Milia are small, harmless bumps under the skin caused by dead skin cell buildup. They can be treated with topical retinoids, chemical peels, dermabrasion, laser ablation, cryotherapy, or curettage. Milia have different classifications and can be associated with other medical conditions or topical medication use.
A milium is a small bump located under the skin. Most patients have more than a million; they are referred to as milia when there is more than one present. These small pearly white cysts are harmless. They contain a type of skin protein called keratin and are caused by the buildup of dead skin cells.
Patients will often see a milium on the face; however, they can appear anywhere. When the bumps appear on the palate, they are called Epstein pearls. Newborns are especially susceptible to developing bumps, usually on the chin, cheeks, and nose.
This skin condition is not a cause for concern and usually goes untreated. The skin typically clears up on its own; however, concerned parents or patients can explore treatment options if the milium persists after three months. Those who have widespread bumps can use a topical retinoid, which can help lighten the skin. When a milia appears inflamed, your doctor may prescribe a tetracycline antibiotic.
Other skin treatments may include chemical peels, during which a dermatologist will apply a chemical to the skin to remove the top layers of skin cells. Dermabrasion, which uses an abrasive tool to resurface the skin, may also be helpful. An alternative to dermabrasion is laser ablation, which uses a laser to shrink or remove milia.
In some cases, your doctor may use a sterilized needle to thread the lesion and then squeeze it. Another option for removing a milia is cryotherapy, which freezes skin growth. Patients can also discuss curettage with a dermatologist. In this procedure, a tool is used to scrape away the milia and then heat is applied to cauterize the area. A local anesthetic is used so that the patient does not feel pain during the procedure.
There are several classifications of milia, such as primary milia in children and adults, which often resolves within a few weeks. It can appear as a row of bumps along the nose or around the eyelids or genitals. Neonatal milia is common in newborns and usually goes away on its own within several weeks. Juvenile milia, which can be present at birth or later in life, is often associated with another medical condition, such as Gardner syndrome or Bazex-Dupre-Christol syndrome.
Adults can develop a milium that is associated with the use of certain topical medications, such as corticosteroids or hydroquinone. They can also acquire the condition following trauma to the skin. The bumps can develop as the skin heals. Milia and plaque are inflamed, can be associated with other skin conditions, and often affect middle-aged women. The latest classification of this skin condition is eruptive milia multiplex, which occurs as a scattering of bumps that can affect the trunk, face, or upper arms.
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