Differences Between Milia, Whiteheads, and Fungal Acne — GalaGlo

Differences Between Milia, Whiteheads, and Fungal Acne

Milia, whiteheads, and fungal acne are three different skin conditions that can produce bumps on your face. However, they differ in the way they develop and the treatment that is needed to clear them up.


Milia are tiny bumps that form when keratin — a protein that makes up part of your outer layer of skin — becomes trapped under your skin. Keratin is what gives your skin its toughness and strength, so it's important for healthy skin. But if it gets trapped under the surface of your skin, it can build up into a hard lump called a milium.

Milia form most often around the nose and eyes, but they can also appear on other parts of the body, such as the cheeks or chin. They're generally smaller than 1 millimeter (mm) in diameter (about one-tenth of an inch). They're usually white or yellowish in color, though sometimes they may appear pinkish or brownish due to blood vessels that lie underneath them in some people.

There are a few different types of milia

  • Epidermoid milia: These are usually found near the nose or eyes, and they're often mistaken for whiteheads or baby acne.
  • Follicular milia: These are similar to epidermoid milia, but they're larger and more common on cheeks, forehead, or chin. They look like whiteheads with tiny black dots inside them.
  • Seborrheic keratosis: This type is like an overgrowth of normal skin cells that form a bump on your skin's surface.

Causes of Milia

Milia form when keratin becomes trapped under the surface of your skin. Microscopic follicles are connected to deeper glands that produce oil (sebum). When these follicles become obstructed, sebum builds up beneath the surface of the skin instead of being released through the pore. This causes an accumulation of dead skin cells around the blocked opening, which then forms into a small lump underneath your skin's surface (milia).

What is the treatment for milia?

There are several ways to treat milia:

Oral antibiotics. Topical retinoids (vitamin A derivatives) such as tretinoin (Retin-A) and tazarotene (Tazorac). Topical corticosteroids such as clobetasol propionate (Clobex), triamcinolone acetonide (Kenalog), fluocinonide (Lidex), and betamethasone valerate 0.1% cream may also be used.


Whiteheads are a type of acne that appears as small, white bumps. They often have a head at the top and a small opening on the surface.

Whiteheads are less common than blackheads and pustules, but they can still be annoying and uncomfortable.

What causes whiteheads?

Whiteheads are caused by hair follicles beneath the surface of the skin become blocked by oil and dead skin cells. Bacteria then enter these blocked follicles and cause infection, which results in inflammation and pus formation. A common cause of this bacterial infection is hormone fluctuations during puberty or during menopause when hormone levels change rapidly due to low estrogen levels in women. Hormone fluctuations can also occur during pregnancy or after childbirth when your body produces more progesterone and testosterone than usual.

What are the symptoms of whiteheads?

The main symptom of whiteheads is a small bump on your skin that looks like an open pore filled with pus or liquid material. The bump may also have an elevated appearance, but it will not be red like other types of acne breakouts such as papules or pustules.

There are various treatments for whiteheads. 

  • Benzoyl peroxide: Benzoyl peroxide is an antiseptic and antibacterial agent that helps to heal acne. It also reduces inflammation and promotes rapid healing of the skin.
  • Salicylic acid: Salicylic acid is known to be a keratolytic agent that helps in dissolving the keratin plugging the pores and reducing the size of the pore. This helps in preventing further clogging of the pore by dead skin cells or bacteria.
  • Azelaic acid: Azelaic acid is an antibacterial agent that helps in killing bacteria causing acne and reducing inflammation associated with it.

Fungal Acne

Fungal acne is a skin condition that causes pimples and blackheads. The cause of this condition is a type of fungus called Malassezia furfur. This fungus lives on all people's skin, but it can cause problems in people with oily or sensitive skin.

What Does Fungal Acne Look Like?

Fungal acne usually begins as small bumps under the skin. These bumps may be red or white and sometimes have a black center. The bumps may be painful and they may grow in size over time. If left untreated, the infected area can become very large and painful.

The most common symptoms of fungal acne include:

  • Blackheads (open comedones) that appear on the face or body.
  • Whiteheads (closed comedones) that appear on the face or body.
  • Papules (small red bumps).
  • Pustules (large red bumps).

Other types of fungal acne

  • Malassezia folliculitis — This type of fungal acne occurs when the fungus grows out of control in your hair follicles and causes small red bumps on your face, neck, and back.
  • Malassezia rosacea — In this rare form of fungal acne, you may develop redness and swell around the nose and chin. It can also affect the eyes and cause them to become inflamed as well as watery or dry out completely due to excess oil production in these areas.
  • Tinea barbae — This form of fungal acne occurs primarily on men's faces.

Fungal Acne Causes

Fungal acne can be caused by molds found in soil and water as well as other organic materials like hay and grass. These molds prefer dark, damp environments and grow best when they have access to oxygen.

Once they enter your body, they can survive on dead skin cells or sebum oil produced by your sebaceous glands. When these fungi reproduce in large numbers, they cause inflammation of the skin which results in pimples or cysts that resemble blackheads or whiteheads.

Treatment for Fungal Acne

Over-the-counter antifungals containing azole compounds such as clotrimazole or ketoconazole help clear up the skin and are considered effective treatments for fungal acne. These treatments are available in lotions, creams, and shampoos. If you're using a topical antifungal medication, apply it twice daily for four weeks. Oral treatment may also be used if needed.

If your condition is severe or doesn't respond to over-the-counter treatment after four weeks, see your doctor about prescription therapy. Oral antifungal pills such as fluconazole (Diflucan) or itraconazole (Sporanox) may be prescribed for two weeks to treat fungal acne.

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