You might have wondered what those small, hard lumps that emerge on the surface of the skin are. Milia are tiny cysts that are packed with a protein called keratin. Although they are usually harmless, they can be unpleasant and unsightly. On this page, we’ll discuss what causes milia, the different variants of the cyst, and the treatments that we offer to remove them.
What Are Milia?
Milia are small spots or bumps that are usually found in clusters on the skin. Although you might mistake them for whiteheads, milia are cysts that grow under the surface of the skin. They are usually white or yellow, though they can turn red when they are irritated. A single spot is known as a milium cyst, whilst many spots are referred to as milia. They can appear on any body region, though they are most commonly found on the nose, cheeks, forehead and around the eye area.
What Causes Milia?
Milia appear when dead skin cells (which contain a protein called keratin) build up and are not expelled naturally by the body. As a result, the keratin becomes trapped in the pores on the skin’s surface, causing a cyst to form. Milia are more likely to form when the skin has been damaged in some way, such as by a burn, rash, or excessive sun exposure, though they can also appear spontaneously.
As its name suggests, neonatal milia affects newborn babies. They primarily appear on the face and the torso and will typically disappear on their own within a few weeks.
Primary milia appear spontaneously on skin that does not have a history of injury. This type of milia can affect both children and adults, and it usually appears on the face, such as the cheeks or forehead. Although primary milia can last for several months, they usually disappear on their own within a few weeks.
Traumatic milia appear in areas of the skin that have undergone an injury, such as a burn or rash. The cysts that appear on the damaged skin can become irritated. When this happens, the edge of the cyst will become red in colour, though the centre will remain white.
Milia En Plaque
This type of milia usually appears on the cheeks, jaw, ear and eyelids. The cysts that appear are typically larger than other forms of milia: they can be several centimetres wide. If you suffer from autoimmune or genetic skin disorders such as lichen planus, you are more likely to develop milia en plaque, and - though it is most common in adult women, it can affect people of either sex and any age.
Multiple Eruptive Milia
Multiple eruptive milia is a rare skin condition characterised by the sudden appearance of lots of milia in clusters, typically on the face, neck, upper arms, chest or back. This type of milia can also be itchy, though it tends to disappear on its own within a few months.
Depending on the type of milia you suffer from, a topical medication could be prescribed to remove the spots. This medication usually comes in the form of a cream that is massaged into the skin, and this treatment is not suitable for removing milia around the eye area.
Milia can also be removed via needle extraction. Before this procedure, the surface of the skin is cleaned thoroughly to remove any built-up oils or dirt. Then, a very small needle is used to open up the top layer of the skin, and this exposes the milia underneath, making it possible to remove them. In total, the treatment will take approximately 15 minutes to complete.
Milia are usually harmless and it is not necessary to seek medical help. However, if your milia are itchy and causing you some discomfort, or if their appearance is frustrating you, then you should arrange a consultation so that we can advise you on a suitable treatment to remove them.
Usually, milia are diagnosed simply by their appearance. However, if the diagnosis is uncertain, a skin biopsy may be advisable. In these cases, a small piece of skin is removed and examined under a microscope.
The best way to reduce your chances of developing milia is to take good care of your skin. Regularly and gently exfoliating will help to prevent dead skin cells from building up on the surface of your skin, which will, in turn, prevent milia.
No. It is very important that patients never cut, scratch or squeeze their milia at home. Doing so could cause the milia to bleed or scab and may create scars. Picking at your milia could also introduce germs to your skin, which could lead to infection or the formation of spots.
Milia can not be popped like spots or blackheads because they do not have an opening onto the skin’s surface. Attempting to do so could lead to the formation of scars or red marks on your skin.
After your needle extraction treatment, you may find small, circular scabs in the areas where your milia once were. These will heal naturally over the course of a few days, and it is perfectly fine to conceal them with make-up.