What are Milia?

Milia are tiny white bumps that can appear on the skin. They occur when keratin, a protein that makes up the top layer of the skin, becomes trapped beneath the surface. This causes small, hard cysts to form under the skin.

Milia are most commonly found on the face, especially around the eyes, cheeks, and nose. However, they can occur on other areas of the body as well. The small bumps are usually painless and do not itch or cause other symptoms.

The condition is very common in newborns and infants. However, milia can occur at any age. They are generally harmless, although some people seek treatment for cosmetic reasons if they are bothersome in appearance. Milia usually clear up on their own within a few weeks, though some may linger for longer.

Types of Milia

Milia can be categorized into two main types: primary milia and secondary milia.

Primary Milia

Primary milia, also known as “milk spots,” are common in newborn babies. They occur when keratin becomes trapped beneath the surface of the skin. Primary milia are usually found on the face, particularly around the nose, cheeks, and eyelids. They are generally harmless and do not require treatment. Most primary milia resolve on their own within a few weeks.

Secondary Milia

Secondary milia occur later in life and are caused by some form of damage to the skin. Blistering diseases, burns, dermabrasion, laser resurfacing, radiation therapy, and other skin injuries can trigger secondary milia. They can occur anywhere on the body, but are most common around the eyes and cheeks. Secondary milia may disappear over time, but often persist unless the underlying cause is addressed. Medical treatment may be required to clear secondary milia.

Causes of Milia

Milia can occur for several reasons:

• Genetics – Some people are simply prone to developing milia due to hereditary factors. Milia tends to run in families, so if your parents had issues with milia, you’re more likely to get them as well. Genetics can make someone predisposed to having clogged pores and trapped keratin that leads to milia.

• Sun damage – Exposure to UV rays from the sun can damage collagen in the skin over time. This damage can disrupt normal skin cell function, leading to irregularities that cause milia to form. Too much sun without protection is a common cause of milia, especially on the face.

• Skin trauma from cosmetic procedures – Any trauma to the skin, like microdermabrasion, chemical peels, laser resurfacing, etc. can potentially trigger milia by disrupting normal skin cell turnover. The irritation and inflammation from these cosmetic procedures can essentially trap keratin under the skin before it’s able to shed, resulting in milia.

Milia Symptoms

Milia are small, painless white bumps that appear on the skin. The most common symptom of milia is the appearance of the small white bumps themselves. Milia are most commonly found on facial skin, especially around the eyes, cheeks, nose, and forehead.

The milia bumps are tiny, usually measuring only 1 to 2 millimeters in diameter. They are dome-shaped and have a smooth texture similar to a pearl. Milia are not painful or itchy, and do not become red or inflamed like acne. They remain as small white bumps just under the surface of the skin.

While milia can occur anywhere on the body, they are most frequently seen on the face. The delicate skin around the eyes is a common location, as are the cheeks, nose, and forehead. Milia sometimes appear after trauma to the skin, so locations prone to acne lesions or injury from picking may develop milia as well. The bumps usually appear in small clusters in these facial areas.

In summary, the main symptom of milia is the appearance of tiny, painless white bumps on the facial skin. The small bumps have a smooth, pearl-like appearance and commonly occur around the eyes, cheeks, nose, and forehead. While harmless, these persistent milia bumps can be an aesthetic concern for some people.

Risk Factors for Milia

Some people are more prone to developing milia than others. The main risk factors include:

• Family History – Genetics can play a role in milia formation. If your parents or siblings have dealt with milia, you may be predisposed as well. The condition can run in families.

• Excessive Sun Exposure – Too much time in the sun without adequate protection can damage the skin and cause issues like milia. The UV radiation leads to an accumulation of dead skin cells that can get trapped beneath the surface. Always wear sunscreen when going outside.

• Use of Heavy Creams and Oils – Using thick, greasy moisturizers and oils on the face can clog pores and cause little cysts like milia to form. Stick to light, non-comedogenic products if you are prone to milia. Avoid any products that feel heavy.

Complications of Milia

Milia are generally not harmful or painful. However, they may sometimes cause psychological effects like embarrassment or anxiety about appearance. Some people find milia unsightly, especially on visible areas like the face. The small white bumps can make people feel self-conscious.

In rare cases, milia that are left untreated for a very long time could potentially become inflamed or infected. But this is uncommon. For the most part, milia do not lead to any major health complications. They may just be considered a cosmetic nuisance by some individuals.

The main reason people seek treatment for milia is due to cosmetic concerns. Milia are benign and pose no real medical threat. The treatment is aimed at removing or reducing the appearance of the bumps for cosmetic reasons. For people with extensive facial milia, the visual effect can cause social anxiety or impacts to self-confidence. But rest assured, milia are normally harmless.

Home Remedies for Milia

There are several at-home remedies that may help treat mild cases of milia. These include:

Gentle Exfoliation

Gently exfoliating the skin can help remove dead skin cells and excess oil that may be trapping the milia under the skin. Using a soft washcloth, cleansing brush, or facial scrub 2-3 times per week may help unclog pores and slough away trapped keratin. It’s important not to scrub too harshly, as this can further irritate the skin. Look for exfoliants with soft, round beads rather than sharp particles.

Retinoids

Applying over-the-counter retinoids such as retinol, retinaldehyde, and adapalene can help increase skin cell turnover. Retinoids may help dislodge trapped keratin and bring milia to the surface. Start by applying a pea-sized amount 2-3 nights per week, then gradually increase frequency based on skin tolerance. Use a moisturizer to combat potential dryness and irritation.

Oil Cleansing Method

The oil cleansing method uses a blend of oils to dissolve debris and impurities. Oils also contain fatty acids and lipids that can aid exfoliation. To oil cleanse: Apply a mixture of castor and olive oil to dry skin and massage gently for 2-3 minutes before rinsing. This may loosen embedded milia so they can be removed. Perform this 2-3 times per week.