Being the outermost layer of our body, our skin is fully exposed to the elements, hence it is logical that individuals worldwide, regardless of age, encounter different skin conditions. From psoriasis to eczema, most of the skin problems we face are rooted in inflammation, however not every lump and discoloration is deemed a skin condition worth addressing. Consider milia for instance.
If White Bumps Appear on Your Skin, You Might Have Milia
You might have encountered milia as a baby, but remained oblivious to it.
Milia, also known as a milium cyst, is typically caused by trapped keratin (the protein found in hair, skin, and nails). It is more prevalent in infants, with up to half of all babies developing it[1]. This is because during this early developmental stage, the infant’s skin is still adapting to the process of exfoliation. However, milia can manifest in individuals of all age groups when there is an obstruction in the ducts leading to the skin’s surface, such as an injury or burn.
Commonly, milia manifests as small white bumps on the nose, chin, or cheeks, and can also emerge in other regions of the body.
While milia is visible in both infants and adults, the varieties of milia differ, and intervention is distinct for each and is typically unnecessary. Milia is generally harmless and tends to resolve on its own. Nevertheless, it is crucial to recognize these tiny bumps to determine whether intervention is required.
Diverse Forms of Milia
Milia categories are distinguished based on the age at which the cyst forms or the triggering factor for the cyst’s development.
Neonatal Milia
Neonatal milia emerge in infants and typically disappear within a few weeks. Cysts are commonly observed on the face, scalp, and upper body[2]. According to the Seattle Children’s Hospital, around 40% of newborns experience milia.
Juvenile Milia
Rare genetic disorders such as Nevoid basal cell carcinoma syndrome (NBCCS), Pachyonychia congenita, Gardner’s syndrome, or Bazex-Dupré-Christol syndrome can lead to juvenile milia[2].
Milia en Plaque
This type of milia is frequently linked to genetic or autoimmune skin disorders, such as discoid lupus or lichen planus, and it impacts the eyelids, ears, cheek, or jaw. It is commonly observed in middle-aged females, though it can occur at any age and in any gender[1].
Primary Milia
This form of milia is observed in older children and adults. Cysts may be present around the eyelids, forehead, or genital area. They may disappear within a few weeks, or persist for several months[1].
Traumatic Milia
Occasionally, milia can develop on the skin where a prior injury (such as a rash or sunburn) occurred. These cysts may become inflamed, appearing red around the edges and white in the middle[1].
Diagnostic Process
Given that milia are easily noticeable, a dermatologist will typically identify milia visually based on the appearance of cysts. Skin lesion biopsies are only necessary in exceptional cases[2]. If you observe similar small white bumps on your skin, it may be advisable to consult a physician to ascertain if you indeed have milia, and to devise a treatment plan (if desired).
Milia Removal and Management
Since infant milia typically vanish on their own within a few weeks, there is no specific milia removal or treatment procedure.
Milia in older children and adults also tends to disappear on its own, but some individuals may opt for treatment if there is discomfort. Common approaches include:
- Cryotherapy – Using liquid nitrogen to freeze the milia. This is the most widely utilized removal technique.
- Deroofing – Employing a sterile needle to extract the cyst’s contents. This method is popular for milia treatment.
- Topical retinoids – Creams containing vitamin A that aid in skin exfoliation.
- Chemical peels – These cause the top layer of skin to peel off, revealing fresh skin.
- Laser ablation – Using a small laser to target affected areas and eliminate the cysts.
- Diathermy – Applying extreme heat to eradicate the cysts.
- Destruction of curettage – Surgically scraping and cauterizing the cysts.
There have been instances where milia was removed using a paper clip, however, it is advisable for such procedures to be carried out by a medical professional and not attempted at home[5]
The following video depicts a dermatologist extracting multiple milia using the deroofing technique.
Preventive Measures for a Milium Cyst
Although milia may not pose a threat to us, they can still be aesthetically displeasing. As milia result from issues on the skin’s surface, altering your lifestyle to focus on maintaining healthy and clean skin can significantly aid in preventing these bothersome bumps.
Shield Your Skin with Sunblock
Milia is often associated with skin damage, hence protect your skin from the sun whether you’re at the beach, watching your kid play baseball, or simply soaking up some rays on your patio.
Avoid Heavy Products
Using heavy products on your skin can impede the elimination of dead skin cells. This includes creams, ointments, makeup, and even lip balm. Utilizing cleansers with microbeads can also escalate the risk of developing milia[4]. Adjusting your beauty routine to exclude heavy products, and instead incorporate safe and light products will help maintain clear skin and keep milia at bay.
Regular Exfoliation
While it may be challenging to exfoliate a baby’s skin due to underdeveloped pores, the same does not hold true for you! Keeping your pores clean can prevent keratin from getting trapped in your skin, causing milia.
In conclusion, milia is benign. Apart from its unattractive appearance, it poses no harm and will resolve over time. If you are worried about your milia and wish to address it, consult your physician for suitable guidance. Otherwise, let these tiny bumps run their course, and they will soon fade away.
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