Milia is a common skin condition that manifests as tiny, often stubborn bumps on various parts of the face and occasionally on the body. Despite diligent efforts to maintain clear skin, these bumps persist, frustrating many individuals. If you are tired of dealing with milia and seeking practical solutions, this article provides insights into the causes, potential remedies, and valuable tips to prevent recurrence.
What is Milia?
Milia, scientifically termed as ‘milium cysts,’ is a cluster of small (1-2 mm. in size) (1) blister-like, dome-shaped lumps formed on the skin that are white or yellow. Though they do not cause pain or itchiness, you may experience redness, irritation, and discomfort due to friction with clothing or rough sheets. The protrusions are most commonly found in newborns and go away automatically within a few weeks (2). It has been found that they affect the skin of almost 40-50% of infants within a month of birth (3). But people in all age groups may develop it regardless of sex, age, or race. Milia typically appears on different parts of the face (eyelids, around the eyes, nose, cheeks, lips, chin, etc.) (4). However, they may also pop up on many other body parts, including the torso and genitalia.
Milia resembles a lot with acne and is referred to as ‘baby acne’ due to its appearance on newborn’s mouth and gum. But the bumps are neither triggered by mothers’ hormones nor cause inflammation or swelling. Hence, they should not be considered as baby acne. Moreover, unlike acne, milia does not pop up from the skin pores. So, it cannot be squeezed easily like acne.
Causes of Milia
If there is a lack of exfoliation, the dead cells (skin flakes) get trapped underneath the surface layer of our skin. As a result, they form buildups, get keratinized, and eventually turn hard to clog the pores as milia (5). Newborns are often born with milia, and the cause is still unknown. Conversely, it is mainly associated with skin damage in older children and adults. Some common possible reasons behind this include:
- Trauma to sweat ducts
- Blistering due to skin conditions like epidermolysis bullosa (EB), cicatricial pemphigoid, or porphyria cutanea tarda (PCT)
- Blistering injuries caused by allergic reactions (from poison ivy, etc.)
- Damage caused by long-term exposure to the sun
- Long-term use of topical steroid creams
- Skin-resurfacing procedures like microdermabrasion and laser resurfacing
- Aging skin that loses its natural exfoliation capacity
- Genodermatosis (an inherited genetic skin condition)
- Regular use of radiotherapy (radiation)
Different Types of Milia
Milia can be categorized as “primary milia” or “secondary milia,” with distinctions based on the individual’s age and the underlying cause of their development. Primary milia refer to the bumps arising from trapped keratin on the faces of both infants and adults, ranging from a few weeks to several months. Secondary milia, conversely, results from the obstruction of ducts leading to the skin’s surface, commonly occurring after traumas such as blistering, burns, or injuries. The following provides additional details on the classification of milia:
1. Neonatal Milia
This type of primary milia develops on the face, scalp, upper torso, and inside the mouth of newborns. It clears up automatically within a few weeks.
2. Juvenile Milia
This type of milia may develop when the skin gets affected by certain rare genetic disorders. These primarily include Nevoid basal cell carcinoma syndrome (NBCCS), Pachyonychia congenital (PC), Gardner’s syndrome, Bazex-Dupré-Christol syndrome, etc.
3. Milia En Plaque
In this type of milia, the cysts clump together to form broad (several cm. in diameter), flat, and raised patches or plaques with clear and defined borders. The condition is occasionally linked to other genetic or autoimmune skin disorders like pseudoxanthoma elasticum (PXE), discoid lupus erythematosus (DLE), or lichen planus. Though middle-aged women experience it the most, children and young adults may also have the milia en plaque on the eyelids, ears, cheeks, and jaw.
4. Multiple Eruptive Milia
It is a rare type of milia that causes itchiness and numerous tiny bumps on the skin of the face, upper arms, and upper torso. They usually take from a few weeks to a few months to appear.
5. Traumatic Milia
This type of secondary milia develops due to injuries to the skin caused by rashes, allergies, blistering, severe burns, prolonged exposure to sunlight, skin resurfacing procedures, etc. It often comes with redness and irritation along the edges of the bumps.
6. Milia from Medications and Makeup
Certain topical medications, such as steroid creams, etc., may lead to milia. Mineral oils (petroleum, paraffin oil, paraffinum liquid, petrolatum liquid, petroleum oil, lanolin) in skincare and makeup products also increase the formation of these bumps.
10 Simple Home Remedies for Milia
As milia carries very few risks, it should not be your cause of concern. Most of the time, it does not even need any treatment to resolve. If you are still searching for remedies for Milia to try at home, here are the options for you:
Steaming opens up the skin pores to remove the buildups or irritants from them (6). Cover your head with a towel and bend over a large bowl filled with hot water. Wait for 5 to 10 minutes so that the steam can work to release all the debris trapped underneath the skin. Finish the process using a gentle facial scrub and practice daily for the best results.
2. Vitamin A
According to some researchers, topical retinoid creams containing retinol or vitamin A effectively eliminate milia to a reasonable extent (7). The vitamin is indispensable for the natural turnover of cells, which promotes skin rejuvenation and maintains health (8). Regular consumption of 700-900 mcg of Vitamin A through carrots, avocados, almonds, etc., or proper supplements will also help.
3. Lemon Juice
Lemon has strong anti-inflammatory properties, which help clear up milia by drying them fast (9). Being a natural astringent, it also helps reduce the size of skin pores (10). So, take one-half of a lemon and rub the affected parts of your skin gently with it. Leave it on for 30-40 minutes, then rinse it with tepid water. Otherwise, add a pinch of salt to some freshly squeezed lemon juice and apply it to your milia.
4. Manuka Honey
The natural antibacterial, antimicrobial (11), and anti-inflammatory properties of manuka honey are well-known. Hence, it is suitable for soothing milia with irritation while preventing further microbial infections (12). You can spread half a tablespoon of manuka honey all over your skin in an even layer and let it sit for 30 minutes before rinsing. A mixture of manuka honey and a little cinnamon extract will also work the same way. But make sure that you use it daily for great results.
5. Granulated Sugar with Lemon Juice and Coconut Oil
Regular skin exfoliation is essential to stop the buildup of keratin beneath its surface. It also helps in eliminating the stubborn lumps of milia over time. So, prepare a natural sugar scrub by mixing the freshly squeezed juice of a lemon and a teaspoon of coconut oil with two tablespoons of granulated sugar. When the sugar becomes partially dissolved, scrub the affected part of your skin with it gently for 3-5 minutes. Then, wait for 20 minutes and wash off with lukewarm water. This needs to be done at least 3-4 times a week.
6. Apple Cider Vinegar (ACV)
Like lemon juice, apple cider vinegar is a natural astringent agent. The milia bumps get removed as it shrinks the skin pores and forces the debris out of them (13). All you need to do is dilute a tablespoon of ACV with a tablespoon of water, apply the mixture to the milia-prone areas of your skin with a clean cotton ball, and wait for half an hour before rinsing it off.
7. Cold-Pressed Castor Oil
The emollient and anti-inflammatory properties of castor oil are excellent for our skin. They may also help in combating milia naturally and successfully (14). It would be best to start by cleansing your skin thoroughly with a mild cleanser and patting it dry. Massage the area of your skin affected by milia with half a teaspoon of cold-pressed castor oil and let it sit for at least half an hour before washing off. It should be repeated daily for the best outcomes.
8. Virgin Coconut Oil
Virgin coconut oil is a brilliant moisturizer and a great anti-inflammatory agent. As it keeps the skin well-moisturized and controls inflammation (15), it can also be used as a remedy for milia lesions (16). Just take one tablespoon of cold-pressed virgin coconut oil and massage your skin’s troubled areas. Wait for half an hour, then rinse it with a gentle cleanser. Also, repeat the process twice daily.
9. Rose Water
The best thing about rose water is that it contains rose oil instead of mineral oils, contributing to its anti-inflammatory properties (17). For the same reason, it is considered an effective remedy for milia. You can spritz some rose water over the affected regions of your skin (excluding the entire eye area) at least twice or thrice a day to see visible improvements.
10. Sandalwood And Rose Water
Make a smooth paste of thick consistency by mixing enough rose water with a tablespoon of sandalwood powder. Spread it all over your affected skin and rinse with cold water after half an hour. Daily use of this remedy will remove the keratinized debris from the skin pores, significantly reducing the appearance of milia (18).
Effective Medical Treatments for Milia
Mila, being harmless, should not be a matter of concern. It does not leave scars on its own. However, it can make you self-conscious about your appearance and badly affect your self-confidence. So, if you need clinical treatments for the issue, check out the following possible options (19):
- Chemical Peels: Different chemical solutions are used to peel the first layer of skin off, thus reducing the appearance of milia and revealing the fresh layer of cells underneath.
- Minocycline: This oral antibiotic is mainly used to treat milia en plaque.
- Cryotherapy: The bumps are frozen off with liquid nitrogen, which usually causes temporary swelling or blistering.
- Deroofing: The contents of the bumps are picked out with the help of a sterile needle or blade. A doctor should always perform it to avoid infections.
- Diathermy: In this procedure, extremely high heat eradicates Mila’s bumps.
- Destruction Curettage: The affected part of the skin is numbed, the bumps are scraped and cauterized surgically, and the skin is sealed with a hot wire.
- Laser Ablation: The bumps are removed by focusing a tiny laser beam on the skin’s troubled regions.
How to Prevent Milia?
It is much easier to prevent the appearance of milia than to remove or treat it. Given below are the most effective ways to avoid milia:
- Exfoliate the skin gently regularly (twice or thrice every week)
- Avoid too much sun exposure and reduce the excessive usage of sunscreen
- Reduce the intake of too salty, sugary, spicy, or high-cholesterol foods
- Keep yourself clean by following hygiene practices and taking baths frequently
- Use a mild and deep cleanser to cleanse your facial skin every day
- Do not use too many skincare and makeup products on the face
- Steer clear of oil-based products or anything with a thick consistency
- Feed your skin with a moderate amount of sunlight regularly
- Stay away from consuming vitamin D supplements
- Never try to extract milia by pricking or poking them
Milia or milium cysts is a cluster of small white or yellow lumps formed on the skin that do not cause pain or itchiness. Almost 40-50% of newborns are born with milia that go away on its own within a few weeks. In adults, it appears on the eyelids, around the eyes, nose, cheeks, lips, chin, torso, and genitalia. Milia is formed when skin flakes get trapped under the skin’s surface, get keratinized, and clog the pores eventually. Trauma to sweat ducts, blistering, burns, injuries, sun damage, aging, radiotherapy, genodermatosis, prolonged use of steroid creams, skin-resurfacing procedures, etc. may increase its development. Some common types of milia include neonatal milia, juvenile milia, milia en plaque, multiple eruptive milia, traumatic milia, milia from drugs and products, etc. It carries very few risks and can be resolved with simple home remedies like steaming, vitamin A-rich foods, lemon juice, manuka honey mask, granulated sugar scrub, diluted apple cider vinegar, cold-pressed castor oil, virgin coconut oil, rose water, sandalwood and rosewater paste, and so on. If it is a concern to you, your doctor may suggest treatments, such as chemical peels, minocycline, cryotherapy, deroofing, diathermy, destruction curettage, and laser ablation. However, it is much easier to prevent the appearance of milia than removing or treating it.
Frequently Asked Questions (FAQs)
Which Skincare Products are Good for Milia?
Oil-free, non-comedogenic skincare, and makeup products are always suitable for Milia.
Can Salicylic Acid Remove Milia?
As salicylic acid increases the skin’s natural turnover by sloughing off dead cells from its surface layer, it can help remove milia faster.
Can Vaseline Cause Milia?
Being petroleum jelly, Vaseline is known to clog skin pores and stimulate the development of milia.
Is Milia Permanent?
In newborns, Milia goes away automatically within just a few weeks. It also clears after months or more in adults. However, secondary milia may take years to clear up.
What Happens If You Pop Milia?
Milia can not be removed by popping or squeezing as it has no opening on the skin’s surface. So, your attempt to pop it may result in redness, inflamed marks, or even scars.
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