Dermatologists Explain How to Get Rid of Milia for Smooth, Bump-Free Skin


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Have you ever tried to pop a pimple, but no matter what you do, nothing comes out? If the so-called “pimples” you poke look like tiny, white bumps free from pus or inflammation, then you might not be dealing with pimples at all. It’s likely something called milia. These spots may look similar to blemishes—but in reality, they’re totally different. Learning how to get rid of milia will get you closer to bump-free skin.

Meet the experts: Karan Lal, D.O., M.S., F.A.A.D., double board-certified adult, pediatric, and fellowship-trained cosmetic dermatologist with Affiliated Dermatology in Scottsdale, AZ; and Marisa Garshick, M.D., a leading board-certified dermatologist at Manhattan Dermatology and Cosmetic Surgery in NYC

Ahead, experts explain what it is, types of milia, how to prevent it, and treatment options to get you closer to a clearer complexion.

What is milia?

Milia is a type of skin spot that can often be confused with blackheads or whiteheads, but is something different altogether—and requires its own treatment plan. “Millium [plural of milia] are these little white cysts underneath the skin, which are basically full of keratin and trapped skin cells,” explains Karan Lal, D.O., M.S., F.A.A.D., double board-certified adult, pediatric, and fellowship-trained cosmetic dermatologist with Affiliated Dermatology in Scottsdale, AZ. “Anybody can get them and they’re super common.”

While you’ll usually find milia around the eyelids, cheeks, nose, and chin, they can form anywhere on the face, says Marisa Garshick, M.D., a leading board-certified dermatologist at Manhattan Dermatology and Cosmetic Surgery in NYC. Other places you might find milia include the genital area or in areas of tattoos. “They may also occur after cosmetic procedures such as chemical peels and lasers, waxing, trauma, or in association with blistering disorders,” continues Dr. Garshick.

While milia can be an annoying roadblock on the path to smooth skin, it’s worth noting that these little bumps are benign and generally harmless, painless, and otherwise asymptomatic.

How to get rid of milia

Luckily, there’s a variety of ways your dermatologist can help you get rid of milia in addition to a few things you can do at home to treat and prevent it in the first place. Below, find the best ways to remove those pesky bumps, according to the pros.

Manual extractions

One of the best ways to safely and effectively remove milia is to visit your dermatologist who will typically remove milia via extraction, “Which typically involves making a small puncture of the capsule and applying pressure to express out the contents,” Dr. Garshick explains.

If you live in a state where estheticians are legally allowed to perform manual extraction, Dr. Lal says a visit to a certified esthetician who can also perform facials and other services may be an option.

Electrocautery

In some cases, heat using electrocautery may be used to remove milia by a dermatologist. “Electrocautery refers to a procedure that uses heat generated from an electric current,” Dr. Garshick explains. “When applied to the milia it causes it to form a scab which helps to destroy and eliminate the milia.”

Cryotherapy

Cryotherapy benefits are vast, and they include getting rid of milia, too. Cryotherapy, using liquid nitrogen, can be used by a dermatologist to destroy the milia, “which may cause it to form a blister or a scab and then subside,” Dr. Garshick explains. “There is a risk of hypopigmentation, especially in those with darker skin tones, so it should be used with caution.”

Topical retinoids

“Using a retinoid or retinol can help remove some milia over time,” explains Dr. Lal, who recommends consistent use of a prescription-strength retinoid for those who are prone to milia to promote skin cell turnover.

Exfoliation

Using exfoliating brushes to cleanse the face or using chemical exfoliants such as glycolic acid-containing products is another way to slowly diminish and prevent milia, according to Dr. Lal. However, Dr. Garshick notes that these types of topical treatments, including retinols and retinoids, are best suited for small milia, as larger milia can often only be removed via manual extraction.

Can you pop milia?

Understandably, you might be tempted to take matters into your own hands. However, experts agree that squeezing the bumps may do more harm than good. “Typically it is not easy to remove milia at home [via extraction] and in general is not recommended as it can lead to inflammation and scarring if not done properly—which can ultimately result in a spot or mark that is more noticeable than the milia itself,” Dr. Garshick warns.

Can I remove milia at home?

While you shouldn’t try popping or squeezing your milia to remove the bumps at home, using topical exfoliating products or prescription retinoids at home may help, Dr. Garshick explains. But if you’re looking to get rid of milia quickly, “the most definitive way to remove them is to extract them, which is generally best to be done in a medical office with sterile instruments,” says Dr. Garshick.

Will milia go away on its own?

Dr. Lal explains that while it is possible for some milia to gradually go away or reduce in size on its own (especially if using topical products like alpha hydroxy acids—AHAs—or retinoids), in most cases the bumps will stay until manually extracted by a professional.

What causes milia?

Milia are often caused by dead skin cells and keratin in the skin getting trapped in the pores, forming tiny white bumps in those areas of congestion. Additionally, Dr. Garshick notes that milia often forms around the eyes—so if you’ve recently tried out a new eye cream, anecdotal evidence shows that it may be the culprit.

What are the different types of milia?

According to the Cleveland Clinic, there are a few different types of milia, including:

  • Neonatal milia: This type of milia, often present at birth, affects infants and young babies. The milia often appears on or around the nose.

  • Primary milia: This common form of milia affects children and adults and can be found on the face or body, most commonly around the eyes, on the cheeks, and on the genital area.

  • Secondary milia: Also known as traumatic milia, it forms after damage to the skin (like burns, rashes, or blisters) or as a reaction to a heavy topical product applied to the skin. Dr. Lal notes that sometimes chronic eye rubbing can cause trauma to the skin, leading to this type of bump, as well.

  • Milia en plaque: Often affecting women aged 40 to 60, this rare condition creates a cluster of milia on a raised patch of skin.

  • Multiple eruptive milia: Another rare type of milia, multiple eruptive milia causes clusters of milia to form on the face and/or body. These milia may also be itchy.

How to prevent milia

Milia prevention actually looks very similar to home treatment. “Because milia may result from dead skin getting trapped, to prevent milia it can be helpful to incorporate retinols as well as to occasionally exfoliate to prevent the buildup of dead skin,” Dr. Garshick explains. “Importantly, while people will try to treat milia with these same ingredients, these tend to work best at prevention, rather than treatment.”

When to see your doctor

Milia are often benign, pain-free, asymptomatic cysts, according to Dr. Lal, so if you notice any sort of irritation or bothersome symptoms, visit your dermatologist. They will help ensure an accurate diagnosis and proper treatment plan. However, if the milia on your face poses an aesthetic issue, feel free to see your dermatologist for one of the professional removal methods mentioned above. And, of course, be sure to check with your dermatologist to ensure that the bump(s) is, in fact, milia and not a more serious issue.

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