and friction, and by repeated shaving or threading over them.

If you are building a routine from scratch, our basic skincare routine by skin type is a good starting point.

When to see a dermatologist

See a dermatologist if:

• A bump bleeds, grows quickly, changes colour or looks different from the others.
• You have many skin tags along with dark, velvety skin, weight gain or a family history of diabetes.
• Milia are spreading or appeared after using a steroid cream.
• Whiteheads are turning into painful pimples or leaving marks.
• You want a bump removed safely, without scarring.

Dr. Maria offers online consultations where you can share clear photos of the bumps, and she can help identify them and advise whether they need treatment or an in person procedure.