Today we address the question, What are milia? And what are the treatment options?
Milia look like small, white bumps on the skin. They’re basically keratin trapped under the skin.
They’re harmless, so there isn’t a pressing medical need to treat them. And often they go away naturally but if not, they can be extracted by a dermatologist or treated with a topical retinoid.
Regular exfoliation either with a chemical exfoliant like hydroxy acids or mechanical exfoliation with a scrub can help prevent milia.
Milia can be confused with whiteheads which are part of the early stages of acne. However, whiteheads are full of sebum often mixed with bacteria that festers into acne pustules. Whereas milia are full of keratin and are hard little bumps.
Both conditions can be alleviated by exfoliation with hydroxy acids or gentle exfoliating scrubs, and treated with retinoids.
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Just stating the obvious: No content on this site should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
What are milia?
Milia, also commonly called milk spots, are small, bumpy white cysts that form on your skin.
What are cysts? Think of cysts like sacs full of stuff just under the skin’s surface. In the case of milia, these are sacs full of keratin which is a structural protein that forms your hair, nails and the tough outer layer of your skin. Here is a closeup of a milium cyst. Milium is just the singular version of milia.
Basically, your body naturally sheds the outermost layer of the skin on a regular basis, so that new growth can take their place.
However, when the old layer doesn’t shed properly then new skin can grow on top of them, trapping spots of old skin underneath.
Milia can also be caused when skin heals from damage but does not do so in a 100% correct way. It’s called traumatic milia or secondary milia. And it can occur after damage to your skin such as burns or bad blisters or sunburn (Berk and Bayliss 2008).
Who gets Milia? Milia versus closed comedones / whiteheads
Milia can be confused with whiteheads or pimples which result from clogged pores. These clogged pores are full of dead skin, sebum which is an oily substance made by sebaceous glands, and bacteria.
Milia on the other hand is full of keratin (Epstein and Kligman 1956). They often form in sweat glands though not always (Tsuji et al. 1975)
Milia is very common in infants where they disappear on their own after a few weeks (Berk and Bayliss 2008).
In adults, milia often occurs on the eyelids, and on the skin around your eyes as well as your forehead.
Milia will often go away on its own, but in cases where it does not, topical retinoids are typically prescribed. Milia can also be quickly excised by a dermatologist in a professional setting.
To excise milia, the skin needs to be punctured first with a knife or needle since milia are entirely enclosed by skin, before the hard keratin is squeezed out with an extractor. Since milia are often close to the surface of the skin, chemical peels may also be used to remove them.
What can I expect if I have milia?
If you have milia and the bumps on your skin aren’t clearing up on their own, there are things you can try to help milia go away faster.
You can of course take a trip to the doctor’s office.
But if you want to try topical remedies to help prevent their formation, which is caused when dead skin is not sloughed off correctly, you can regularly exfoliate your skin with chemical exfoliants like hydroxy acids such as glycolic acid or lactic acid, or with mechanical exfoliation with a gentle exfoliating scrub. An exfoliating scrub worked well for me in my experiences dealing with occasional milia.
Once they have actually formed, retinoids are typically prescribed since this helps your skin turnover the outer layer more efficiently. You can try serums or creams that contain retinoids, which are also recommended for acne and white heads. `
Now, in terms of what NOT to do. Don’t pick at the bumps or squeeze them. You can cause skin injury or infection that leads to scarring or hyperpigmentation.
Again, milia has no opening on the skin’s surface, so it’s not something you can pop like whiteheads or blackheads. Rather, if you choose to remove them, visit a dermatologist to properly get them removed.
Click here for Maelove's Deep Exfoliating Clay Scrub
Click here for Maelove's Super Smooth Resurfacing Serum
Click here for Maelove's Retinal Super Serum
References
Berk DR, Bayliss SJ (2008). “Milia: A review and classification.” J Am Acad Dermatol. 59(6): 1050-1063.
Epstein W, Kligman AM (1956). “The pathogenesis of milia and benign tumors of the skin.” J Invest Dermatol 26(1): 1-11.
Tsuji T, Sugai T, Suzuki S (1975). “The mode of growth of eccrine duct milia.” J Invest Dermatol 65: 388-393.
