Keratin pearls, also known as milia, are common, small, and generally harmless skin bumps. They often appear as tiny white or yellowish spots on the skin’s surface. While they typically pose no health risk, individuals may seek their removal for cosmetic reasons.
What Are Keratin Pearls?
Keratin pearls are small cysts that form when keratin, a protein naturally found in skin, hair, and nails, becomes trapped beneath the skin’s surface. Instead of shedding normally, these dead skin cells accumulate and harden, creating a visible bump. They are distinct from acne blemishes like whiteheads because they do not involve clogged pores or infection.
These small, firm bumps typically measure less than 1 to 2 millimeters in diameter, though they can occasionally be larger. Keratin pearls often appear in clusters and are commonly found on the face, particularly around the eyes, on the eyelids, nose, and cheeks. They can also develop on other parts of the body, including the trunk and limbs. While newborns frequently experience them, keratin pearls can affect individuals of any age.
At-Home Approaches
Managing keratin pearls at home involves gentle and consistent skincare practices, prioritizing safety to avoid skin damage. Cleanse the affected area daily with a mild soap to prevent irritation. Gentle exfoliation helps by encouraging the skin’s natural shedding process, which can release trapped keratin. Exfoliating cleansers containing ingredients such as salicylic acid, citric acid, or glycolic acid can be beneficial, but it is important to start with infrequent use to assess skin tolerance.
Topical retinoids, derivatives of vitamin A, aid in the removal and prevention of keratin pearls by accelerating skin cell turnover. For those new to retinoids, beginning with a lower-strength form like retinol, applied once daily to clean, dry skin, is often recommended. Using non-comedogenic products is also important to avoid further trapping dead skin cells. It is crucial to avoid aggressive methods such as picking, squeezing, or attempting to remove keratin pearls with sharp objects. Such actions can lead to bleeding, scabbing, infection, and potential scarring.
Clinical Removal Options
When at-home methods are insufficient or professional intervention is preferred, several clinical procedures can remove keratin pearls. Professional extraction involves a dermatologist using a sterile lancet or small needle to create a tiny opening, then gently removing the trapped keratin. This method typically results in minimal scarring.
Cryotherapy involves freezing keratin pearls with liquid nitrogen, causing them to break down and fall off, though this procedure can lead to temporary swelling or blistering. Laser therapy, such as CO2 laser treatment, uses focused light beams to target and destroy keratin pearls, allowing them to be naturally absorbed or manually removed. This precise method is effective for multiple lesions and minimizes the risk of scarring. Additionally, chemical peels, particularly those containing glycolic or salicylic acid, can be applied in a clinical setting to exfoliate the top layers of skin, promoting the release of trapped keratin. These professional treatments are performed under controlled conditions to ensure safety and effectiveness, and they should not be attempted at home.
When to See a Doctor
While keratin pearls often resolve on their own, seek professional medical advice in specific situations. If keratin pearls become inflamed, painful, or show signs of infection like redness or pus, a visit to a dermatologist is warranted. Rapid growth, widespread appearance, or persistence despite consistent at-home care also warrant consulting a healthcare provider.
If uncertain about the diagnosis, seek a professional opinion, as other skin conditions can resemble keratin pearls. Attempting self-diagnosis or aggressive home treatments can lead to complications like scarring, irritation, or infection. A dermatologist can accurately diagnose the condition and recommend the most appropriate treatment plan.
Preventing Future Occurrences
Maintaining a consistent skincare routine helps reduce the likelihood of new keratin pearls forming. Regular cleansing removes excess oil and debris that can contribute to their development. Incorporating gentle exfoliation two to three times a week assists in shedding dead skin cells and prevents their accumulation.
Using non-comedogenic skincare products, especially moisturizers and sunscreens, can help prevent pores from becoming blocked. Adequate sun protection is also important, as sun damage can thicken the skin and impede the natural exfoliation process, potentially leading to keratin pearl formation. Wearing sunscreen with an SPF of 30 or higher daily helps reduce future occurrences. Avoiding overly heavy or occlusive creams, particularly around the eyes, also helps prevent these small cysts.