Milia

Milia are tiny white bumps that appear primarily on the face, although they can also develop on other areas of the body.

What are Milia?

Milia are very common in infants. These small, firm bumps form on the nose, cheeks or chin. The dome-shape cysts resemble tiny pimples and develop when keratin, a protein found in skin cells, builds up under the outermost layer of skin.

There are two kinds of milia that occur in adults: primary and secondary. The cause of primary milia in adults is an accumulation of dead skin cells, just like the milia in infants.

Secondary milia develop after skin damage has occurred. If the pilosebaceous unit (the structure containing hair, hair follicles, sebaceous glands and erector pili muscle) is damaged due to trauma, blistering, contact dermatitis, topical medications or other factors – secondary milia can develop.

Symptoms of Milia

The small epidermal cysts are usually white in color, but may also have a yellowish tint. They appear as raised, rounded bumps and are not painful. The cysts typically develop around the eyes, nose, cheeks and forehead. Infants may develop milia in the mouth, on the upper palate. Milia that develop in the mouth are called Epstein pearls.

Secondary milia may also appear on the back, in areas where other dermatological conditions are present, and on skin that has suffered severe sun damage.

Treatment of Milia

Since milia are not harmful and do not lead to other conditions or skin cancer, treatment is not necessary. If adults are bothered by the appearance of milia, they should consult a dermatologist about milia treatment options, since scarring and skin damage can occur if cyst removal is attempted at home.

Treatment options for adult milia include:

  • Cyst removal
  • Topical retinoid creams
  • Microdermabrasion
  • Chemical peels

Milia in infants resolve without treatment.

Milia Prevention

It may not be possible to prevent all cases of milia but taking steps to protect skin from sun damage is helpful.

Talk with your dermatologist about other ways to prevent adult milia including, microdermabrasion and glycolic acid products to remove dead skin. Avoiding the use of heavy makeup and oil-based products is also recommended.

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