Milia, Milky spots; are the small white raised bumps, keratin-filled cysts, each Milium (Singlar) is an almost 1mm diameter, they are usually found under the outer skin layer that is called “Epidermis”. sometimes, they are found all over the upper area of cheek and sometimes they are found in aggregates on the chin area or under eyes.
You may wake-up at the morning and find those annoying bumps! You may also find those bumps on the face of newly born infants. So, Milia can affect everyone at any time! However, its persistence may differ from one person to another as follows; It usually fades away after few weeks in case of infants while in case of adults it may last for months and sometimes for weeks!
Milia may seem to be of only one kind; however, it has different kinds and causes! Keep scrolling…
Define your Milia type
The most common type between the newborn babies; they are supposed to occur due to the presence of sweat glands that are not fully developed “Immature”. They are developed in form of few numerous lesions or cysts on the face especially around the eyes, cheeks, and sometimes inside the mouth. Mothers are usually asked their general practitioner about the available treatment options for their babies, however, they usually refuse to prescribe any kind of medications as the neonatal milia considered as a normal condition, that is usually healing on their own within few weeks after birth.
Primary milia in children and adults
The most common type that usually occurs as a result of trapping keratin beneath the skin due to low exfoliation. This type is usually found around the eyes, forehead, and on the genitalia! Sometimes they become itchy and you feel some kind of discomfort, however, they usually disappear within few weeks
Milia en plaque
The rarest type, that usually affects middle-aged women and associated with a genetic or autoimmune disorder. Milia appear in form of inflamed, raised bumps that are named by “plaque”. Milia en plaque usually appears on the eyelid, cheeks, and behind ears.
Multiple Eruptive Milia
This type considered as rare & Asymptotic, found in form of clusters, patches, or cysts. they usually appear on the face, upper arms, and persist for few weeks and then fade away on its own.
It has been found that this type of milia usually occurs due to certain injuries such as thermal laser burns or dermabrasion, or blistering rashes. They commonly occur on hands, fingers, however, it is rare on the face.
Milia associated with drug
A type of milia that is associated with using certain kind of medications
Type of milia that usually arise due to a genetic disorder.
How milia diagnosed?
Milia could be defined easily by a dermatologist who usually evaluates the appearance of milia and sometimes, he/she perform a skin biopsy form more information about the type of milia and for prescribing the appropriate medications.
So, what are the causes of milia in order to prevent milia occurrence?
Milia causes are many, some causes could be managed and others could not! However, the main reason of milia formation is the development of tiny skin cyst filled with dead skin and protein called “Keratin”. The exact cause of milia is not known or fully understood until now; however, it was reported from patients who are diagnosed with milia the following causes;
Excessive exposure to sun
Yes, people who are intensively exposed to harmful sun’s radiation and experienced sunburns can easily develop milia due to the skin damage; making it difficult for the dead skin to rise normally to the skin’s surface and therefore, difficult to shed away from the skin, resulting in the formation of milia!
- The wrong use of skincare products
The use of skincare that is too rich or heavy could be one the reasons too, for example; it has been found that the using of sunscreens with SPF that doesn’t suit your skin type or condition may also be one of the reasons. Moreover, using oil-based beauty products could also worsen the situation.
Any injury or burns could be a reason for milia formation in form of cysts, injuries such as;
- Chemical Peeling
- Surgical procedure such as dermabrasion
- Radiation procedure such as laser resurfacing applications
- Injuries result from tattoos, piercing, blistering injury
- Skin infection
Some bacterial or viral infections may have the ability to initiate milia skin condition such as Herpes viral infection.
Exfoliation and Aging
The most common cause for milia formation is when the skin exfoliation process rate is too slow due to many factors such as ageing natural process; this results in trapping of keratin protein and dead skin below the skin surface leading to milia formation.
The usage of steroid creams, Hydroquinone, clobetasol, Fluorouracil cream; may also initiate the formation of milia on the long run. Other medications can also induce milia such as vemurafenib and dovitinib medications that are used in the cancer treatment.
Sometimes, it is associated with disease disorder condition!
- Porphyria Cutanea Tarda (PCT)
- PCT considered as one of a group of disorders known as “Porphyrias“, that caused by a range of enzymes disturbance in one of its pathways in the body. The common causes of PCT could be as follows;
- Oral contraception
- Iron accumulation in the liver
- Excessive alcohol consumption
- Viral disease such as infection with viral hepatitis C
- The common symptoms of PCT vary from the formation of fluid-filled blisters, increase sensitivity to the sun, to the formation of white raised bumps that are defined as Milia.
- Basaloid Follicular Hamartoma (BFH)
The rare, harmless hair follicle tumor that usually affects the face; this syndrome is usually categorized into two main groups that are “Hereditary BFH” and “Acquired BFH”. From the symptoms that are associated with hereditary BFH is the formation of milia (Cutaneous feature), and other symptoms are usually associated with milia formation.
- Bazex-dupré-christol syndrome
Based on scientific evidence this syndrome is defined as “Rare genodermatotic with a predisposition to early-onset basal cell carcinoma.” The symptoms of this syndrome vary from :
- Formation of Milia
- Multiple basal cell carcinomas of the face
- Hypotrichosis (reduced body and scalp hair)
- breakdown of follicles on the skin of the extremities
- Localized or generalized hypohidrosis (diminished sweating)
- Gardner Syndrome
According to the National Center For Advancing Translational Science; the Gardner Syndrome is defined as “form of Familial Adenomatous Polypus (FAP) that is characterized by multiple colorectal polyps and various types of tumors; both non-cancerous and cancerous .”The symptoms of Gardner Syndrome vary from dental abnormalities, osteomas, milia, and many other symptoms.
Sometimes, the formation of milia is due to poor hygiene! And what we mean by poor hygiene is not only the frequent washing of face but also, leaving heavy and greasy make-up on your face for a too long time.
Therefore, your dermatology will provide you with some skincare products and care routines that you should follow to rid yourself from milia.
What are the best available treatment options for Milia removal?
You have first to ask yourself why you need to remove milia…? You have to know if you are feeling discomfort with the presence of Milia, sometimes you experienced an itchy feeling, milia persist for months! So, your removal decision is good. However, if milia skin condition doesn’t force any kind of discomfort, pain, or harm; so you can leave them and they will eventually clear up by themselves, especially in case of infants “Clear up within few weeks”.
If your case demands to remove milia so, the available treatment options can be any of these;
After the evaluation of your dermatologist; he/she will prescribe a gentle cleanser with granules, that can work perfectly in some cases. Sometimes, he/she prescribe topical retinoid (Creams that contain vitamin A compound) and he/she will ask you to apply a little amount on the affected area. Moreover, if you experienced milia en plaque; your dermatologist will prescribe you “minocycline” (a tetracycline antibiotic).
Based on patient’s reviews, it was reported that “You will notice a good improvement in the affected area, however, you will find a disadvantage in using retinoid creams if the affected area is your eyelid because retinoid is not allowed to be used on the eyelid area.”
In this procedure, a thin sterile needle is used that named by “Milia removal needle” or “Lancing tool” that usually used to force a pressure and open up the white bumps and squeeze out the little hard bumps. Most of the dermatologists recommend performing this procedure as it provides excellent results with a minimal scarring problems. However, you should follow preventative routines to ensure that milia won’t appear again.
One of the disadvantages of the lacing procedure is that; it is not suitable for all milia types.
- Chemical peels
Some dermatologists recommend using chemical peels in case of small milia that are not easily seen by naked eyes. Chemical peels such as glycolic acid and salicylic acid peels are working perfectly by removing all of the dirt, trapped oil, and enhance the milia pop out; therefore, giving you fresh and healthy look.
If you choose chemical peel option; you should look for an experienced dermatologist in order to avoid any kind of irritations!
A procedure that works by the same mechanism of chemical peeling; it usually works by removing the outer surface layer of the skin that contains dead skin. Therefore, cell turnover occurs and new fresh skin develops immediately. A follow-up and aftercare routine are usually required and recommended after performing microdermabrasion.
Yes, milia could be treated and removed by the means of cooling through freezing the affected area; from few years, the procedure was carried out by using liquid nitrogen. However, the process is now more advanced by using the Dermapen Cryo™ device that uses a very precise jet of highly-compressed liquefied nitrous oxide (N2O). based on patient’s reviews for the procedure; it was reported that cryotherapy produces perfect results with minimal downtime, however, there are some side effects that may occur after the procedure such as; pigmentation issues “either Hypopigmentation or Hyperpigmentation” and sometimes nerve damage!
So, you must choose a well-known dermatologist that can perform the procedure for you, giving you the maximum benefits with minimal side effects.
Heating could be also an effective way for milia removing. Based on research, it has been found that Diatherapy works by “Heat that cauterizes the skin, and used to burn off harmless non-malignant imperfections. Heat is delivered through an extremely fine filament (needle) directly onto the area of concern, immediately dissolving the skin tag, milia or cauterizing blood flow to a stubborn broken capillary.”
- Laser applications
“Laser is the solution for most of the patient’s imperfections!”; laser applications could be used too for the removal milia in an easy and perfect way with minimal side effects, especially the co2 laser resurfacing application.
You can also treat Milia at home through using some home remedies as follows;
- Sugar & Honey
The most familiar natural components that can help you get rid of milia as they are considered as powerful exfoliators and moisturizers. They can be used separately or in combination with other ingredients such as lemon juice and olive oil.
- Pomegranate Peel Powder
This powder can provide you excellent antioxidant and exfoliating properties, helping you rid yourself of milia and calm acne and pimples too.
- Castor Oil
As we said before, milia could occur due to bacterial or viral infection! Castor oil can help in this situation, due to its antibacterial properties in addition to its role in controlling the quantity of oil produced and trapped that cause milia formation.
- Tea Tree Oil
Irritation and the itchy feeling resulting from having milia could be managed through using tea tree oil that has an amazing healing property.
Last but not the least, Milia is a controllable disease, harmless, and could be treated in a very simple way.
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