Our skin, being the body’s outermost layer, is constantly exposed to the environment, making it susceptible to various conditions. From psoriasis to eczema, many common skin issues stem from inflammation. However, not every bump or discoloration is a cause for concern. Take milia, for instance.
Milia: What Are These White Bumps on Your Skin?
Milia are small white bumps that often appear on the skin. Though many people first encounter them as infants, milia can affect individuals of all ages.
Milia, or milium cysts, are caused by trapped keratin—a protein found in hair, skin, and nails. These bumps are particularly common in infants, with nearly half of all babies developing them. This occurs because a baby’s skin is still adapting to exfoliation during early development. However, milia can also form in adults when ducts leading to the skin’s surface become blocked due to factors like injury or burns.
Typically, milia appear on the nose, chin, or cheeks, but they can also occur elsewhere on the body.
While milia are harmless and often resolve on their own, it’s helpful to understand what they are to determine if any action is needed.
Types of Milia
Milia can be classified based on the age at which they appear or the underlying cause.
Neonatal Milia: These bumps appear in newborns and usually disappear within a few weeks. They are most commonly found on the face, scalp, and upper body. About 40% of newborns experience milia.
Juvenile Milia: Rare genetic disorders, such as Nevoid basal cell carcinoma syndrome (NBCCS), Pachyonychia congenita, Gardner’s syndrome, or Bazex-Dupré-Christol syndrome, can cause milia in children.
Milia en Plaque: This type is often associated with genetic or autoimmune skin conditions like discoid lupus or lichen planus. It typically affects the eyelids, ears, cheeks, or jaw and is more common in middle-aged women, though it can occur in anyone.
Primary Milia: Common in older children and adults, these cysts usually appear around the eyelids, forehead, or genital area and may persist for several months before resolving on their own.
Traumatic Milia: These develop in areas of the skin that have been injured, such as after a rash or sunburn. The cysts can become inflamed, appearing red around the edges with a white center.
Diagnosis and Treatment
Milia are usually easy to identify visually, so a dermatologist can often diagnose them just by looking at the cysts. In rare cases, a skin biopsy may be necessary. If you notice small white bumps on your skin, it might be worth consulting a doctor to confirm whether it’s milia and discuss treatment options if needed.
Managing Milia
For infants, no treatment is typically required as milia usually disappear within a few weeks. In older children and adults, milia may also resolve on their own, but if they cause discomfort or concern, several treatment options are available:
Cryotherapy: This involves freezing the milia with liquid nitrogen and is one of the most common removal methods.
Deroofing: A sterile needle is used to remove the contents of the cyst. This is another popular treatment.
Topical Retinoids: Creams containing vitamin A help exfoliate the skin.
Chemical Peels: These remove the top layer of skin, revealing fresh skin beneath.
Laser Ablation: A small laser targets and removes the cysts.
Diathermy: Extreme heat is used to eliminate the cysts.
Curettage and Cautery: The cysts are surgically scraped and cauterized.
While some have resorted to home remedies like using a paper clip to remove milia, it’s strongly recommended to seek professional treatment to avoid complications.
Preventing Milia
Although milia are harmless, they can be aesthetically bothersome. Since they form due to surface-level skin issues, adopting a skincare routine that keeps your skin healthy and clean can help prevent them.
Use Sun Protection: Since milia can be linked to skin damage, protecting your skin from the sun is crucial. Whether you’re at the beach, watching a baseball game, or just relaxing outside, always use sunscreen.
Avoid Heavy Products: Heavy skincare products can block the removal of dead skin cells, increasing the risk of milia. This includes creams, ointments, makeup, and lip balm. Using cleansers with microbeads can also contribute to milia formation. Opt for lightweight products to keep your skin clear.
Exfoliate Regularly: While exfoliating a baby’s skin isn’t advisable, older children and adults should exfoliate to keep pores clean and prevent keratin from getting trapped.
In summary, milia are benign and typically harmless, despite their appearance. If you’re concerned about them, consult your doctor for advice. Otherwise, let them run their course, and they’ll likely fade over time.
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