Milia Definition, Type, Reason, Symptoms, Treatment

Worried about those little white bumps that gather under your eyes or on your nose? These lumps may be small cysts called milia. Generally, these small cysts are harmless, but there are causes of milia that require medication and skin care.

What are milia?

Milia are a group of small bumps, usually white, and clustered on the skin of the face. This white lump condition is a small cyst that often appears on the cheeks, nose, eyes, and eyelids.

Milia can also be referred to as small cysts. This condition is divided into several types based on age, where it appears, and what causes this lump to appear.

Apart from type, milia are divided into primary or secondary categories. Primary milia form directly from keratin trapped under the skin. This primary cyst is usually found on the face of a baby or an adult.

The secondary type has a shape similar to the primary. However, the secondary type develops after something clogs the duct leading to the surface of the skin, such as after an injury, burn, or skin scald.

Milia Type

This skin condition is divided into several types which are described below.

1. Neonatal

This type appears in infants after birth. Milia are undeveloped sweat glands. Plus, this condition occurs in around 50% of babies in the world so it is considered normal and will go away on its own.

2. Primer

This type can appear in both children and adults. Primary milia often appear on the eyelids, forehead, cheeks or genitals, can occur in children or adults. This condition is not caused by skin damage.

3. Secondary or traumatic

This type often appears near wounds, such as burns or rashes. It also appears after you apply certain types of creams, such as corticosteroid skin creams. Then, these small white bumps can also be caused by excessive sun exposure.

4. En plaque

This type of small cyst is very rare, growing close together so that it looks like there is a raised skin surface. This type of small cyst is generally lumpy with dead skin.

Usually appears behind the ears, eyelids, on the cheeks and jaw. This type of en plaque tends to affect mainly middle-aged women.

5. Multiple eruptions

This type generally disappears after weeks or months and is very rare.

6. Juveniles

This is a type caused by a genetic disorder. Below is the condition of the disorder that is the cause.

1. Nevoid basal cell carcinoma syndrome: this syndrome can lead to basal cell carcinoma (BCC).
2. Pachyonychia congenital: this condition can cause thick or abnormal nails.
3. Gardner’s syndrome: this rare genetic disorder can lead to colon cancer over time.
4. Bazex-Dupré-Christol syndrome: this syndrome affects hair growth and the ability to sweat.

How common is this condition?

Milia is a common condition. This condition affects more women than men, although patients are of all ages. These small lumps can generally be overcome by reducing risk factors. Discuss with your doctor for more information.

Signs and symptoms of milia

Common signs and symptoms of milia are not serious and will go away on their own over time. Below is the list.

1. There are small white bumps on the face.
2. Lumps that appear along the cheeks, nose, and chin.
3. White bumps like pearls on the gums or roof of the mouth.

Primary milia in infants usually appear 1-2 protrusions around the nose, eyes, cheeks, chin and forehead. These lumps can also appear on the trunk, legs, arms, penis, and mucous membranes.

According to the Mayo Clinic, this condition can sometimes be seen on the roof of a baby’s mouth and is called Epstein pearls. Sometimes, these bumps can be present with other skin conditions such as baby acne.

Some other symptoms or signs may not be listed above. If you feel worried about these symptoms, consult your doctor immediately.

When to see a doctor?

If you have any of the above signs or symptoms or have any questions, please consult your doctor. This is often not a serious condition.

Discuss with your doctor to find the best solution for your situation.

Causes of Milia

The exact cause of milia has not been clearly established. In children and newborns, this condition can be caused by underdeveloped sweat glands. This condition is also often mistaken for baby acne which is triggered by hormones from the mother.

Unlike baby acne, milia don’t cause inflammation or swelling. Babies with milia are usually born with it, whereas baby acne doesn’t appear until 2 – 4 weeks after birth.

Whereas in adults, these small white bumps appear when dead skin cells are trapped under the skin. Milia can also develop if the skin loses its natural ability to exfoliate. This can occur due to aging.

In addition, some of these skin conditions can be caused by the things below.

1. Skin conditions that have blisters.
2. There is a burn on your skin.
3. There are blisters on the skin.
4. Are undergoing treatment for the skin such as dermabrasion or laser treatment.
5. Long-term use of steroid creams.
6. Long-term sun damage.

The use of creams with steroids can cause milia on the skin. However, this side effect is rare. Some ingredients in skincare and makeup products can cause milia in some people.

Risk factors for Milia

There are many risk factors for milia, namely:

1. not keeping skin clean
2. wearing clothes that are rough in texture
3. often exposed to sunlight, as well
4. if you have a condition of skin injury (sore), skin rash, and blisters on the skin.

If you have pimples and blackheads, there may be a risk of having milia. That said, these little white bumps can develop even if you don’t have a skin problem like acne. This condition is a normal condition.

Although these bumps often fall into the comedonal acne category, they are different from pimples. Pimples and blackheads can develop when skin pores are clogged.

Meanwhile, this condition is a small cyst that occurs just under the top layer of skin, and not in the pores. The loss of milia also tends to take longer than regular acne.

If acne can disappear in a matter of days or weeks, milia can take months or even years.

Diagnosis of Milia

Doctors can diagnose just by looking directly at your skin. However, in some cases, if the diagnosis is uncertain or an en plaque type is suspected, the doctor may suggest a skin biopsy.

A skin biopsy is an easy and painless examination procedure. This procedure is performed by the doctor by examining the small sensory nerves in the skin. This nerve functions to pass on pain and temperature information that is felt by the skin.

This type of test is often implicated in some health conditions such as peripheral nerve damage ( neuropathies ). This test also lets doctors find the nerves, see how many of them there are, and whether they’re healthy.

When the nerves under the skin are damaged, this will indirectly show under a microscope.

Treatment of Milia

Milia in children does not need to be treated because it will go away on its own after a few months in a baby’s life. Adults also don’t need a special way to get rid of milia.

However, in rare types such as the en plaque type, the doctor may treat it by prescribing a cream made from isotretinoin or tretinoin. Another way to get rid of this type of milia is with a cream made from minocycline as an anti-infection.

If this small cyst enlarges over time and interferes with your appearance, please submit further treatment to the doctor. Since this small lump is difficult to remove when pricked or squeezed, it requires medical action with a doctor.

The doctor will do several ways to get rid of milia which are generally considered safe because they don’t need anesthesia. This treatment procedure for how to get rid of milia must be done in a hospital by a dermatologist.

Do not attempt the procedure for removing milia yourself at home, as it may result in infection and scarring. Some of the ways are below.

1. Cryotherapy

Cryotherapy is a technique for removing milia which is done by freezing the skin where there are cysts filled with keratin.

Doctors often use this method to remove en plaque milia. After that, the doctor will usually get rid of milia by giving a medicated cream or antibiotic called minocycline.

2. Facial with a dermatologist

Facial facials can be done as a way to get rid of milia. This method is done by removing the milia from the skin.

To be safe, it’s best to do facials at a beauty clinic with a certified doctor or therapist. In the facial procedure, later in the cyst part a small hole will be made with a small scalpel.

Later, the hard blockage that forms the milia will be pushed out gently through the fingers or using a tool called a comedone extractor process. This procedure is sometimes also called deroofing.

Although it sounds terrible to use a knife, some people say this method does not hurt. In fact, a dermatologist who performs blackhead extractions doesn’t even need anesthesia to endure the pain of the puncture.

3. Use a retinoid cream

If you are prone to experiencing this skin problem, your doctor will generally recommend that you use a cream containing retinoids that is rubbed on the problematic areas of your face.

Retinoid creams will help exfoliate skin effectively. When dead skin cells are sloughed off and don’t build up, it can help prevent plugging of keratin from getting trapped under the surface of the skin.

In addition, retinoid creams help loosen the keratin plugs in the milia on your face. This cream also helps the keratin plugs rise to the surface of the face so they can easily come out or disappear on their own.

4. Use drugs sold in pharmacies

For initial conditions, you can treat these small white spots on your face with drugs that are sold in pharmacies. Check the drug BPOM number and buy it at the pharmacy. Ask the pharmacist how to use and dosage is safe for getting rid of milia.

Generally, milia drugs sold in pharmacies contain salicylic acid and glycolic acid. Medication for acne ( adapalene ) can also help with this condition. These products help with exfoliating the skin.

If you only have a few small white bumps on your face, it’s best to use drugs that are sold in pharmacies first. Even though it doesn’t disappear overnight, this drug will be effective if used regularly.

Basically, milia is a skin problem that is difficult to get rid of and requires patience in its treatment.

Home care for Milia

There’s no way to prevent milia. However, there are some home remedies that can help prevent this condition.

Even though there is no specific drug that is proven to get rid of milia quickly, you can do the methods below.

1. Always wash your face to clean areas affected by dust and dirt every day.
2. Use soap that is safe and not harsh to prevent skin irritation.
3. Do facial steam. You can also take a warm shower to open your facial pores and allow skin oil to escape naturally.
4. Perform regular exfoliation procedures, for example once a week. However, avoid over-exfoliating, as daily exfoliation can irritate the skin.
5. Use sunscreen every day, 10 minutes before leaving the house. Sunscreen with a high SPF may help prevent overexposure to UV rays.
6. Use a topical retinoid cream for acne. Retinoid creams are creams or gels that are derived from vitamin A. Although they are designed to treat acne and other skin problems, there is little evidence that they are effective in treating milia.
7. Several studies have shown that extracts of rose, cinnamon, and honey have antibacterial properties that can treat several skin problems. However, there has been no research on their effectiveness against the condition of small white bumps on the face.
8. Avoid poking or squeezing these white bumps. This can increase the risk of infection and can cause facial scarring.

If your condition does not improve within a few weeks, contact your doctor. This is done to ensure that the small bumps are not the result of another skin condition.