If you have ever noticed tiny, white bumps around your eyes, nose and forehead that tend to appear and disappear on their own, you might want to stick around for this. The bumps aren’t exactly acne and definitely should not be treated like so. In actuality, they are tiny cysts called milia that are harmless in nature, often subside on their own and should not be picked at on a whim. Even though they are harmless, some people might experience an aesthetic or mild physical discomfort from the same and want to get it treated. We asked our in-house skin expert, Dr. Sravya C Tipirneni, to shed some light on the condition and give us a guide on how to get rid of milia on the face. Read on to know more about the symptoms, causes and treatment of milia, as explained by an expert...

According to Dr. Tipirneni, “Millia, also called as milium in its singular form, is a kind of a cyst. It appears in the form of a small and white bump. It is typically found on the upper half of the face - namely around the eyes, nose and cheeks. The cysts are usually found either in groups or solitarily and occur because of the protein of the skin (keratin) getting trapped beneath the surface of the skin. This happens because of some kind of occlusion - the blockage of pores in some kind of way. Keratin is a potent form of protein that is found in all kinds of hair, skin and nail tissues. As such, milia can occur in anybody and at any age; however, being  very common in certain age groups and the classification of the same is done accordingly."

 

Symptoms of milia

Symptoms of milia

The symptoms of milia consist of small, dome-shaped, whitish or pearly white bumps. They are not itchy or painful most of the time; however, in very few people, they may cause a little bit of discomfort and itching. Some of them may get inflamed or infected at some point and are called Inflamed milia in that case.

Milia are typically found on the face, lips, eyelids or cheeks; and they can be found on other body parts also such as the trunk or the genital region. The causes of milia are dependent on the age-group and the treatment of the same should be prescribed accordingly.

 

Causes of milia in newborns

Causes of milia in newborns

Newborn babies have something called infantile milia. It is often mistaken for baby acne, which is usually triggered by hormones from the mother. But milia in the newborns does not have any redness, swelling or irritation. The infants who usually have it are born with it and the condition typically subsides on its own. The way to differentiate it from baby acne or infantile acne is that infantile acne doesn't appear till 2-4 weeks after birth due to maternal hormones and milia is usually present at birth.

 

Classification of milia in older children and adults

Classification of milia in older children and adults

In this age group, milia is caused because of some type of damage to the skin. The damage can be mild, moderate or even severe at times. Severe forms of damage include blistering skin conditions, blistering injuries, or various kinds of burns. The moderate conditions include long-term sun-damage or use of topical steroid creams. The milder forms of damage can be caused by laser procedures or dermabrasion done on the skin. Milia in this age group can also be due to an age-related change because the skin loses its ability to exfoliate itself and hence continually traps keratin. So, milia in older adults can be the result of just ageing or the combination of ageing and UV radiation as well.

 

Classification of milia according to cause

Classification of milia according to cause

The classification of milia can be done in two ways - the age at which they occur, details of which we saw above. We based the other classification on the cause, namely -

1. Primary milia -

Primary milia are formed directly because of the keratin entrapment and is usually found in infants and adults. Primary milia, which includes neonatal milia, clears within a few weeks. In older children and adults, primary milia may stay for a few weeks or last for several months. Drugs or products like oily skincare and makeup products containing occlusive like paraffin, petroleum or mineral oils can also cause primary milia.

2. Secondary milia -

Secondary milia can develop after something clogs your pores or ducts after an injury, burn or blistering disorder. This also consists of multiple-eruptive milia and traumatic milia caused by an injury to the skin.

 

How to remove milia from face

How to remove milia from face?

The diagnosis of milia is pretty easy - it is a visual diagnosis by a dermatologist as you can easily make it out because of its very typical appearance. Usually, it is not even necessary to treat infant milia because it disappears on its own in a few weeks. In older children and adults, you can either wait for it to to resolve on its own; but if it is causing discomfort, there are some ways to deal with it -

  • Deroofing, which includes using a needle to pick out the contents
  • Cryotherapy, in which liquid nitrogen is used safely on parts of the body other other than the face, because you have to be very careful where facial skin is concerned
  • Topical retinoids, which exfoliate the skin and increase the skin turnover time, can also be used under the guidance of an expert
  • Chemical peels, which bring about the chemical exfoliation of the top layer of the skin can help get rid of milia as well
  • Laser ablation, which is the easiest and personally preferred technique by Dr. Tipirneni herself. The procedure is simple with a slight touch of the laser being used to vaporise the cysts easily
  • Destruction curettage, a form of cautery that can be used to get rid of milia as well

 

Can milia be treated at home

Can milia be treated at home?

A common question that many have is that since milia isn't harmful in nature, can it be treated at home? Dr. Tipirneni revealed, "there are very few over-the-counter creams that work in my opinion. The physical procedures work much better and faster, with visible and immediate results." She also pointed out that the outlook on leaving milia to resolve on itself is positive. They are not dangerous or life-threatening in nature.

Dermatologists often ask for newborn milia to be left alone, and give adults a choice because it is not harmful. It's only a question of cosmetic and aesthetic appearance and how much discomfort it is causing you; plus, you can easily get it removed with a trip to your dermatologist or to an aesthetician.

 

FAQs on getting rid of milia on the face

FAQs on getting rid of milia on the face

Q. Can regular exfoliation help manage milia on the face?

A. One of the causes of milia on the face is that your skin lacks the ability to exfoliate itself. As such, regular exfoliation with a chemical or physical exfoliant can help slough off the dead skin cells that often clog your pores and cause milia. Make sure to exfoliate your skin twice a week in order to maintain a clean and healthy appearance as well.

Q. What happens when you try to pick milia on your face?

A. Even though milia themselves are not harmful, they should never be picked by yourself at home. Picking on milia can cause the cyst to bleed - leading to scabs and scarring on the skin. Improper picking with dirty tools or hands can also lead to infections, which will create even bigger skin issues than the harmless milia bumps themselves.