What is Milia: Causes, Types, and Treatment

Milia, those tiny, mysterious white bumps that can appear on your skin, might leave you wondering what they are and how to deal with them. In this comprehensive guide, we will delve into the world of milia, exploring their causes, types, and treatment options. Whether you’ve encountered these tiny cysts or are simply curious, this article is your go-to resource for understanding milium cysts.

What is a Milium Cyst?

A milium cyst, often referred to as milia, is a minute, white bump that typically emerges on the nose and cheeks. These cysts often cluster together, forming what we call “milia.” These tiny bumps are a result of keratin, a robust protein found in skin tissues, hair, and nails, becoming trapped beneath the skin’s surface. While milium cysts can affect individuals of all ages and ethnicities, they are most commonly observed in newborns.

Symptoms of Milia

Milia manifest as small, dome-shaped bumps that are usually white or yellow in color. They tend to be non-itchy and painless, although some individuals may experience discomfort. Friction from rough sheets or clothing can irritate the milium cyst, causing it to appear red and inflamed. These cysts predominantly appear on the face, including the lips, eyelids, and cheeks, but can also occur on other parts of the body such as the torso and genitalia. It’s important to note that milium cysts are sometimes mistaken for other conditions like Epstein pearls or “baby acne.”

What are the Causes of Milium Cysts?

The causes of milium cysts can differ depending on the age group.

Newborns

Milia in newborns often has an unknown cause and is occasionally misidentified as baby acne, which is triggered by maternal hormones. Unlike baby acne, milium cysts do not cause inflammation or swelling and are typically present at birth.

Older Children and Adults

In older individuals, milium cysts are often associated with skin damage. This damage can result from various factors, including skin conditions like epidermolysis bullosa (EB), blistering injuries, burns, prolonged sun exposure, the use of steroid creams, and certain skin resurfacing procedures. Additionally, milium cysts can develop as a consequence of the skin losing its natural ability to exfoliate, a process that can occur with aging.

Types of Milium Cysts

Mmilium cysts can be categorized based on the age at which they occur and their underlying causes. These categories are further divided into primary and secondary milia.

Neonatal Milia

Neonatal milium cysts, considered primary milium cysts, emerge in newborns and typically disappear within a few weeks. These cysts are commonly found on the face, scalp, and upper torso, affecting approximately 40 percent of newborns.

Primary Milium Cysts in Older Children and Adults

Primary milia in older individuals can be found around the eyelids, forehead, and genitalia. They may resolve in a few weeks or persist for several months.

Juvenile Milium Cysts

Rare genetic disorders affecting the skin, such as Nevoid basal cell carcinoma syndrome (NBCCS), Pachyonychia congenita, Gardner’s syndrome, and Bazex-Dupré-Christol syndrome, can lead to juvenile milium cysts.

Milia en Plaque

This condition is often linked to genetic or autoimmune skin disorders like discoid lupus or lichen planus. Milia en plaque can affect various areas, including the eyelids, ears, cheeks, or jaw, and can result in larger cysts, sometimes several centimeters in diameter.

Multiple Eruptive Milium Cysts

This type of milium cyst presents as itchy areas on the face, upper arms, and torso. The cysts appear gradually over a period of weeks to months.

Traumatic Milium Cysts

Traumatic milium cysts occur at sites of skin injury, such as severe burns and rashes. These cysts may become inflamed, with redness around the edges and a white center.

Milia Associated with Drugs or Products

Steroid creams can sometimes lead to milium cysts at the application site, although this side effect is rare. Additionally, certain ingredients in skincare and makeup products may trigger milia in susceptible individuals. Ingredients to avoid include liquid paraffin, liquid petroleum, paraffin oil, paraffin liquid, petrolatum liquid, petroleum oil, and lanolin.

How Are Milia Diagnosed?

Diagnosing milia typically involves a visual examination by a healthcare provider. In rare cases, a skin lesion biopsy may be required for confirmation.

Milia Treatment Options

The treatment of milia varies depending on the age of the individual and the discomfort caused by the cysts.

Infant Milia

For infants with milium cysts, no treatment is usually necessary, as the cysts tend to resolve on their own within a few weeks.

Older Children and Adults

In older individuals, milium cysts often disappear within a few months. However, if they cause discomfort or cosmetic concerns, several treatment options are available, including:

Cryotherapy

Cryotherapy involves freezing the milium cysts with liquid nitrogen and is one of the most commonly used removal methods.

Deroofing

Deroofing utilizes a sterile needle to extract the contents of the cyst.

Topical Retinoids

These creams containing vitamin A can aid in exfoliating the skin.

Chemical Peels

Chemical peels remove the top layer of skin, revealing new skin underneath.

Laser Ablation

A laser is focused on the affected areas to remove the cysts.

Diathermy

Extreme heat is used to destroy the cysts.

Destruction Curettage

The cysts are surgically scraped and cauterized.

Conclusion

In conclusion, milia are common skin cysts that can occur at any age. Understanding their causes, types, and treatment options can help individuals manage these benign cysts effectively. Whether you’ve encountered milia or are simply curious about these tiny white bumps on the skin, this article has provided valuable insights into their nature and how to address them. Remember, while milium cysts may be a temporary concern, they are not harmful in the long run, and with the right approach, you can ensure your skin remains healthy and blemish-free. If you have any concerns or questions about milium cysts, it’s always advisable to consult with a healthcare professional for personalized guidance and treatment.

FAQs (Frequently Asked Questions)

1. Are milia contagious?

No, milium cysts are not contagious. They are not caused by bacteria or viruses and cannot be spread to others.

2. Can I pop Milia at home?

It is not recommended to try and pop milium cysts at home. Attempting to squeeze or pop them can lead to infection or scarring. It’s best to consult a healthcare provider for proper removal.

3. Do milia always require treatment?

No, milium cysts in infants often resolve on their own, and treatment is not necessary. In older children and adults, treatment may be considered if the cysts cause discomfort or cosmetic concerns.

4. Can milia be prevented?

While it’s not always possible to prevent milium cysts, avoiding harsh skincare products and excessive sun exposure may reduce the risk of their development.

5. Are there any natural remedies for milia?

There is limited scientific evidence for natural remedies for milium cysts. Consult with a healthcare professional for appropriate treatment options.