Milia are small bumps formed of keratin fluid that appear on the skin. They develop mostly on the nose and cheeks. They grow as a single cyst (milium) or in groups (Milia). They are commonly seen in the infants. However, they can appear in any age group. They develop due to deposition of keratin under the skin or loss of ability to exfoliate.[1]
They are usually white in color which does not cause itching or pain.[2] Most of them go on their own and do not require treatment. If they cause discomfort and cosmetic problems, it can be treated efficiently.
Is Milia A Serious Condition?
Milia are tiny white bumps that appear in the face, nose, and cheeks. These cysts comprise of keratin, a protein found in the skin, nails, and hair. These bumps are formed due to trapping of keratin under the surface of the skin. They can appear as a single cyst or in groups. They can develop at any age, but they are more commonly seen in newborns.
They are not a serious condition and can settle in a few weeks to few months after birth. They may take a longer time to resolve in older children and old people. They do not require treatment in most of the cases. When they cause discomfort and cosmetic problem in the skin, they may require treatment.[3]
Milia Symptoms
Milia are small cysts that have white or yellow heads. They do not cause itching or pain in most of the cases. In some cases, discomfort is experienced. They don’t cause any swelling or redness. On rubbing with rough sheets or clothes on Milia can render irritation or redness.
They develop typically on the face, eyelids, nose, cheeks, and lips. However, they can appear on other parts of the body as well even on genital parts. They develop commonly in newborn babies. They are often confused with acne. But they are not baby acne. Epstein pearls are similar to Milia that also represent white yellow cysts that appear on gums and mouth of a newborn baby.
Milia are harmless growth that may disappear in a few weeks or months without treatment.
Milia Causes
The exact cause of the appearance of Milia is not known. They are often confused with baby acne. They are supposed to be caused by hormones of the mother. They are present in infants from birth but baby acne develops after two or four weeks of birth.
In older children and adults, Milia are formed due to damages or injury to the skin.[4] Aging may also cause the skin to lose its ability to exfoliate.[5] The injuries to the skin can be resulted from-
- Burns
- Sunburn
- Injuries leading to the formation of blisters such as poison ivy
- Blistering due to ailments of skin such as porphyria, epidermolysis bullosa, etc.
- Overuse of steroid creams
- Laser resurfacing or dermabrasion[6]
Milia Diagnosis
A milia cyst is diagnosed on the base of its typical appearance and its time of appearance. In very rare cases, skin lesion biopsy is needed.[7]
Milia Treatment
In infants, no treatment is needed as it resolves by itself in a few weeks. In old children and adults, it also clears in a few months. If it causes discomfort, it can be treated by-
- Removal of cysts by a sterilized needle. This is called deroofing.
- Application of liquid nitrogen to freeze the Milia. This is called cryotherapy.
- Application of vitamin A creams
- Chemical removal of the first layer of skin to expose new skin
- Removal of cyst by laser
- Application of heat on the cyst (diathermy)
- Surgical scrapping of the cyst[8]
Conclusion
Milia are an overgrowth on the skin filled with keratin. It is most common in newborns. It is a harmless and non-serious condition that recovers by itself in a span of a few weeks or few months.
- https://www.healthline.com/health/milia
- https://patient.info/skin-conditions/milia-leaflet
- https://www.ncbi.nlm.nih.gov/books/NBK560481/
- https://my.clevelandclinic.org/health/diseases/17868-milia
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047276/
- https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/skin-injury
- https://emedicine.medscape.com/article/1058063-overview
- https://www.mayoclinic.org/diseases-conditions/milia/diagnosis-treatment/drc-20375078
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