What is it and what does it look like
Milium is a tiny cyst in the top layer of skin, the walls of which are lined with the same cells as the surface. Horny scales are tightly packed inside, so the nodule feels hard and not soft, like a wen. The size is usually from 1 to 3 millimeters, the color is white or yellowish, the shape is hemispherical. The skin over the nodule is not inflamed, there is no hole in the center. Milia are most often located in groups around the eyes, on the cheekbones, on the nose and forehead, and in infants - on the nose and cheeks.
- Dense white nodules 1–3 mm
- No black dot and hole
- The surrounding skin is not inflamed
- Favorite places - eyelids, cheekbones, nose
- Often found in groups
Why do they appear?
Primary milia occur for no apparent reason: it is believed that the horny masses are retained at the mouth of the hair follicle or sweat gland. This happens in newborns when the sebaceous glands are just starting to work. Secondary milia appear after skin damage: burns, including sunburn, blistering dermatoses, laser and chemical procedures, long-term use of thick occlusive creams and some external medications. Sometimes a hereditary tendency plays a role, so millet grass is often found in several family members.
- Primary - without obvious reason
- Milia of newborns
- After burns and sun damage
- After blistering skin diseases
- Against the background of dense fatty creams
- After aggressive cosmetic procedures
How are they different from acne and pimples?
A closed comedon also looks like a white dot, but it is connected to the sebaceous gland, has a duct and, when inflamed, turns into an abscess. The milium is dense, does not become inflamed and has no outlet. A lipoma, which in everyday life is called a wen, lies deeper, is soft to the touch and is usually larger. Xanthelasmas on the eyelids are yellow, flat and much larger in size. Examination with a dermatoscope helps to distinguish these formations, and if in doubt, the doctor may suggest removal with tissue examination.
- Comedon - sebaceous gland and open duct
- Milium is a dense closed cyst
- Lipoma - soft subcutaneous formation
- Xanthelasma - yellow flat plaque
- Syringoma - multiple flesh-colored nodules
How to remove
In newborns, you don’t need to do anything: the elements disappear on their own within a few weeks; normal skin care is sufficient. In adults, milia rarely go away on their own. The standard procedure is simple: the skin is treated with an antiseptic, a micropuncture is made with a sterile needle and the contents are carefully removed. Small elements are removed by electrocoagulation or laser. The procedure takes a few minutes, is practically painless and leaves no noticeable marks. To prevent new elements, your doctor may prescribe topical retinoids or mild exfoliants.
- In infants - observation only
- Opening and extracting contents
- Electrocoagulation of small elements
- Laser removal
- Topical retinoids for prevention as prescribed by a doctor
- Antiseptic treatment after the procedure
Care and prevention
You cannot squeeze out milia on your own: the contents will not come out without a puncture, but it is easy to cause an infection and leave a scar or stain, especially on the thin skin of the eyelids. Revision of care helps reduce the likelihood of new elements: lighter textures instead of dense fatty creams, regular gentle cleansing, products with acids or retinoids as prescribed by a doctor. Sun protection is also important: ultraviolet radiation thickens the stratum corneum and helps retain scales. If there are multiple or persistently recurring elements, you should see a dermatologist.
- Do not squeeze or pick
- Light non-comedogenic textures instead of thick creams
- Gentle cleansing without aggressive scrubs
- Products with acids and retinoids according to their intended purpose
- Sun protection throughout the year
- Examination by a dermatologist for multiple elements