Gentle and Reliable Methods for Eliminating Small White Facial Bumps
Milia, those pesky little white bumps resulting from trapped dead skin cells, often fade away on their own within weeks or months. While treatment isn’t usually necessary, there are several effective strategies for removing them if their appearance bothers you:
- Professional manual extraction performed by a dermatologist
- Over-the-counter (OTC) exfoliating skincare products
- Prescription medications like antibiotics or retinoids
- Chemical peels
- Curettage
- Cryotherapy
- Laser ablation
Keep in mind, milia can be stubborn and might require months of treatment. If your attempts to address suspected milia at home aren’t yielding results, there could be another underlying cause for the bumps on your skin. In such cases, seeking advice from a healthcare provider is recommended.
This article outlines the most effective and safest methods for eliminating milia, should you choose to pursue treatment.
DIY Milia Treatment: Effective Home Remedies
If you have just a few small milia bumps here and there, you might consider using an over-the-counter (OTC) product designed to exfoliate dead skin cells from the surface. To see continuous results, you’ll need to use these products consistently over time.
However, if you have numerous milia, they persist despite using OTC treatments, or they are in a difficult-to-treat area (such as your eyelid), it’s best to consult a dermatologist.
Although milia and pimples may look similar, they are different. Pimples contain a soft core of dead skin cells, sebum (skin oil), and bacteria, which release fluid when popped. In contrast, milia are filled with a hard plug of keratinized dead skin cells and cannot be popped.
What is Milia?
Milia these are tiny little white bumps on the skin typically one to three millimeters so super small and they’re made up of dead skin cells or keratin. which is the protein that makes up skin and it’s when it gets trapped right below the skin’s surface forming a small little cyst if you have a single spot it’s called a million and if you have multiple spots then they are called milia.
Types of Milia
We talk about two different types primary milia and secondary milia.
- Primary milia
come directly from entrapped keratin below the skin’s surface and they most often are associated with a hair follicle these are the most common type of milia that I see in my clinical practice and they’re often on the faces of infants even fresh out of the womb babies and adults. - Secondary milia
in medicine anytime we say anything is secondary to something else it means it’s due to something else and in the case of milia are secondary to trauma so secondary milia are also known as traumatic milia. and they occur or can occur anytime the skin is damaged unlike primary milia which typically are associated with a hair follicle or are attached to a hair follicle secondary milia arise from the equine sweat gland as I mentioned earlier secondary milia can be due to trauma to the skin.
Causes of Milia
(1) Laser
(2) chemical peel
Laser or chemical peel can leave milia behind also people who have chronic skin rubbers so people who have allergies and kind of manipulate the skin around their eye a lot are going to be more prone to forming milia and then infections can lead to milia so herpetic infections and staph infections especially if they cause blisters can leave milia behind there are certain lifestyle factors that can also predispose you to milia so for example if you are a smoker you are more likely to get milia if you have chronic long-term sun exposure more likely to get milia if you use steroids topically for long periods you can be predisposed to milia and then some people though not everyone if they use thick or occlusive creams can be more prone to milia with all of that being said we still don’t fully understand why some people get milia and some don’t we see it in about 40 to 50 percent of newborn babies
Who Gets Milia:
Through all phases of their life, I mentioned it happens in infants we see it in kids and we see it in adults especially as you get older you will become more and more prone to milia It happens equally in men and women but we tend to notice it probably in women more because women are the ones that usually are looking in the magnifying mirrors and two women tend to have thinner skin and so anything that’s trapped below the skin surface is going to be more visible before I get into the treatment of milia which is probably.
Skin Concerns Mistaken for Milia:
What you’re here for I do want to talk about the fact that there are so many things that show up on the face that mimic milia but aren’t one of the most common skin concerns that are mistaken for milia is something called four dice. spots These are sebaceous glands also known as oil glands and they appear as small like one to two-millimeter white to yellowish bumps they’re often most visible under the eye on the lips and in the genital skin where the skin tends to be thin and allow those oil glands to be visible through the skin another skin condition that’s commonly mistaken for melia is something called Syringomas.
In-Office Milia Treatments:
Trapped below the skin’s surface you can’t just pop them out there’s no direct connection between the milia cyst and the skin surface so what we’re doing in the office,
we are creating an opening in the skin through which that cyst can be extruded we will often do that with a sterile needle or a scalpel blade sometimes we’ll even do something called Electrodesiccation. or cautery to essentially use heat to melt the overlying skin or burn the overlying skin to allow that cyst to make its way to the skin surface but we are doing this all in a sterile manner.
I want to make that point because a lot of people are like hey can I just like get rid of my milia at home by popping my skin and I do not recommend it if you don’t want to manipulate your skin with non-sterile instruments you also want to make sure that you’re treating the right thing I’ve had so many patients try to remove their milia and then when they come to the office is not what it is I find that Melia’s removal in the office works best for larger milia now all milia by definition are small but sometimes people will have hundreds of little pinpoint milia and that’s not very amenable to in-office treatment so be mindful of the fact that if you can only see your milia.
At-Home Milia Treatments:
About at-home milia treatment, you should know that smaller milia tend to go away on their own with time that doesn’t always happen but over the course of a few years especially in kids they often will completely resolve and two the best at-home topical treatment for milia is retinoids you would think other types of exfoliants like alpha hydroxy acids and beta-hydroxy acids. might also help with Milia .
It seems that when you’re using these types of topical retinoids they need to be used consistently for six months and up to a year before you see the improvement so if you’re trying to get rid of Milia just know that it might take some time if someone comes to see me in my office and they want recommendations for at-homily treatment I will often prescribe tretinoin 0.025 or even 0.05 for the treatment of milia at home so those are the main treatments of millions nothing crazy exciting either in office extraction or treatment with topical retinoids at home or a combination of both I do think it’s worthwhile to spend a minute talking.
Summary
Milia are tiny cysts that form under the skin, most commonly on the face. They are primarily a cosmetic issue, so deciding whether to treat them is up to you.
If you decide to treat milia, you have several options. These include at-home exfoliating products, professional manual extraction, prescription medications, and procedures like laser resurfacing.
It’s crucial never to attempt popping milia yourself. This won’t work and can cause complications such as skin infections.
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