Milia – what are they and what to do about them

It’s common for babies to get tiny white bumps called milia – but adults can get them, too. Find out what causes them and what you can do about them.

Are there different types of milia? 

What causes them? 

Self-care tips 

When to see a doctor and getting diagnosed 

How are milia treated?

Have you noticed tiny white bumps around your eyes or on your face? These could be milia, which are mostly harmless but can leave you feeling self-conscious. Read on to find out what causes them, and what can help.

Sometimes called “milk spots” milia are tiny, pearly white bumps (cysts) that contain keratin (which is a protein in your skin). A single cyst is called a milium.

Milia sit beneath the surface of your skin and most commonly appear on your face – around the eyes, nose, cheeks, or chin.

While they’re often thought of as something that only affects babies – up to half of newborns have milia – you can get them at any age.

Milia are not acne, although they can be confused with whiteheads. They’re usually white to yellow in color, or can have a faint blue tint on darker skin. They’re usually around 1mm-3mm in diameter and have a smooth dome shape.

Although they’re harmless, they can be annoying. The good news is that most of the time they go away without treatment, and if not, some things can help.

## Are there different types of milia? 

There are several forms including:

- __primary milia__ – may appear on eyelids, cheeks, forehead, or genitals, and can occur in children and adults. It can clear up within a few weeks, or can take up to a few months or longer to go

- __neonatal milia__ – found in newborns and are present at birth. Usually appears on the nose but may develop in the mouth. Usually heals within a few weeks after birth

- __secondary milia__ – this happens after damage to your skin from an injury, a burn, or a rash, for example. It can also develop after using some skin creams 

- __milia en plaque__ – this is when multiple milia cluster together on a raised patch of skin and are found around the eyes, behind the ears, and on the jaw. It’s rare and tends to affect women between 40 and 60 more often. It can be associated with other skin conditions. including discoid lupus and [lichen planus](https://www.livehealthily.com/health-library/conditions/lichen-planus)

- __juvenile milia__ – a symptom of a condition that’s inherited. Symptoms are present at birth or they may develop at a later age

- __multiple eruptive milia__ – this is when groups of milia appear on your body over the course of weeks or months. It’s a rare type, can be itchy, and affects your face, upper arms, and upper abdomen. 

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## What causes them? 

Depending on what type you have, milia can be caused by different things.

Milia can form when dead skin cells get trapped under the outer layer of your skin. This happens when your body tries to shed old skin cells, but they don’t fall off so new skin grows on top of them.

Mila can also be caused by:

- sun damage
- a skin injury
- steroid creams used over a long period
- a genetic condition
- an autoimmune disease. 


## Self-care tips 

Milia usually go away on their own, but there are things you can do at home that may help, including:

- washing your skin every day using warm water and a mild soap or cleanser to prevent clogged pores. Pat skin gently dry with a clean towel
- wearing sunscreen (minimum SPF factor 30)  daily even when it’s overcast to protect your skin 
- using over-the-counter treatments such as exfoliators. Speak to a doctor or pharmacist to find out what might be suitable for you.

You should never try to pop or remove a milia yourself, as this can lead to scarring and infection.

## When to see a doctor and getting diagnosed 

In most cases you don’t need to see a doctor if you have milia, as they are harmless and go away on their own. 

If milia bumps are not going away, or are causing you problems, see your doctor. In some cases they may suggest you see a dermatologist, or skin specialist, to rule out any other conditions.

A doctor will be able to diagnose milia by a physical exam. They’re usually easy to diagnose, but rarely a doctor may refer you for a skin biopsy to rule out other conditions and cysts.

## How are milia treated?

Milia will usually go away on their own. Congenital milia often resolves itself without treatment, but primary and secondary types of milia can stay around for longer. If milia is bothering you and affecting your confidence, there are treatments available from a doctor or dermatologist, including:

- using a sterile blade to pierce the milium and squeeze out the contents 
- freezing off using a method called cryotherapy 
- burning off using electricity and heat on the skin 
- prescribing topical creams and treatments, for example topical retinol if large parts of your skin are covered in milia
- using minocycline (a tetracycline antibiotic), which may help improve milia en plaque
- procedures such as chemical peels, microdermal abrasions, and laser treatments.

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References

Rosa Bowden

Jo Wheatley

Dr Maria Reza

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