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Milia (milk spots): causes and treatments

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 3 minutes read
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Milia is the condition describing tiny pearly-white bumps on the skin under the eyes. These are little cysts (or sacs) containing a hard semi-solid protein called keratin.

There may be one, two, or a few, and they usually cause no symptoms except that people become self-conscious about their appearance. They are entirely harmless, they need no treatment, and most disappear within a few months (although new ones may form in time).

What causes milia?

In adults, these may form in response to recent sunburn or from skin damage such as from a burn or unusual skin conditions. They appear in up to half of newborn babies, appearing around the eyes, nose and across the cheeks and clearing up a short while later.

Doctor’s advice

Is milia contagious?

There is nothing contagious about milia.

It can be tempting to squeeze or scratch milia with the hope of them going, but this will risk damage, infection and scarring. If the appearance is very bothersome or you wish to have them treated, you should book an appointment with a private dermatologist.

How is milia treated?

While milia are harmless, some people may choose to have them treated for cosmetic reasons. Here's a detailed yet easy-to-understand explanation of milia treatment:

Topical retinoids

Dermatologists often recommend topical retinoids, such as tretinoin or adapalene, to promote skin cell turnover. These medications help to exfoliate the skin and may aid in the removal of milia over time.

Topical exfoliants

Products containing alpha-hydroxy acids (AHAs) or beta-hydroxy acids (BHAs), like glycolic acid or salicylic acid, can be beneficial. These exfoliants help to remove dead skin cells, preventing the formation of milia and assisting in their resolution.

Microdermabrasion

Microdermabrasion is a non-invasive procedure that involves the use of tiny crystals to exfoliate the outer layer of the skin. This can help in removing milia.

Laser therapy

Laser treatment, such as laser ablation or fractional laser therapy, can be used to target and remove milia. Lasers work by breaking down the keratin deposits, allowing the cysts to be absorbed by the body.

Cryotherapy

In some cases, dermatologists may use cryotherapy, a method that involves freezing the milia with liquid nitrogen. This can cause the cysts to dry up and eventually fall off.

Topical antibiotics

Not so much treating milia, but in cases where milia become inflamed or infected, topical antibiotics may be prescribed to prevent or treat infection.

Avoiding heavy, oily creams

People prone to milia should avoid using heavy, oil-based creams or products. Instead, opt for non-comedogenic (won't clog pores) skincare products.

It's crucial to note that attempting to squeeze or remove milia at home can lead to scarring, infection, or further irritation.

When should I see my doctor?

There is no need to see the doctor about milia unless you are unsure of the diagnosis or have other skin conditions or symptoms.

If you wish to have milia treated, you can book an appointment with a private dermatologist. As this is a harmless condition, the NHS does not provide any treatment.

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023
EmailFacebookPinterestTwitter