What Causes You To Have Milia?

Milia are described as small, white bumps that usually appear on a small baby’s nose, cheeks or chin. Milia are usually seen more in newborns, but they are known to occur at any age. Milia are also known as milium cysts.^[1]

The causes of milia are different for different age-groups.

Causes of milia in newborns are-

• The causes of milia are unknown in newborns
• Milia are usually mistaken for baby acne, which get triggered by the hormones from the mother
• However, milia do not cause inflammation and swelling like how baby acne do
• Also, babies are usually born with milia, but baby acne occurs only after two – four weeks of birth^[2]

Causes of milia in older children and grownups are-

In older children and also grown-ups, the causes of milia are associated with some kind of a skin damage-

• There can be a skin condition which can lead to blistering. These may include conditions like cicatricial pemphigoid, epidermolysis bullosa (EB) or porphyria cutanea tarda (PCT)
• There can be other injuries that may cause blistering, like poison ivy
• There can be a skin damage due to a long -term exposure to harmful sun rays
• There could be a skin damage due to a long -term use of steroid skin creams
• There could be damage to the skin due to burns
• There could be damage to the skin due to procedures like laser resurfacing or dermabrasion^[3]

Also, if the skin cannot exfoliate naturally, it can result in milia. This is most commonly seen during the process of aging

Neonatal milia-

• Neonatal milia is a type of primary milia
• It is seen to be occurring in newborns and goes away within a few weeks
• This type is seen to be affecting typically the face, scalp and the upper torso of the baby^[4]

Primary milia in older children and adults-

• In this type, the cysts are seen to be forming around the eyelids, forehead and on the genitals
• These usually go away in a few weeks or may last up to months

Juvenile milia-

• This type is caused as a result of some rare genetic skin disorders. The disorders may include-Gardener’s syndrome- this is a rare genetic disorder and can lead to colon cancer over a period of time^[5]
• Nevoid basal cell carcinoma syndrome – also known as NBCCS, this can lead to basal cell carcinoma^[6]
• Bazex-Dupre-Christol syndrome- this syndrome is seen to be affecting the hair growth and the skin’s ability to sweat^[7]
• Pachyonychia congenita- this condition leads to abnormally shaped or thick nails

Milia en plaque-

• This type is linked with autoimmune or genetic skin disorders
• This may include lichen planus or discoid lupus
• This type may affect the ears, eyelids, cheeks or jaw
• The cysts in this type can be as big as several centimeters in diameter
• It can be seen affecting children or grown-ups of any age and sex
• However, they are primarily seen in women of middle-age^[8]

Multiple eruptive milia-

• In this type, the face, upper arms and the torso get affected by areas that itch
• The cysts tend to develop over a period of time, from a few weeks to a few months^[9]

Traumatic milia-

• These cysts occur at the site of injury to the skin
• The injury can be due to rashes, burns etc.
• The cysts may get irritated and become white in the center and red at the margins

Milia related to drugs or products-

• It is seen due to the effect of steroid creams or similar products, though it is quite rare
• Contents like liquid paraffin, liquid petroleum, paraffin oil etc. may cause milia

There is no known cause of milia in infants and it goes away on its own. In older children and adults, there are several causes of milia and the treatment varies accordingly.^[10]

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