What is a milium cyst?
A milium cyst is small, white bump that typically appears on the nose and cheeks. These cysts are often found in groups, and in these cases are called milia. The cysts occur when keratin becomes trapped beneath the surface of the skin. Keratin is a strong protein that is typically found in skin tissues, hair, and nail cells.
Milia can occur in people of all ages, but they’re most common in newborns. They’re typically found on the face, eyelids, and cheeks. Milia are often confused with a condition called Epstein pearls, which involves the appearance of harmless white-yellow cysts on a newborn’s gums and mouth. Milia are also often inaccurately referred to as “baby acne.”
Keep reading to learn more about milia as well as their causes and what you can do to treat them.
What causes milia?
The cause of milia in newborns is unknown. It’s often mistaken for baby acne, which is triggered by hormones from the mother. Unlike baby acne, milia doesn’t cause inflammation (swelling). According to the Stanford School of Medicine, infants who have milia are born with it, while baby acne doesn’t appear for a few weeks after birth.
In older children and adults, milia are typically associated with some type of damage to the skin, such as:
- blistering due to a skin condition
- 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
What are the types of milia?
Milia are small, dome-shaped bumps that are usually white or yellow. They’re 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.
There are various types of milia. These cysts are classified based on the age at which they occur or the injury that causes the cysts to develop.
This condition develops in newborns and heals within a few weeks. Cysts are typically seen on the face, scalp, and upper torso. According to the Stanford School of Medicine, milia occurs in about 40 percent of newborn babies.
This condition is caused by genetic disorders. These include:
- nevoid basal cell carcinoma syndrome
- pachyonychia congenita
- Gardner syndrome
- Bazex-Dupré-Christol syndrome
Primary Milia in Children and Adults
This condition is caused by keratin trapped beneath the skin surface. 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.
Milia en Plaque
This condition is commonly associated with genetic or autoimmune skin disorders, such as discoid lupus or lichen planus. Milia en plaque can affect the eyelids, ears, cheeks, or jaw.
The cysts can be several centimeters in diameter. This condition is primarily seen in middle-aged women, but it can occur in adults and children of all genders and ages.
Multiple Eruptive Milia
This type of milia consists of itchy areas that can appear on the face, upper arms, and torso. The cysts often appear over a span of time, ranging from a few weeks to a few months.
These cysts occur where injury to the skin has occurred. Examples include severe burns and rashes. 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 lead to milia on the skin where the cream is applied. However, such side effects from topical medications are rare.
How are milia diagnosed?
Your doctor will examine your skin and can 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. There are some treatments that can be effective for eliminating these cysts if they cause discomfort.
- deroofing, or using a sterile needle to pick out the contents of the cyst
- medications, such as topical retinoids (creams that contain vitamin A compounds)
- chemical peels
- laser ablation, which involves using a small and focused laser to destroy the cyst
- diathermy, which involves using extreme heat to destroy the cysts
- destruction curettage, which involves surgical scraping and cauterization to destroy the cysts
- cryotherapy, which involves freezing and is the most frequently used method to destroy the cysts
Milia don’t cause long-term problems. In newborns, the cysts usually go away within a few weeks after birth. While the process might take longer in older children and adults, milia aren’t considered harmful. If your condition doesn’t improve within a few weeks, however, you may want to follow up with your dermatologist to make sure it is not another skin condition.