Posted by Audrey Kunin, MD There have been 4 comment(s)


What's with those annoying little white heads that just never seem to come to the surface and go away? What is that thick, white stuff that comes out when you finally get so frustrated you pick and poke and finally pop the bump? Milia can be the bane of your existence, particularly when they continue to form despite your best efforts at keeping your skin "clean". Unfortunately, cleanliness isn't problem. The skin's ability to naturally exfoliate is.

Milia are deep seeded white bumps that form when skin cells become trapped rather than exfoliate naturally. The trapped cells become walled off into tiny cysts that appear like white beads below the surface of the skin. Milia can occur on the skin or even on mucous membranes such as the inner surface of the cheek or the vermillion border of the lips.

As the surface is worn away, the tiny cyst may resolve on its own. Far too often, though, intervention to remove the cyst may offer more rapid resolution.

Why Me?

Milia form for a variety of reasons. Some you can fix, others aren't so easily dealt with. But you need to scrutinize your skin care routine whenever milia make their appearance. Although some people naturally make milia, and I certainly expect everyone to have an occasional bump at one time or another, milia are often the result of a problem that has affected the skin's surface.

  • Heavy Skin Care Products
    No doubt the most common reason milia form is from smothering your skin with heavy skin care products or hair care items. Comedogenic creams and lotions may prevent the sloughing of dead epidermal skin cells. Hidden problem products include make-up removers not labeled oil-free or non-comedogenic, hair spray, hair mousse and gel, heavy sunscreens and some moisturizers. The eyelids are very thin and more likely to experience problems with milia due to cosmetics. Re-evaluate your eye make-up and eyelid make-up remover if you are finding this to be a concern.Certain lipsticks, lip balms and products meant to help with chapped lips may be the cause of little white pearly milia developing around the lipstick edge (aka vermillion border) of the lips. Again, if you see these forming, take a good look at the ingredients on the label.
  • Prolonged History Of Sun Damage
    The formation of milia can also be due to cumulative sun exposure. Aging skin forms a thicker epidermis that may make it far more difficult for skin cells to find their way out of the glands. And thicker skin also makes for more road blocks in the pathway to exfoliation.
  • Porphyria Cutanea Tarda
    Milia can also be associated with certain skin diseases, particularly blistering disorders such as Porphyria Cutanea Tarda. Fortunately, there are other symptoms associated with these blistering diseases. Blisters, for one and increased hair on the face and backs of hands and knuckles, for another. PCT is an unusual disorder. If you have milia, don't initially jump to the conclusion you have a blistering condition.
  • Genetics
    Sometimes we just inherit certain undesirable skin tendencies.

What's a Girl (Or Guy) Gonna Do?

Exfoliation can go a long way in helping deal with milia prone nn eyelid skin. By keeping the epidermis thin and smooth, you can cut down on their formation. By mentioning exfoliation, I'm not talking about scrubbing off the top layer of your skin! One way is to use a gentle exfoliating microdermabrasion scrub such as DERMAdoctor Physical Chemistry.

Retinol is also very helpful for both fighting and preventing milia. Again, retinol should not be applied to the upper eyelids. Apply no more than a pea size drop of DERMAdoctor Poetry in Lotion 1% Retinol for the face no more than every other night 30 minutes after cleansing.

Sometimes milia won't come out in spite of your best efforts. Then you may need the milia to be extracted by your dermatologist. In a physician's office, milia are easily removed. The skin is cleansed with some rubbing alcohol or other antiseptic. The skin overlying the milia is gently opened with a sterile lancet or needle. Then pressure is applied with a comedone extractor, and the milia typically pop out. I find that one of the most difficult areas from which to remove milia is the upper eyelid. There simply isn't a good way to press on the area and avoid the eyeball, so the lid has to be pulled either upwards or to the side, which is somewhat challenging.

What can you do to prevent milia? Besides keeping your lifelong sun exposure limited, wearing oil-free sunscreen such as DERMAdoctor Ain't Misbehavin' SPF 30 or anti-aging lotion Photodynamic Therapy with SPF 30. Cleanse with a buffered glycolic acid such as DERMAdoctor Wrinkle Revenge Cleanser to remove unwanted surface debris and cleanse the pores. Exfoliating and deep cleansing once or twice weekly with DERMAdoctor Physical Chemistry can help speed up the process, while addressing other rejuvenation concerns.

No more worrying about milia. Remove them, prevent them and enjoy bump-free beauty.

Thank you for taking the time to read my newsletter. As always, I hope you have found it informative.

Audrey Kunin, M.D.

This content is sponsored by DERMAdoctor. The author receives compensation for its creation. All content is the legal copyright of DERMAdoctor, Inc, and it may not be used, reprinted, or published without written consent.

The information provided is for entertainment purposes only and is not intended to provide medical, legal or other professional advice.

This post was posted in Articles, Milia and was tagged with milia, microdermabrasion, acne

4 Responses to Milia

  • dhana says:

    i hav done melia extraction.i do take a lot of care of my skin
    how i can prevent them.i really dont want them to cum back.wat are the cause of milia?my skin is pimple free but only bcz of milia it looks bad.

    Posted on March 17 at 11:15 am

  • Annu says:

    I have done laser on My face for removing them.Doctor Firstly burn them & then take out from needle.But they occur on my face again.Please tell what to do.Even i exfoliate my skin with scrub in week.Please tell any other solution which is not Expensive & time taken.

    Posted on October 16 at 5:43 am

  • Sometimes milia won't come out in spite of your best efforts. Then you may need the milia to be extracted by your dermatologist. In a physician's office, milia are easily removed. The skin is cleansed with some rubbing alcohol or other antiseptic. The skin overlying the milia is gently opened with a sterile lancet or needle.

    Posted on April 18 at 1:29 am

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