Milia are small, white or yellowish bumps that commonly appear on the skin. While generally harmless, many individuals seek professional removal for cosmetic reasons. Dermatologists offer safe and effective methods for their removal.
Understanding Milia
Milia are tiny cysts formed when keratin, a protein found in skin, hair, and nails, becomes trapped beneath the skin’s surface. This process occurs when dead skin cells do not shed naturally, and new skin grows over them, encasing the hardened keratin. Milia typically appear as 1-2 mm, dome-shaped cysts that are not painful or itchy. They are frequently observed on the face, particularly around the eyes, nose, and cheeks.
Milia can be categorized into two main types: primary and secondary. Primary milia develop spontaneously and are often found on the face of infants or adults. Secondary milia, conversely, arise following some form of skin damage, such as burns, rashes, blistering, or even prolonged sun exposure. These can also form as a reaction to certain heavy skin creams or ointments.
When Professional Removal is Needed
Attempting to remove milia at home carries significant risks and is not recommended. Self-removal efforts, such as squeezing or picking, can lead to skin damage, infection, inflammation, or permanent scarring. Milia are not like typical pimples; they cannot be “popped” because they are encased beneath a thin layer of skin, not within a pore. Without sterile tools and proper technique, the keratin plug may not be fully extracted, leading to incomplete removal.
A dermatologist can accurately diagnose milia, distinguishing them from other skin conditions. They determine the most appropriate and safest removal method based on the milia’s type, size, and location. Professional intervention minimizes complications and ensures complete, hygienic extraction.
Dermatological Removal Techniques
Dermatologists employ several precise techniques to remove milia, chosen based on the milia’s characteristics and location. One common method is de-roofing, or manual extraction. This procedure uses a sterile needle or small blade to create a tiny opening over the milium. Gentle pressure is then applied with a specialized tool, like a comedone extractor, to express the trapped keratin plug. Patients typically feel only a mild prick or slight pressure during this procedure.
Cryotherapy utilizes liquid nitrogen to freeze and destroy milia. A professional applies the liquid nitrogen, causing targeted cells to freeze and fall off. While less common for milia than for other skin lesions, this is a quick procedure that may cause a mild tingling sensation. Temporary swelling or blistering can occur, usually resolving within a few days.
Electrocautery uses a heated electric current to destroy milia. A fine-tipped probe delivers a controlled electrical current to the milium, vaporizing the cyst wall. This precise technique targets only the milium, minimizing damage to surrounding skin. Patients typically experience minimal discomfort as numbing cream is often applied beforehand.
Laser ablation is an advanced option, useful for multiple or stubborn milia. Specialized lasers, such as CO2 lasers, emit focused light beams that target water within milia cells. This vaporizes the milium, allowing remnants to be manually removed or naturally reabsorbed. Laser treatment offers precision, minimizes scarring, and is often completed in a single session with little to no downtime.
Post-Procedure Care and Expectations
After milia removal, patients can expect temporary side effects at treated sites. Mild redness, slight swelling, or small scabs are common. These effects typically subside within a few hours to a few days. For extractions, a small scab may form, usually healing within one to two weeks.
Proper aftercare facilitates healing and prevents complications. Keep the treated area clean with a mild, fragrance-free cleanser. Avoid applying harsh products, heavy creams, or oil-based cosmetics, as these can impede recovery or lead to pore clogging. Sun protection with consistent sunscreen use is important to prevent hyperpigmentation. Refrain from picking or scratching scabs to prevent scarring and infection.
If unusual symptoms like increased pain, excessive swelling, pus, or prolonged redness occur, contact your dermatologist. When performed by a skilled professional, scarring after milia removal is rare.