Show a dermatologist any bump that grows, bleeds, crusts over, or heals and comes back. The American Academy of Dermatology lists those changes, along with a cluster of shiny bumps and a sore that won't heal, among the signs of basal cell carcinoma, the most common skin cancer. DermNet, the dermatology reference run by New Zealand dermatologists, notes that sebaceous hyperplasia, the first bump below, is sometimes confused with it. A dermatologist tells them apart in a few minutes with a dermatoscope.
Most small bumps on an adult face are one of four benign things. Sebaceous hyperplasia is an enlarged oil gland. Milia are tiny cysts of trapped keratin. Closed comedones are pores plugged shut under the surface. Xanthelasma is cholesterol settling in the skin around the eyes. They look alike in a mirror, and each one responds to a different fix. The photos below show each one. Use them to narrow it down, then let a dermatologist confirm it before you treat anything.
Only closed comedones clear with something you can buy without a prescription, and the three picks below cover them. Milia sometimes respond to the same retinoid. Sebaceous hyperplasia and xanthelasma need a doctor.
What each one looks like.
Sebaceous hyperplasia
Soft, yellowish bumps a few millimeters wide, often with a pore in the center. DermNet says they show up on the forehead and cheeks of middle-aged and older adults.
Milia
Firm, pearly-white dots the size of a pinhead, here along the eyelid. DermNet says they often clear on their own within a few months.
Closed comedones
Small, skin-colored bumps on the forehead, where DermNet says closed comedones cluster. Each one is a pore plugged shut under the surface.
How a whitehead forms
A whitehead is a plug of oil and dead skin that stays closed under the skin. A blackhead is the same plug with the pore open to the air.
Xanthelasma
Flat, soft yellow patches on or near the eyelids, made of cholesterol in the skin. Start with your doctor and a blood test.
Basal cell carcinoma: see a doctor
A raised, shiny pink bump on the nose, a nodular basal cell carcinoma. The AAD lists shiny bumps, sores that won't heal, and spots that bleed or crust as warning signs. If your bump looks like this or keeps changing, book a dermatologist.
Photo: M. Sand et al., Head & Face Medicine 2010, CC BY 2.0, via Wikimedia Commons
Differin Adapalene Gel 0.1%
Adapalene 0.1% · 15 g tube · Galderma · sold by Amazon · 4.5 stars, 70,116 reviews · ~$12.97
Adapalene used to need a prescription, and the FDA approved it for over-the-counter sale in July 2016. Galderma's listing says it targets clogged pores and inflammation, the two things that build a whitehead. Amazon sells it, and 70,116 buyers rate it 4.5 stars.
- The only pick with an FDA Drug Facts label
- DermNet lists topical retinoids as a treatment for both closed comedones and widespread milia
- Water-based, oil-free and fragrance-free, per Galderma
- The cheapest pick, sold by Amazon itself
- The label warns your skin may look worse in the first weeks
- Up to three months before you see the full result
- Does nothing for sebaceous hyperplasia or xanthelasma
Buy this if your bumps are small, skin-colored and sit on your forehead or chin, the places DermNet says closed comedones cluster. Galderma says adapalene normalizes how fast the skin lining the pore turns over, so fewer plugs form.
The Drug Facts label sets the routine: once a day, a thin layer over the whole area, on clean dry skin. Irritation is most likely in the first few weeks, and the label says acne can take up to three months of daily use to clear. Galderma cites up to an 87% reduction in breakouts after 12 weeks in its own clinical study.
If you have milia across a wide patch of skin, DermNet lists a topical retinoid as one option. A single milium usually needs the needle described in the guide below. Ask a doctor first if you are pregnant or breastfeeding, and wear sunscreen while you use it.
Paula's Choice Skin Perfecting 2% BHA Liquid Exfoliant
2% salicylic acid · leave-on liquid · Paula's Choice store · 4.5 stars, 117,404 reviews · ~$37
Salicylic acid dissolves in oil, so it reaches into a pore that a water-based acid skips. Paula's Choice puts 2% in a leave-on liquid without fragrance, and 117,404 buyers rate it 4.5 stars, the most reviews on this page.
- DermNet lists salicylic acid among the treatments for closed comedones
- States the dose, 2%, in the product name
- No fragrance, per Paula's Choice
- Sold by Paula's Choice and shipped by Amazon
- Three times the price of Differin
- A cosmetic, with no Drug Facts label
- Using it the same night as a retinoid raises the odds of irritation
Buy this if your skin can't handle a retinoid, or if you want a second step for the nights you skip one. Paula's Choice says the liquid works on enlarged pores, blackheads and dead skin, and DermNet includes salicylic acid in its list of comedolytics, the drugs and acids that loosen comedones.
Pat it on with your fingers or a cotton pad after cleansing and let it dry before moisturizer. Start every other night. If you also use Differin, put the two on alternate nights for the first month.
It won't flatten an oil gland or dissolve a milium. Give it eight weeks on the whiteheads before you judge it.
CeraVe Renewing SA Cleanser
Salicylic acid + niacinamide + 3 ceramides · 8 oz · CeraVe · sold by Amazon · 4.7 stars, 84,535 reviews · ~$12.37
A foaming gel cleanser with salicylic acid, niacinamide and CeraVe's three ceramides. It costs $12.37, Amazon sells it, and 84,535 buyers rate it 4.7 stars, the best score here.
- CeraVe says it cleans without over-drying, with ceramides and hyaluronic acid
- Easy to add to a routine you already have
- The highest rating on the page
- Salicylic acid sits after salt in the ingredient list, so the dose is low
- A wash rinses off, so it does less than a leave-on
Buy this if your skin is dry or easily irritated and you want the mildest way into salicylic acid. CeraVe calls it less abrasive than a scrub, and the ingredient list backs that up: the acid appears near the end, after sodium chloride, below niacinamide and the ceramides.
That low dose makes it a support step. Use it morning and night alongside Differin, or alone for a month to see how your skin takes salicylic acid before you buy the Paula's Choice.
The numbers.
| Differin | Paula's Choice | CeraVe SA | |
|---|---|---|---|
| Active | Adapalene 0.1% | Salicylic acid 2% | Salicylic acid, low |
| Type | OTC drug | Leave-on exfoliant | Cleanser |
| Helps with | Whiteheads, widespread milia | Whiteheads | Whiteheads, mild |
| Size | 15 g | Liquid | 8 oz |
| Rating | 4.5 stars | 4.5 stars | 4.7 stars |
| Reviews | 70,116 | 117,404 | 84,535 |
| Street price | ~$12.97 | ~$37 | ~$12.37 |
Other strong options.
Differin Adapalene Gel 0.1%, 45 g pump
The same gel in a 45 g pump Galderma sells as a 90-day supply, $19.19 from Amazon with 4.6 stars across 19,675 reviews. Three times the gel for about $6 more. Buy it once the tube has shown you that adapalene suits your skin.
View on Amazon →La Roche-Posay Effaclar Adapalene Gel 0.1%
The same drug at the same 0.1% strength, in a 1.6 oz tube for $39.99 from Amazon, 4.6 stars across 8,131 reviews. La Roche-Posay says it clears blackheads, whiteheads and clogged pores and tells you to apply a pea-size amount in the evening. Pick it if you prefer the brand. The adapalene matches Differin's.
View on Amazon →Telling them apart, and what a doctor does.
Sebaceous hyperplasia
An oil gland that has grown larger than normal. DermNet describes small yellow bumps up to 3 mm across, with a hair follicle in the center surrounded by yellowish lobules and, under magnification, visible blood vessels. They show up on the forehead and cheeks of middle-aged and older adults, and more often in people on ciclosporin after an organ transplant, per a 2021 review in the Journal of Dermatological Treatment. Squeezing won't help, since the bump is the gland itself.
Milia
Tiny, pearly-white cysts filled with keratin, sitting under the surface, most often on the eyelids and cheeks. DermNet says they are harmless and often clear by themselves within a few months. Some form after burns, blistering or dermabrasion.
Closed comedones
Pores plugged shut, so the contents stay under the skin as small skin-colored bumps. DermNet says they cluster on the forehead and chin. They respond to retinoids, salicylic acid, azelaic acid and benzoyl peroxide, including the actives in the three picks above, and DermNet warns that improvement takes several weeks to months.
Xanthelasma
Soft yellow patches on or near the eyelids, made of cholesterol in the skin. GPnotebook, a UK clinical reference, says about half of people with xanthelasma have normal blood lipids. A Copenhagen study of 12,745 adults, published in the BMJ in 2011, found xanthelasma predicted heart attack and heart disease even after accounting for cholesterol. If you see these, ask your doctor for a lipid panel and a heart-risk check. GPnotebook adds that lowering your cholesterol does not shrink them.
What a dermatologist does
In a 2024 survey of 224 dermatologists in the Journal of Drugs in Dermatology, 83.9% used electrodesiccation for sebaceous hyperplasia, which destroys the gland with a fine electric needle. Cryosurgery came next at 35.3%, oral isotretinoin at 32.6% and CO2 laser at 19.2%. Respondents priced electrodesiccation and cryosurgery from under $200 to $400, reported one or two sessions for most cases, and rated electrodesiccation and CO2 laser the least likely to recur. DermNet notes that isotretinoin clears the bumps, and they can return when you stop it. For milia, a doctor opens the top with a sterile needle or blade and lifts the contents out.
Why squeezing backfires
A sebaceous hyperplasia bump or a milium has nothing loose inside to push out. Pressing on it inflames the skin around it and can leave a red mark. DermNet lists follicle rupture from squeezing among the things that make comedones worse. Leave the tweezers and blackhead tools in the drawer.
FAQ.
Yes, at least once. These four bumps and an early skin cancer can look alike in a mirror, and a dermatologist tells them apart in a short visit with a dermatoscope. Go back if a bump changes after that.
No published trial shows that a topical retinoid removes it. The treatments with study data are electrodesiccation, cryotherapy, lasers, photodynamic therapy and oral isotretinoin, all through a doctor. A retinoid still helps if closed comedones sit next to the oil-gland bumps.
You can't be sure at home. The American Academy of Dermatology lists a firm raised growth, a cluster of shiny bumps, a sore that won't heal or keeps coming back, and a spot that bleeds or crusts as signs of basal cell carcinoma. If a bump grows, bleeds or changes, see a dermatologist.
Often, within a few months, per DermNet. If one stays and bothers you, a dermatologist can remove it in a short visit with a sterile needle.
Not always. About half of people with it have normal lipids, per GPnotebook. The 2011 Copenhagen study still linked it to heart disease, so get your lipids and heart risk checked.
The Drug Facts label says up to three months of daily use. Take a photo in the same light on day one and compare at week twelve.
Small skin-colored whiteheads: Differin Adapalene Gel 0.1%, $12.97.
Skin that can't take a retinoid: Paula's Choice 2% BHA, $37.
Yellow oil-gland bumps or eyelid patches: a dermatologist.
Have a dermatologist name the bump before you buy anything. If it turns out to be closed comedones, start Differin once a day and give it three months, with the CeraVe wash if your skin runs dry. A dermatologist removes sebaceous hyperplasia and milia in one or two visits, with electrodesiccation or a needle. For yellow patches on the eyelids, ask your doctor for a blood test. Show a dermatologist anything that grows, bleeds or keeps reopening, whatever you think it is.