Milia are small, white or yellowish bumps that can appear on the skin, typically on the face that can be tricky to remove. These harmless cysts are common among people of all ages and are sometimes mistaken for acne. In this post, we’ll explain exactly what they are, what causes them and how to get rid of milia under the eyes, on the nose and other facial areas.
What Are Milia?
Milia are tiny, dome-shaped cysts filled with a protein called keratin. These tiny bumps are usually white or yellowish in colour. They are often mistaken for pimples or whiteheads. Milia are filled with keratin, a type of protein found in the skin, hair, and nails. They are often found on the face, most commonly on the eyes, nose and cheeks. While they might look like pimples, they are not related to acne or any other skin condition. This means a different approach is needed to remove them.
Although they most commonly found on the face, especially around the eyes and nose, milia can appear on other parts of the body as well. They are usually harmless and don’t cause pain or discomfort. However they are very noticeable and some people may seek treatment to remove them for cosmetic reasons.
Types of Milia
Milia are often classified into two categories which can affect how to prevent and how to remove them:
- Primary Milia: these are often found in infants but can occur in adults. They are commonly located on the face, especially on the eye region, nose, and cheeks.
- Secondary Milia: these are caused by skin trauma or burns and can appear anywhere on the body.
What Causes Milia?
Milia are caused by a build-up of keratin that gets trapped under the skin. The reasons for this can vary and more than one factor may cause them. Here are some common causes:
- Skin Regeneration: very fast skin rejuvenation can produce excess keratin. This builds up if skin turnover doesn’t also increase. This may happen as the skin heals from blistering or injuries. This is usually the cause of secondary milia.
- Clogged Pores: using heavy creams or makeup products that clog the pores can contribute to the formation of milia on the face.
- Sun Damage: long-term sun exposure can thicken the outer layer of skin. This traps keratin underneath the surface to cause build-up.
- Genetic Factors: some people may have a genetic predisposition to developing milia.
- Age: mature skin may be more prone to developing milia because the skin’s natural exfoliation process slows down. This leads to the accumulation of dead skin cells and keratin build up. Newborns and infants often develop milia, particularly on the nose and cheeks, due to their still-developing skin.
- Dermatological Procedures: skin resurfacing procedures, such as dermabrasion or laser treatments may cause trauma to the skin which can cause milia as the skin heals.
- Health Conditions: certain skin conditions, like blistering disorders, can increase the risk of milia.
- Using Steroid Creams: prolonged use of steroid creams can lead to milia on the areas where you usually apply the cream.
How to Prevent Milia
Whilst the exact cause may vary from person to person, understanding the potential triggers can help in managing and preventing milia, especially if you are prone to developing them. Prevention involves maintaining a proper skincare routine and being aware of potential triggers. Here are some general guidelines that can help to prevent milia:
- Gentle Exfoliation: exfoliate your skin regularly to help remove the dead skin cells that contribute to the formation of milia. Use a gentle chemical exfoliator suitable for your skin type to avoid causing irritation, post-inflammatory hyperpigmentation or damage.
- Properly Cleanse Your Skin: double cleanse your skin to prevent makeup, moisturisers and sunscreens from clogging your pores.
- Avoid Heavy Creams: If you’re prone to milia on the face, consider avoiding heavy, rich creams that might clog your pores, especially around the eye area.
- Protect Against Sun Damage: wear sunscreen daily and protect your skin from UV rays to prevent skin thickening which can lead to milia.
- Avoid Overusing Steroid Creams: if you are using steroid creams, follow the guidelines provided by your healthcare provider and be aware of the potential risk of milia formation.
- Professional Skincare Treatments: Regular professional facials, including chemical peels, may help prevent milia by increasing skin turnover. Prescription retinoids like Tretinoin can also achieve this.
- Follow Post-Procedure Care Instructions: if you have professional skin treatments, follow the post-care instructions provided by your provider and let them know beforehand if you are prone to milia. This will help minimise the risk of secondary milia.
- Consult a Dermatologist: If you think that you are prone to milia or have concerns about your skin, seek professional medical advice. A dermatologist can evaluate your skin and recommend more specific preventive measures tailored to your needs.
How to Remove Milia
You should seek professional help for removing milia. Although they may appear like typical whiteheads, milia are cysts that are located deep under the skin’s surface and lack an opening or pore. This means that if you try to extract them at home you will probably end up with scarring or infection.
Professional Skin Treatments
You should always see a a dermatologist or similar skin specialist to remove milia. They will firstly ensure that the white bumps are indeed milia and choose the best treatment for your skin type and location of the lesions. In general, these are the most common skin treatments for getting rid of milia:
This is the most common method for removing milia. A skincare professional, such as a dermatologist, can safely extract them using specialised tools. This might involve the use of a sterile needle or lancet to carefully make a tiny incision over the lesion. They will then carefully extract the cyst. It’s essential to perform this process under sterile conditions. This will minimise the risk of infection and scarring.
Topical retinoids can help exfoliate the skin and aid in the natural elimination of milia. Prescription-strength retinoid creams, like tretinoin and adapalene boost skin cell turnover and promote the release of trapped keratin. This both treats and prevents formation of milia.
These work by exfoliating the top layer of the skin and encouraging new skin growth. This can help to dislodge milia over time, especially when combined with other treatments like topical retinoids.
This involves freezing the milia with liquid nitrogen. Cryotherapy is a quick procedure that should only be performed by an experienced and qualified healthcare provider. This will ensure that they don’t damage the surrounding skin.
Certain laser treatments can be used to reduce milia, particularly for those that are widespread or persistent. This procedure should only be performed by a qualified medical professional experienced in laser treatments. This will avoid damaging the skin and also prevent secondary milia formation.
This treatment uses a machine to exfoliate the skin deeply and may help in reducing milia. Like lasers, its important to have it done by a qualified skincare provider to avoid risks including developing secondary milia.
At Home Treatments
At home, you can prevent and get rid of milia by following a good skincare routine and avoiding triggers that can cause it mentioned earlier. Regularly exfoliate your skin with an acid product that suits your skin type such as an AHA, BHA or PHA. Over-the-counter skincare products containing retinol are also great as they help promote skin turnover. Avoid picking or squeezing the milia at all costs as this can cause infection, scarring and hyperpigmentation.
How to Get Rid of Milia Under Eyes
Milia under the eyes or in other delicate areas such as the nose and lips can be particularly challenging to deal with. These areas are more sensitive, and improper handling can lead to scarring or other issues. In particular, the delicate skin under the eyes requires special care. It’s best to consult with a dermatologist or skincare specialist for milia on these areas to avoid damaging the skin. They can safely extract milia using specialised tools and techniques suited for these sensitive areas. They may also offer you prescription retinoids and skincare as an alternative or for maintenance to prevent further episodes.
If you want to treat milia in these areas at home, follow the directions in the earlier sections but with greater care. Opt for the most gentle exfoliating acids and lowest strength retinols to avoid irritating your skin. Always perform a patch test and build up strength and frequency very slowly. Avoid heavy, oily eye creams and vaseline in the undereye area or on the nose as these can contribute to milia formation. Protect your skin from the sun and remember that patience and consistency is key to getting good long-term results. Also, never attempt to extract milia yourself and especially in these delicate regions.
Whilst milia on the face are harmless, they can cause significant cosmetic concern. It is important to understand what causes milia in order to prevent and get rid of it. There are a number of at home skincare protocols you can follow that can help improve the appearance of these lesions over time and even get rid of them. If you are looking for faster results or battling with milia in delicate areas like the under eyes, then you should see an experienced skin doctor. They can offer you safe and effective skin treatments to get rid of milia. Please do not be tempted to take matters into your own hands! Never squeeze or try to extract milia yourself as this can cause permanent scarring and hyperpigmentation.
We passionately believe that skincare is personal and that this is the only way to get great results. We are a doctor-led online prescription skincare clinic offerring treatments like Tretinoin and Hydroquinone to treat conditions such as acne, scarring, hyperpigmentation, melasma and skin ageing. Book a virtual consultation today and take your first step towards better skin.