Milia: Everything You Need To Know About These Tiny Bumps

Milia, often mistaken for acne or whiteheads, are small, harmless cysts that can appear on the skin of both children and adults. These tiny, white or yellowish bumps, commonly called “milk spots,” can affect the face, eyelids, and other areas of the body. Despite their benign nature, they can be persistent and frustrating for those who wish to achieve smooth, flawless skin. In this blog, we’ll explore the different types of milia, their causes, treatment options, and how to prevent them.

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What is Milia?

Milia are small cysts that form when keratin, a type of protein, becomes trapped beneath the skin’s surface. Unlike acne, they do not form in hair follicles or involve oil production. Milia can appear anywhere on the body but are most commonly found on the face, particularly around the eyes, cheeks, nose, and forehead. These harmless white bumps are often mistaken for acne or other skin conditions but have distinct causes and characteristics.

Common Types of Milia

While milia can occur in people of all ages, including newborns (such as neonatal milia), we will focus exclusively on adult milia. Adult milia present unique challenges and causes, often linked to skin trauma, aging, or environmental factors.

1. Primary Milia

Primary milia develop spontaneously without any apparent external cause. They are frequently seen in both newborns and adults. In newborns, these bumps, often called "milk spots," are common on the cheeks, nose, and forehead. In adults, they may appear on various parts of the face and are typically associated with natural skin shedding processes that occasionally fail, causing keratin to get trapped under the skin.

2. Secondary Milia

Secondary milia occur as a result of skin trauma or damage. Burns, rashes, excessive sun exposure, or prolonged use of topical steroid creams can lead to the development of this type. The trauma disrupts the normal exfoliation process, allowing keratin to accumulate under the skin, forming these cysts. They can appear anywhere on the body where the skin has been damaged.

3. Milia en Plaque

This rare type of milia appears as raised, inflamed patches of skin covered with clusters of milia. Milia en plaque is often linked to underlying inflammatory skin conditions such as discoid lupus erythematosus or lichen planus.

These patches can appear on the eyelids, cheeks, jawline, or behind the ears and are more prevalent in middle-aged women.

4. Multiple Eruptive Milia

Multiple eruptive milia present as groups or clusters of milia that appear over weeks or months. These are commonly found on the upper trunk, face, and upper arms.

This type is less common and may be associated with underlying skin or genetic conditions. Unlike primary milia, multiple eruptive milia often cause cosmetic concern due to their widespread nature.

5. Traumatic Milia

Traumatic milia arise after skin injuries such as burns, blisters, or surgical incisions. These injuries create an environment where keratin gets trapped under the healing skin, forming small cysts. They can also develop in areas of friction or irritation, such as from tight clothing or accessories.

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5 Causes and Triggers of Milia

Diagnosing milia accurately is essential to differentiate them from other skin conditions such as acne, small cysts, or baby acne. Milia appear as small, firm, white or yellowish bumps that are painless and non-itchy. Unlike acne, milia do not exhibit redness, inflammation, or pus formation. These are the common causes of why will they appear:

1. Dead Skin Cells

Milia form when dead skin cells fail to shed properly. These cells can become trapped beneath the skin’s surface, resulting in small cysts. Improper skincare routines or the use of heavy, pore-clogging products may exacerbate this issue.

2. Skin Trauma

Injuries such as burns, blisters, or rashes disrupt the skin’s natural healing process. This disruption allows keratin to accumulate, leading to secondary or traumatic milia. Common triggers include surgical scars, excessive exfoliation, and skin irritation from harsh treatments.

3. Excessive Sun Exposure

Prolonged exposure to the sun can thicken the skin, making it more difficult for dead cells to shed naturally. This condition, often called solar elastosis, is a common trigger for secondary milia in sun-damaged areas such as the face, neck, and upper arms.

4. Genetics

Some people are genetically predisposed to developing milia due to inherited skin traits or conditions. For example, people with thicker or less elastic skin may experience more frequent occurrences of milia.

5. Underlying Skin Conditions

Conditions such as epidermolysis bullosa, a rare disorder that weakens the skin’s outer layers, can increase susceptibility to milia. Other contributing factors include chronic dermatitis and skin-barrier dysfunctions.

Other Conditions That Milia Affected Skin May Have

People with milia may also experience other skin conditions due to shared contributing factors such as skin damage, clogged pores, or impaired skin barriers. Some common skin conditions that may coexist with milia include:

- Acne

Milia are sometimes mistaken for acne due to their similar appearance. Individuals prone to acne, especially comedonal acne, may also develop milia as a result of clogged pores and keratin buildup.

- Rosacea

This chronic inflammatory skin condition, characterized by redness and small bumps, can coexist with milia, especially when the skin barrier is compromised.

- Eczema (Atopic Dermatitis)

People with eczema often have a weakened skin barrier, which can make them more prone to secondary milia due to irritation, inflammation, or the use of heavy creams or steroid ointments.

- Sun-Damaged Skin

Prolonged sun exposure can thicken the outer layer of the skin, making it harder for dead skin cells to shed, which may lead to milia formation. Individuals with solar lentigines ("sun spots") or actinic keratosis may also notice milia.

- Seborrheic Dermatitis

This condition involves oily and flaky skin, which can contribute to clogged pores and lead to the formation of milia in affected areas.

- Psoriasis

Psoriasis accelerates skin cell turnover, often leading to flaky, scaly patches that can trap keratin under the skin, potentially resulting in milia.

- Lichen Planus

Milia en plaque, a rare form of milia, is sometimes associated with inflammatory skin conditions like lichen planus or discoid lupus erythematosus.

- Skin Trauma-Related Conditions

Conditions such as scars, burns, or areas affected by surgical incisions are prone to traumatic milia. These skin areas may also be more vulnerable to other issues like pigmentation or keloid formation.

- Dry or Dehydrated Skin

Dry skin can lead to an accumulation of dead skin cells, contributing to milia. Individuals with xerosis (abnormally dry skin) may also be at risk.

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2 Main Ways to Treat Milia Confidently

While milia are harmless and may resolve on their own, persistent or numerous milia often require intervention. Here are some effective methods:

1. Perfect Medical’s Acne Treatment

Perfect Medical’s Acne Treatment employs advanced vacuum dermabrasion technology, which gently exfoliates the skin by removing dead skin cells and unclogging pores. This process effectively targets the root causes of milia while revitalizing the skin’s surface.

As part of the treatment, medical-grade hydrating essence is infused into the skin to promote collagen repair and the formation of new skin. This step not only enhances the treatment's efficacy but also ensures the skin remains moisturized and supple.

Why Choose Acne Treatment?

One of the key advantages of this treatment is that it is non-invasive and painless. Suitable for all skin types—including sensitive and acne-prone skin—it ensures a comfortable and safe experience for individuals dealing with persistent milia, as well as other skin concerns such as acne and dry skin.

2. Extraction with a Sterile Needle

For stubborn milia, dermatologists often recommend professional extraction. This involves making a tiny incision using a sterile needle to create an opening in the cyst.

The trapped keratin is then gently removed, restoring the skin’s smooth appearance. This method should only be performed by trained professionals to avoid potential scarring or infections.

3. Topical Medications

Dermatologists may prescribe topical retinoids or exfoliating agents containing AHA (alpha hydroxy acids) or BHA (beta hydroxy acids).

These compounds accelerate skin cell turnover, helping to prevent the formation of new milia and gradually reducing existing ones. Regular use of these medications can significantly improve skin texture and clarity.

4. Chemical Peels

Mild chemical peels containing glycolic acid or salicylic acid are another effective treatment option. These peels work by dissolving the bonds between dead skin cells, promoting their removal, and preventing keratin buildup. Regular sessions can help reduce milia and improve the skin's overall appearance.

5. Laser Therapy

For severe or recurring cases, laser treatments such as fractional laser therapy can be employed. These procedures target affected areas with precision, removing milia and promoting new skin growth.

Laser therapy is particularly useful for larger or more widespread outbreaks of milia.

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7 Tips to Keep Milia at Bay

Prevention is always better than cure. Here’s how you can keep milia at bay:

Maintain a Regular Skincare Routine

A consistent skincare routine is crucial in preventing milia. Use a gentle cleanser to remove dirt and excess oil without stripping the skin of its natural moisture. Regular exfoliation with chemical exfoliants like alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) can help prevent the buildup of dead skin cells. Avoid physical exfoliants, which may irritate the skin and exacerbate milia.

Protect Your Skin

Daily sunscreen application is essential to minimize sun damage, which can thicken the skin and make it prone to milia. Opt for a broad-spectrum sunscreen with at least SPF30 and reapply every two hours when outdoors. Use non-comedogenic and lightweight sunscreens to avoid clogging pores.

Avoid Skin Trauma

Be gentle with your skin by avoiding harsh scrubbing or using abrasive skincare tools. Overuse of steroid creams or harsh chemicals should also be avoided as they can lead to secondary or traumatic milia. Treat your skin gently, especially when dealing with existing conditions or healing wounds.

Stay Hydrated

Proper hydration is key to maintaining healthy skin. Drink plenty of water to keep your skin hydrated from within. Incorporate hydrating products such as hyaluronic acid serums or water-based moisturizers into your routine to enhance skin barrier function and prevent dryness.

Use Non-Comedogenic Products

Choose skincare and makeup products labeled as non-comedogenic. These products are designed not to clog pores and can significantly reduce the chances of developing milia.

Practice Good Hygiene

Always cleanse your face after sweating or wearing makeup for long periods. Avoid touching your face with unclean hands, as bacteria and dirt can contribute to clogged pores and the formation of milia.

Limit Sun Exposure

Excessive exposure to UV rays not only damages your skin but also increases the risk of developing milia. Wear protective clothing, such as hats and sunglasses, and seek shade whenever possible.

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Milia Removal Made Simple: Your Path to Clearer Skin

Milia, while harmless, can be a cosmetic concern for many. Taking proactive measures to treat and prevent them can help you achieve clear and radiant skin. Perfect Medical’s Acne Treatment provides an innovative and effective way to address milia and other skin issues, ensuring your skin stays healthy and smooth. Don’t let those tiny white bumps hold you back—consult with Perfect Medical today and take the first step toward flawless skin!