Milia (Milk Spots): Types, Causes, Symptoms
Milia are tiny, white or yellowish bumps that commonly develop on the skin, especially on the face. These harmless and non-painful bumps often appear around sensitive areas such as the eyes, cheeks, nose, lips, and even the eyelids. They occur when keratin, a natural protein in the skin, becomes trapped beneath its surface. Milia on the face are not restricted to any particular age group and can affect both newborns and adults.
For adults, milia on eyelid, milia under the eye, and milia on lips are frequent concerns, as these areas are delicate and prone to such issues. These tiny bumps may be mistaken for acne but are distinct in nature. While milia skin conditions often resolve on their own, persistent cases may require professional treatment.
Milia vs. Pimples
Making the distinction between pimples and milia is crucial for selecting the right course of action. Because of bacterial infections and clogged pores, pimples are red, swollen, and frequently filled with pus. Milia, on the other hand, are rigid, non-inflammatory, and lack a pore opening.
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Get A Second OpinionWhat are the Types of Milia?
Milia are small white or yellowish bumps on the skin that form when keratin gets trapped beneath the surface. They are quite common and harmless. The types of milia depend on how they are caused and where they appear on the skin. Here are the different types of Milia:
- Primary Milia: These happen naturally when keratin gets trapped. They are common in both newborn babies and adults.
- Secondary Milia: These occur due to skin damage like burns, rashes, or injuries, which interrupt the skin's healing process.
- Juvenile Milia: These are linked to rare genetic conditions such as Bazex-Dupré-Christol syndrome or Gardner syndrome.
- Milia en Plaque: These are clusters of milia seen on raised or inflamed patches of skin and are sometimes related to conditions like discoid lupus.
- Multiple Eruptive Milia: These are groups of milia that appear suddenly over days or weeks, mostly on the face, arms, or chest.
- Neonatal Milia: Common in newborns, these are harmless and go away on their own within a few weeks.
What Causes Milia?
Milia are small, white or yellowish bumps that form when keratin, a natural protein in the skin, gets trapped beneath its surface. While they can occur at any age, many people wonder, "What causes milia in adults?" Several factors contribute to this common skin concern, especially in adults.
Common Causes of Milia in Adults
- Sun Damage: Prolonged sun exposure thickens the skin’s outer layer, making it harder for dead skin cells to shed naturally. This can result in milia on the face, especially on sun-exposed areas.
- Heavy or Occlusive Skincare Products: Using thick creams, oil-based moisturisers, or heavy makeup can block the skin's surface, leading to the formation of milia, particularly around the eyes and lips.
- Aging Skin: As adults age, the skin’s natural exfoliation process slows down, increasing the risk of milia in adults, especially on delicate areas like milia on eyelids or milia under the eyes.
- Skin Trauma or Damage: Injuries such as burns, rashes, or even cosmetic procedures like laser treatments can disrupt the skin’s healing process, trapping keratin and forming milia.
- Unscaled Skincare Routine: Not properly cleansing or not regularly exfoliating leaves dead skin cells on your skin which in turns make it prone to milia problems.
- Underlying Skin Conditions: Primary Milia arouse in the face, lips or even at some other parts too may cause due to certain skin conditions, treatments etc.
What are the symptoms of milia?
Milia are small, painless, white or yellowish bumps that form just under the skin. They are harmless and usually appear on the face, but they can show up on other parts of the body as well. The symptoms might slightly differ depending on the type of milia. Here are the most common Milia symptoms:
- Appearance: Tiny, round, white or yellow bumps that look like small pearls.
- Size: Usually about 1–2 millimetres in size.
- Texture: Firm to touch and not itchy or red unless they get irritated.
- Common Locations: Mostly on the face, especially around the eyes, nose, and cheeks, but sometimes on the scalp, chest, or arms.
- Painless: They do not hurt or cause discomfort unless they are rubbed or irritated.
- No Inflammation: Unlike pimples, milia are not red or swollen unless they get irritated.
How are Milia Diagnosed?
Milia are usually easy to diagnose based on their clear appearance. A doctor or skin specialist can identify them with a simple physical examination. In some cases, if the diagnosis isn’t clear or the milia are part of a more complex skin issue, some additional steps may be taken. Here are the Steps Involved in Milia Diagnosis:
- Physical Examination: The doctor will look at the skin, especially the face or other common areas where milia form. Their white or yellowish appearance makes them easy to recognise.
- Patient History: The doctor may ask about any recent skin damage, such as burns, rashes, or blisters, to help figure out if the milia are secondary.
- Exclusion of Other Conditions: If the milia don’t look typical or appear in unusual places, the doctor might check for other conditions with similar symptoms, like acne, cysts, or sebaceous hyperplasia.
- Biopsy (Rare): In rare situations, a small sample of the skin may be taken to check out other skin conditions if the milia don’t follow the usual pattern or if there’s concern about an underlying issue.
What is the Treatment for Milia?
Since mila are benign and frequently go away on their own, especially in babies, treatment is typically not required. If milia are bothersome for aesthetic reasons, uncomfortable, or persistent, there are treatments available. These operations should ideally be carried out by a dermatologist to avoid problems. The following are the available options for Milia treatment:
- No Treatment (Self-Resolving): Most of the time, milia will clear up naturally without treatment, especially in milia newborn, where they typically disappear in a few weeks.
- Topical Retinoids: For adults, topical retinoids for milia are often used in the form of creams or gels to help exfoliate the skin and encourage the milia to clear. These are usually prescribed by a dermatologist.
- Manual Extraction: A dermatologist may use a sterile needle or lancet to gently remove the trapped keratin, a process known as milia removal. This should only be done by a professional to avoid infection or scarring.
- Cryotherapy: This method involves freezing the milia using liquid nitrogen, which helps the cysts to fall off. It's particularly useful for stubborn or clustered milia, especially for milia on face treatment.
- Laser Treatment: In some cases, milia removal can be done using lasers, especially when the milia are large or located in sensitive areas like the eyelids.
- Chemical Peels: Chemical peels can help remove the outer layers of skin, preventing future milia from forming, and can be effective for milia on face treatment.
- Avoiding Skin Trauma: If secondary milia are caused by skin damage or irritation, avoiding further trauma to the skin is essential to allow healing and prevent new milia from appearing.
How to Prevent Milia?
The key to preventing milia is maintaining a healthy skincare regimen to prevent skin damage and clogged pores. Adopting specific habits can help lower the likelihood of acquiring milia, even though factors like age or genetics can contribute to their production. The following are a few precautions for Milia:
- Good Skin Care Routine: Wash your face once a day with a mild facial cleanser to remove too much oil and dirt that can be configuring grease glands and cause milia.
- Exfoliate Often: Use exfoliating products that contain salicylic acid or alpha hydroxy acids (AHAs) to help remove dead skin cells and stop potential buildup of affected skin area which can cause milia in future.
- Stay moisture: Use a non-comedogenic moisturiser to keep your skin hydrated. It will avoid dryness leading to milia formation.
- Do not traumatize your skin: This means any type of abrasive products such as scrubbing tools, scrubs or excessive sun exposure because this can lead to secondary milia.
- Avoid Comedogenic Products: Choose cosmetics and skincare items that are non-comedogenic—they won't obstruct your pores.
- Take Care with the Eye Area: The skin around your eyes is so delicate, don't use heavy oils or creams here because they can clog pores on this part of your face and cause milia to pop up there.
- See a Dermatologist: If you are dealing with milia every so often or they continue to appear, have them view your skin to help keep them at bay.
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Book an AppointmentHome Remedies for Milia
A warm compress: Keep a cloth soaked in warm water on the affected area for a few minutes. This will loosen the skin and get them to come out. Perform this 2–3 times daily for best results.
- Honey and Lemon face mask: Honey is an antibacterial agent, Lemon helps in exfoliation of the skin. Prepare a paste of 1 Tbsp honey and a few drops of lemon juice applied on the pimples. Let it sit for 10–15 minutes and rinse with lukewarm water.
- Aloe Vera Gel: Calming and slightly anti-inflammatory properties of aloe vera. At the end of your day, add some fresh aloe vera gel to those areas with milia and let it sit overnight. So washing it off in the morning will help calm the irritation and promote healing.
- Baking soda Exfoliation: Baking Soda acts as a natural exfoliant and helps to sweep away dead cells. Take some baking soda and a bit of water to make it in a paste, and scrub that zone gently only once a week. Do not over scrub as it can lead to skin irritation.
- Tea tree oil: It has antimicrobial properties, and can help keep your wound from getting infected. Mix a few drops of tea tree oil with a carrier oil such as coconut and apply the mixture in milia. Apply to a small skin area before using.
- Moisturising: Dry skin can of course increase the risk of breakouts, using coconut oil on your skin will oftentimes help keep it moist thereby helping you avoid dryness. Massage gently with a little organic virgin coconut oil on the area, before going to bed at night and leave it overnight.
- Apple Cider Vinegar: Apple cider vinegar is a mild exfoliator and improves skin cell turnover. Water it down by 1:1 with H2O and blot on skin using a cotton ball. Allow it to rest for 10–15 mins, after that rinse using lukewarm liquid.
Milia Removal: What to Avoid
While it might be tempting to try and remove milia at home, certain methods should be avoided to prevent skin damage and infection.
Avoid Popping or Squeezing
Never attempt to pop or squeeze milia. Unlike pimples, milia do not have an opening, and squeezing them can lead to skin damage, scarring, and infection.
Avoid Aggressive Exfoliation
Over-exfoliating can cause skin irritation and exacerbate milia. Stick to gentle exfoliation methods and avoid using harsh scrubs.
Frequently Asked Questions
Can salicylic acid remove milia?
Yes, salicylic acid can help exfoliate the skin and may assist in clearing milia over time.
Can I pop milia with a needle?
It’s not recommended to pop milia with a needle as it can lead to infection or scarring. Professional removal by a dermatologist is safer.
Can I use salicylic acid every day?
Yes, but start slowly to avoid skin irritation. It's best to follow the instructions and consult a dermatologist if unsure.
Do milia hurt when touched?
No, milia are usually painless and firm to touch unless they get irritated.
Is milia permanent?
No, milia are not permanent. They usually go away on their own, but persistent milia can be treated by a dermatologist.
How many days does milia last?
Milia may last from a few days to several weeks. In newborns, they often resolve within a few weeks.
Which serum is best for milia?
Serums containing salicylic acid, retinoids, or AHAs are often recommended to help prevent or treat milia.
What is the root cause of milia?
Milia are caused by the buildup of keratin trapped beneath the skin's surface, often due to clogged pores, skin damage, or genetics.
What should I eat to reduce milia?
Eating a diet rich in antioxidants, vitamins A, C, and E, and drinking plenty of water can help maintain healthy skin and prevent milia.