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Milia: Causes and Treatments

What Are Milia?
Types and Causes of Milia
Treatments for Milia

What Are Milia?

Milia are small (1-2 millimeters), white or yellowish bumps that typically appear on the eyelids, forehead, nose, and cheeks. They occur when keratin, a skin protein, becomes trapped under the surface of the skin. These harmless cysts are usually not itchy or painful. This condition can affect people of all ages, but are especially common among newborns.

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Types and Causes

There are several different types, from common to rare.

Neonatal milia occur in 40-50% of newborns, typically on the face, scalp, and upper torso. It typically heals on its own within a few weeks. Often mistaken as “baby acne,” which is triggered by hormones from the mother, this condition may occur as a result of sweat glands that aren’t fully developed or mature.

Primary milia occur in older children and adults, resulting from trapped keratin – most often on the eyelids, forehead, nose, and cheeks. No treatment is needed. This condition typically clears up on their own after a few weeks, although some cases can take months to resolve.

Secondary milia occur due to an injury to the skin such as a burn, blistering rash like poison ivy, or long-tern sun damage. The milia develop as the skin heals, possibly as a result of damage to the sweat glands. This condition may also appear after using corticosteroid skin creams for a long time.

Juvenile milia is a condition caused by genetic disorders such as nevoid basal cell carcinoma syndrome, pachyonychia congenita, Gardner syndrome, or Bazex-Dupré-Christol syndrome.

Milia en plaque is a rare form of the condition commonly associated with genetic or autoimmune skin disorders, such as discoid lupus or lichen planus. The milia develop on a plaque, which is an inflamed, raised patch of skin several centimeters in diameter. This type of condition primarily occurs in middle-age women and appears on the eyelids, cheeks, jaw, or behind the ears.

Multiple eruptive milia, another rare form of the condition, present as crops of milia on the face, upper arms, and upper torso. They develop slowly over the course of a few weeks to months. The cysts may be itchy.

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Treatment Options

Since most types of milia normally clear up on their own, they usually do not require any treatment. However if they are widespread or unsightly, there are several treatments your Water’s Edge Dermatology practitioner may recommend:

  • Cryotherapy (freezing off the cysts)
  • Deroofing (using a fine needle to pick out the contents)
  • Laser ablation (using a laser to destroy the cysts)
  • Dermabrasion
  • Chemical peel
  • Diathermy (using electrically induced heat to destroy the cysts)
  • Curettage and cautery (scraping off and applying heat to the cysts to destroy them)

Milia en plaque may also resolve with the use of tretinoin, a topical retinoid cream, or minocycline, an oral antibiotic.

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