Milia & All You Need To Know About It

Milia is often mistaken for acne. However, they are both very different. Read more to learn all you need to know about milia and how to treat it. 

 

Author Nuffield Aesthetics 15 July 2021 | 4 mins read

Are you noticing bumps on your face that don’t quite look like pimples but are textured? They aren’t really red and inflamed yet they appear in a group on your face? Chances are, you are experiencing milia. They are easily confused with other skin conditions like comedones, miliaria and cysts. They are a very common skin condition that is easily treatable. Read about how they are caused and how you can prevent and treat them.

What is Milia?

A milium or multiple milia are small cysts or bumps that form when bits of skin protein, known as keratin, get trapped under the surface of the skin. They usually bunch around the eyelids, nose, cheeks and lips though they can even appear in the mouth and groin area. They are neither red nor painful but these tiny white bumps can sometimes be itchy. They are spontaneous and benign spots that do not pose more threats than just bumps.

 

milia

How is Milia caused?

 

Milia form when specks of keratin getting trapped under the skin, at the base of a hair follicle or sweat gland. Keratin is one of the proteins in your skin that helps to form the toughness in the skin. 

Milia form when the skin cells turnover rate is slower than usual causing a buildup of keratin under the skin. This is known as primary milia. For adults with milia, it is usually from overexposure to the sun that results in a leathery skin texture, which makes it difficult for the skin to expel keratin from the skin.

Types of Milia

There are a few types of milia that occur in both children and adults.

 

Neonatal Milia (Baby Milia)

Neonatal milia are considered primary milia that are common with newborn babies. They can appear anywhere on the baby from the scalp to the upper trunk to inside the mouth and other areas of the face and body. 

If the bumps appear on the roof of the mouth and gums, they are known as Epstein pearls or gingival cysts. They occur with about 80% of newborns and do not require treatment as they usually dissolve away in the coming weeks.

 

Milia En Plaque (MEP)

MEP is a rare and uncommon version of milia due to genetic or autoimmune skin disorders like discoid lupus erythematosus or lichen planus. It is characterized by multiple milia on an inflamed wound usually found on the eyelid, behind the ear, on the cheeks or jaw area. This type can affect both children and adults.

 

Multiple Eruptive Milia

This type of milia consists of itchy bumps on the face, upper arms and torso. The cysts often appear over a span of time, ranging from a few weeks to a few months. They may be red and inflamed depending on the severity of the condition.

 

Traumatic milia

Traumatic milia, also known as secondary milia, follows after skin trauma as it clogs the ducts leading to the skin surface like: 

  • over-exposure to sunlight
  • burns
  • blisters from a skin condition
  • allergic reaction
  • skin resurfacing procedures like dermabrasion or laser resurfacing

 

Juvenile milia

Some rare genetic disorders can lead to milia which are categorised as juvenile milia. They can appear at birth or a few years later in older children. These can include:

drugs-causing-milia

Milia Associated with Drugs or Products

Although rare, the use of certain steroid creams can sometimes cause milia to the area cream is applied. Some creams like phenols, hydroquinone, 5-fluorouracil cream, and a corticosteroid are just some examples. 

Some people have sensitivity to certain ingredients used in skin care and makeup products which also cause them to develop milia. If you have sensitive skin, avoid products with the following ingredients:

  • paraffin oil
  • petroleum oil
  • paraffinum liquidum
  • petrolatum liquid
  • liquid paraffin
  • liquid petroleum

 

How to prevent milia?

Milia is difficult to prevent, especially since it emerges with newborns from birth anyway. However, with adults, it could be reduced and managed by:

  • Avoiding excessive sun exposure
  • Using sunscreen (minimally SPF 50 and reapplying every 2-3 hours)
  • Exfoliating the area once or twice a week
  • Avoiding the use of oil-based or heavy products

 

How to treat milia?

Depending on the kind of milia you are experiencing, there may be different cures. In most cases, milia do not have long term implications on the skin as they typically disappear on their own for both babies and adults. However, if you wish to speed up the recovery process, there are professional treatments to treat adult milia.

 

1. Electrocautery

milia-treatment-electrocautery

This is a professional procedure where a small handheld tool produces minor electric currents which are used to remove the unwanted growth. Electrocautery is a multi-functional treatment procedure that can be used to heal milia, brown spots, skin tags and warts. You may need just one to two treatments to fully recover the skin.

Electrocautery is an extremely fast, safe and efficient method when there is precision. Therefore, it is crucial to get an experienced dermatologist to lead the procedure. At Nuffield Aesthetics, we ensure safety for all procedures. Our aim is to make you feel the most comfortable before, during and after your treatment.

 

2. Chemical peels

A chemical peel, also known as a skin peel, is a more dermatological approach to get rid of milia. Chemical peels use certain acids called Alpha Hydroxy Acid (AHA) and Beta Hydroxy Acid (BHA) to get rid of dead skin cells. It removes the topmost layers of the skin by mildly irritating the skin. The use of acids, helps to break down any dirt or bacteria that has formed on the skin, exfoliating it and encouraging new skin cells to grow, giving a healthier and more rejuvenated look to the skin.

There are a few types of chemical peels which use a spectrum of acids ranging from mild to strong. You will be recommended on the kind of chemical that is best suited for your skin. Some common acids used are glycolic acids and salicylic acid.

At Nuffield Aesthetics, we provide chemical peels to help rejuvenate your skin and remove the milia. Read more about our chemical peels here.

 

3. CO2 Laser Ablation

co2-laser

 

The CO2 laser is a common resurfacing treatment for skin conditions like acne and wrinkles. However, they can be used to treat milia as well. Ultra pulse CO2 laser, due to its ultra-short pulses, delivers an ablative effect with minimal thermal damage by removing thin layers of skin, allowing new skin to rejuvenate from within.   CO2 laser poses little to no threat of damaging the skin. You may be required to give your skin a few days of downtime but do not need any more commitment for the recovery of your skin. Once treated with laser, milia generally do not recur very fast but new milia may still develop over time. 

At Nuffield Aesthetics, we provide CO2 laser treatment for skin conditions like milia, acne, wrinkles and sunspots. Read more about the technology we use and how it may work for your skin condition.

 

4. Cryotherapy

Cryotherapy, also known as cryogenic therapy, is a form of treatment that uses freezing or near-freezing temperatures to destroy abnormal cells. This can include cryosurgery, or cryoablation, where liquid nitrogen kills tumours or cancerous cells. Some forms of cryotherapy include facials and ice bath immersion.

 

5. De-roofing

Dermatologists will use a clean needle to poke the tiny flap of skin trapping the keratin inside the pore and squeeze out the flake.

 

6.  Curettage

Although a less-common practice is a cure, the procedure involves surgical scraping off each milium milia then sealing the skin with a hot wire with the use of a spoon-shaped tool with an edge called a curette.

 

Review

 

If you have milia and are bothered by it, Nuffield Aesthetics offers you a variety of treatments to help cure the issue. With our friendly aestheticians and experienced dermatologist, you will be able to get an individualised treatment plan that works well for your skin.

 

Book an Appointment

 

Frequently Asked Questions

What are some “do’s” and “don’ts” when you have milia?
What are some “do’s” and “don’ts” when you have milia?

Do

  • Keep the affected area clean using a mild facial cleanser or soap. 
  • Exfoliate the area once or twice a week, depending on the sensitivity of your skin. Regularly steam your area to further remove irritants. This can be done by running a hot shower or using a facial steamer.
  • Protect your skin from sun damage - use sunscreen daily.

Don’t 

  • Don’t pick on your milium/milia. Just like acne scarring, poking/squeezing/manually extracting them can cause inflammation and scar your skin. 
  • Do not over-exfoliating as it can irritate the skin and exacerbate the condition.
  • Do not self-extract your milia using tools like comedone extractor, especially around the delicate eye area. If you extract them wrongly, it could be even more difficult to get rid of. Go to a trusted dermatologist for manual extraction.

 

Are there any home remedies to treat milia?

Start by having a routine skin care regime that works for your skin. Do note that these are common treatments that work for certain skin, it may not work for you. It is important to know what kind of skin you have (dry, oily, sensitive) before inculcating these products or steps. 

  • Use a gentle cleanser, whether it is for your face or body. This helps to keep the affected area clean without irritating the bump. 
  • Avoid using oily makeup removers
  • Exfoliate your skin at least once a week to get rid of dead skin cells on the face which cleansers cannot reach.
  • Topical retinol is typically used for acne-prone skin. However, they have worked for skin conditions like milia as well. Apply topical retinoids (in form of creams or gel) on the affected area before going to bed. It is important to note that retinol makes your skin more sensitive to the sun therefore it is crucial to wear sunscreen.

 

How much does treatment for milia cost?

As you can see, there are a few types of treatments typically used to treat milia. Hence, the cost depends on the treatment of choice and on the skin condition. Generally, the price range is from $200-400 per session of treatment. However, it is important to note that it does depend on your skin condition and which treatment will help your skin the best. If you prefer to get a specific price for your treatment, book a consultation with us to get professional advice from our dermatologist.

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