Milia, or small cysts, are commonly found on the face around the eyes, on the eyelids and on the cheeks. According to an article on the Patient UK website by Dr. Olivia Scott, these tiny white or yellow epidermoid cysts arise under the skin from pilo-sebaceous follicles or immature sebaceous glands. Infant milia are most common in infants, but occasional facial milia are very common in people of all ages as well.
Causes
According to an article on the DermaDoctor website article by Dr. Audrey Kunin, there are several factors that cause milia to occur on the face. Milia can be caused by heavy skin care products and by prolonged exposure to the sun. Milia may also be caused by a facial burn or a blistering disease called porphyria cutanea tarda, or by a genetic condition that causes facial skin to become somewhat thickened. Milia also can occur after topical steroid treatments, according to Scott. Milia is not related to lifestyle, poor hygiene, infection or diet.
Home Treatment
Though milia are a significant cosmetic concern for some people, they generally do not require medical treatment unless they become blistered, painful or infected under the skin. However, pinching or trying to pop these sebaceous cysts without medical supervision is contraindicated, as it can cause serious skin infections that may be painful and damaging to skin and lead to permanent scarring.
Potential
Left unattended, milia is considered a benign condition that most often takes care of itself naturally as the epidermal layer of the skin exfoliates itself. Medical treatment is generally not necessary unless the condition is of personal concern to the individual aesthetically, or an infection occurs, at which time medical intervention may be appropriate. However, cleaning the face well with a wet washcloth often helps loosen hardened skin and can smooth skin and loosen and remove dead skin cells. The next step is using a gentle exfoliant, similar to one used to treat mild acne, to attempt to loosen and remove dead skin. In the event these steps do not work, medical intervention may be necessary.
Medical Removal
In the event that one finds the milia on the face of concern, or an infection develops under the skin, surgical lancing of sebaceous cysts may be indicated. In that case, the procedure is done by a licensed physician with an aseptic technique to prevent causing any infection or the spread of infection if one is present.
Prevention/Solution
According to Kunin, gentle facial washing and exfoliation is important in keeping the skin on the face from thickening on the epidermal layer, thereby promoting development of milia. Micro-abrasion is also helpful in prevention of milia, though it may be uncomfortable or even painful. Vitamin A creams are also used in the prevention of milia, though care must be taken not to use on the eyelids, as they may damage eyes.
