Understanding Milia: Causes, Types, and Treatments
As the outermost layer of our body, the skin is constantly exposed to external factors, making it prone to various conditions. While many skin issues, such as psoriasis and eczema, are rooted in inflammation, not every bump or discoloration requires medical intervention. One such condition is milia—small, harmless white bumps that can appear on the skin.
What Is Milia?
Milia (plural of milium) are tiny, white cysts that develop when keratin, a protein found in hair, skin, and nails, becomes trapped beneath the skin’s surface. Milia is common among infants—up to 50% of newborns experience it because their skin is still adapting to exfoliation. However, milia can also affect people of any age, often appearing due to blocked ducts caused by injuries, burns, or other skin conditions.
Milia usually appear as small white bumps on areas like the nose, cheeks, and chin but can also be found elsewhere on the body. Although these bumps are harmless and typically resolve on their own, understanding their types and causes can help determine whether treatment is necessary.
Types of Milia
Milia are classified based on age or the underlying cause.
- Neonatal Milia
- Common in newborns, affecting around 40% of infants.
- Typically seen on the face, scalp, and upper torso.
- Resolves naturally within a few weeks.
- Juvenile Milia
- Associated with rare genetic disorders like Nevoid Basal Cell Carcinoma Syndrome (NBCCS) or Gardner’s Syndrome.
- May persist longer and require specific medical attention.
- Milia en Plaque
- Often linked to autoimmune or genetic conditions such as discoid lupus or lichen planus.
- Commonly affects the eyelids, cheeks, jaw, or ears.
- Predominantly seen in middle-aged women but can occur at any age.
- Traumatic Milia
- Occurs in areas where the skin has been damaged, such as burns or rashes.
- Cysts may appear irritated, with red edges and a white center.
- Primary and Secondary Milia
- Primary: Arises naturally without any clear external cause.
- Secondary: Develops after skin trauma or certain treatments.
Diagnosing Milia
Milia are often diagnosed visually by dermatologists based on their appearance. In rare cases, a skin biopsy might be performed to rule out other conditions. If you’re uncertain about bumps on your skin, consulting a doctor can help confirm whether they are milia and determine if treatment is necessary.
Treatment and Removal
While milia in infants typically resolves without treatment, adults may choose to remove it for cosmetic reasons or if it causes discomfort. Common treatment options include:
- Cryotherapy: Freezing cysts with liquid nitrogen.
- Deroofing: Using a sterile needle to remove the contents of the cyst.
- Topical Retinoids: Creams containing vitamin A to promote exfoliation.
- Chemical Peels: Removing the outer skin layer to clear clogged pores.
- Laser Ablation: Using targeted lasers to eliminate cysts.
- Diathermy: Heat treatment to destroy cysts.
- Curettage and Cauterization: Surgical removal followed by cauterization.
Note: Attempting to remove milia at home is not recommended. Seek professional help to avoid infections or scarring.
Preventing Milia
Though milia are harmless, taking preventive measures can reduce their likelihood:
- Use Sunscreen
- Protect your skin from sun damage, which can lead to milia.
- Avoid Heavy Skincare Products
- Heavy creams or ointments can block pores. Opt for lighter, non-comedogenic products instead.
- Exfoliate Regularly
- Regular exfoliation helps keep pores clear and prevents keratin buildup.
Conclusion
Milia may be a cosmetic nuisance, but they are completely harmless and often resolve on their own. If you’re concerned about their appearance or experience discomfort, consult a dermatologist to explore treatment options. Otherwise, patience and good skincare habits can help keep these small bumps at bay.