Milia: Causes, Symptoms, and Treatment PDF

Milia  Definition o Milia are small, dome-shaped bumps that typically range in size from 1-2 millimeters, about the size of a pinhead. o Milia or Milialar appear as whitish-yellow, pearly cysts with a firm and smooth texture on the skin surface. o The most common location is...

Milia  Definition o Milia are small, dome-shaped bumps that typically range in size from 1-2 millimeters, about the size of a pinhead. o Milia or Milialar appear as whitish-yellow, pearly cysts with a firm and smooth texture on the skin surface. o The most common location is Milia on eyelid, and the skin under the eye, where they resemble tiny pearls embedded under skin  Pathophysiology o Milialar occurs when Keratin becomes trapped beneath the skins surface o They are often seen in newborns o adults can also develop milia, often as a result of skin damage  Types of Milia o Primary Milia o Secondary Milia  Primary Milia o Formed directly due to the entrapment of Keratin within the skin o common in neonates o Key characteristics :  Small, white- to- yellow cysts  Found on the face, especially on cheeks, nose, and around the eyes  Generally asymptomatic  Resolve spontaneously in infants within weeks-months  Secondary Milia o Arise as a result of skin injury or trauma o Occur in adults o Key characteristics:  Same appearance of primary in the area of injury or trauma  Symptoms according to the underlying cause, e.g. pain from burns  Duration varies, depend on the cause  Treatment options, Laser therapy, manual extraction, medications  Risk Factors o Genetics o Sun exposure o Skin trauma o Certain medical conditions e.g. eczema o Medications i.e. steroids, this side effect is rare in steroids. o Heavy creams & make-up o Some ingredients in skin care and makeup products can cause milia in some people. If you have milia-prone skin, avoid the following ingredients:  liquid paraffin  liquid petroleum  paraffin oil  petrolatum liquid  petroleum oil  Signs & Symptoms o Small, Pearly white bumps on the eyelids or around the eyes o Dome-shape, smooth bumps resembling pearls under the skin o Whitish-yellow or yellowish-white in color o May appear singly or in clusters o Painless without itching & irritation o Remain unchanged for weeks- months and disappear on their own o Sometimes may secrete waxy, cheese-like discharged if ruptured  Prevention strategies o Use oil-free moisturizers and make-up o Avoid heavy, greasy creams and cosmetics near the eyes o Cleanse gently & exfoliate the skin regularly to unclog pores o Shave carefully using proper techniques to avoid skin injury o Daily sun-screen o Keep the skin well-hydrated and avoid skin dryness o Remove make-up before bedtime o Discard old make-up o Treat underlying skin conditions such as eczema o Avoid intensive facial or chemical peels which may worsen the milia condition  Pharmacologic Treatment o In most common cases Milia resolves spontaneously and no need for pharmacologic intervention o If bumps persist or cause distress they need one of the following medications: o Prescription Retinoids creams:  Creams containing Tretinoin, adapalene, or trazodone, can help dry out and slough off the milia o Microdermabrasion:  Using fine crystals to gently exfoliate the outer skin layers & stimulate healing o Electro-cautery:  Burning off the milia with hyfrecator cauterizing device, with using local anesthetics o Chemical peels:  Mild glycoloic acid or salicylates solutions helps soften & remove the lesions o Manual Extraction (Deroofing):  Dermatologist can open the cyst with a sterile needle and squeeze out the contents o Cryotherapy:  Freezing the bumps with liquid nitrogen to eliminate the lesion o Laser ablation:  A small laser focuses on the affected areas to remove the cysts o Surgical removal:  In some cases, the dermatologists may opt for surgical removal by cutting open & draining the milia, sometimes requiring stitches o Diathermy:  Extreme heat destroys the cysts.