Milium Cyst

Written by Tricia Kinman | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What Are Milium Cysts?

Milium cysts are small, white bumps (or milia when they occur in groups) that typically appear on the nose and cheeks. The cysts occur when keratin become trapped beneath surface of the skin. Keratin is a strong protein that is typically found in skin, hair, and nail cells.

Milia can occur in people of all ages, but are most common in newborns and are typically found on the face, eyelids, and cheeks. Milium cysts are often confused with a condition called Epstein’s Pearls, where harmless white-yellow cysts appear on a newborn’s gums and mouth. Milia are often inaccurately referred to as “baby acne.”

What Causes Milia?

The cause of milium cysts in newborns is unknown. In older children and adults, the cause is typically associated with some type of damage to the skin, such as:

  • skin conditions that cause blistering, such as bullous pemphigoid, epidermolysis bullosa, and porphyria cutanea
  • burns
  • blistering injuries, such as poison ivy
  • skin resurfacing procedures, such as dermabrasion or laser resurfacing
  • long-term use of steroid creams
  • long-term sun damage

Identifying Milium Cysts

Milium cysts are small, dome-shaped bumps that are white or yellow. They are usually not itchy or painful. However, they may cause discomfort for some people. Rough sheets or clothing may cause milia to become irritated and red.

What Are the Types of Milia?

There are various types of milium cysts. These cysts are classified based on the age at which they occur or the injury that causes the cysts to develop.

Neonatal Milia

This condition develops in newborns and heals within a few weeks. Cysts are typically seen on the face, scalp, and upper torso.

Primary Milia in Children And Adults

This condition is caused by keratin trapped beneath the skin. Cysts can be found around the eyelids, forehead, and on the genitalia. Primary milia may disappear in a few weeks or last for several months.

Juvenile Milia

This condition is caused by genetic disorders, including basal cell nevus syndrome, pachyonychia congenita, Gardner syndrome, or Bazex-Dupré-Christol syndrome.

Milia en Plaque

This condition is commonly associated with genetic or autoimmune skin. Milia en plaque affects the eyelids, ears, cheeks, and jaw. Milia can be several centimeters in diameter.

Multiple Eruptive Milia

These cysts are often itchy and appear on the face, upper arms, and torso.

Traumatic Milia

These cysts occur where injury to the skin has occurred. The cysts may become irritated, making them red along the edges and white in the center.

Milia Associated with Drugs

The use of steroid creams can produce milia on the skin where the cream is applied.

How Are Milia Diagnosed?

Your doctor will examine your skin and will be able to determine if you have the condition based on the appearance of the cysts.

How Are Milia Treated?

There is no treatment necessary for infant milia. The cysts will usually clear up within a few weeks. In older children and adults, milia will go away within a few months. If it causes discomfort, then there are some treatments that can be effective for eliminating these cysts.

Treatments include:

  • de-roofing, or using a sterile needle to pick out the contents of the cyst
  • destruction of the cysts using diathermy (extreme heat), curettage (surgical scraping and cauterization), or cryotherapy (freezing)
  • medications, such as topical retinoids (creams that contain compounds of vitamin A)
  • chemical peels or laser ablation (destroying cysts with a small, focused laser)
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