Medically Reviewed by Dr. Yasir Bari
Bsc, (Med) Bsc, (Nutrition), MBBS, DCN (Diploma in Clinical Neurology) – Reviewed & Approved on October 26, 2018
-Written by Marc Seward
What is Milia?
Milium cysts or milia are small white lumps which appear on the face most commonly on the nose, cheeks and eyelids. They usually form in groups when a protein called keratin gets trapped beneath the skin’s surface.
What Causes Milia?
The condition is far more common in new born babies but it can actually occur at any age. In babies, milia are often referred to as baby acne but in reality, they have little in common. While baby acne is triggered by the mother’s hormones, the cause of milia is unknown and unlike acne, milia do not cause inflammation.
In adults and older children, there are many possible causes of milia but it is usually related to skin damage of some description including burns, blister injuries, sun damage and the long term effects of steroidal creams.
Milia is not a harmful condition and the small lumps produced are generally not painful or itchy. It is not a contagious condition and will generally clear up inside a few weeks without treatment for newborns though it might take significantly longer for adults and juveniles. Occasionally however, milia might cause discomfort as well as being cosmetically unattractive.
Types of Milia
There are several types of milia.
- Neonatal milia affects between 40 and 50% of newborns. (1)
- They are often seen on and around the nose but can also appear on the face, scalp, upper torso or the inside of the mouth.
- They are often mistaken for neonatal acne.
- Neonatal milia usually heals with no treatment within the first few weeks after birth.
- Occurs in both children and adults.
- They may disappear of their own accord within weeks or last for a number of months.
- Primary milia can occur on the eyelids, cheeks, genitals and forehead.
- primary milia can also occur in the nasal crease of young children.
Milia en plaque
- This is a rare type of milia often associated with other skin diseases including discoid lupus erythematosus, lichen planus and pseudoxanthoma elasticum.
- The condition is characterized by multiple bumps appearing in a raised and inflamed patch above the surrounding skin. The patch can be several centimeters in diameter.
- The milia are usually seen on the eyelids, behind the ears or on the jaw or cheek.
- It can affect both children and adults but is most common in middle aged women.
Multiple eruptive milia
- This is another rare form of milia which involves multiple bumps presenting over a period of weeks or months.
- The affected area is often asymptomatic but it can be itchy.
- This type of milia usually appears on the face, the upper arms and the upper torso.
Traumatic milia (secondary milia)
- This type of milia occurs following injury to the skin usually as the skin is healing.
- They can follow burns, blistering or rashes from allergic reaction.
- They can also follow skin damaged by sun exposure.
Milia linked to medication
- Milia may also be caused by certain topical medications including corticosteroids and hydroquinone
How to Treat Milia
If you or your baby have milia, there is usually no cause for concern. The condition does not require medical treatment and typically clears up on its own within a couple of months. Treatment is usually only necessary, if there is concern about the patient.
Conventional treatment options include the following :
- De-roofing the lesions with a needle or a blade witht he contents being squeezed out.
- The lesions can be destroyed with cryotherapy or diathermy.
- Topical retanoids can help treat widespread lesions.
- In rare cases where the patient has extensive milia, chemical peels and laser treatment may be effective.
- Milia en plaque is sometimes treated with antibiotics.
However, if you would prefer to go down the natural route, there are a variety of safe natural treatment options that you can try in the comfort of your own home.
Natural Treatments for Milia
Before looking at these home remedies, it is worth pointing out that you should resist the urge to pick or poke at your lesions. Trying pick off the bumps can cause them to bleed or scar while scraping at the skin may also introduce germs increasing the risk of infection.
For babies under the age of six months, it is better to do nothing at all.
1. Facial steam bath
A facial steam bath is an excellent way to treat milia and keep your skin smooth and fresh. The steam from the hot water helps to unclog your pores and remove dead skin from your face. A steam bath is both effective and very easy to make.
- Fill your sink with hot water then cover your head with a towel and lean over the sink but make sure that you keep your eyes closed and stay far enough away from the water that you do not scald yourself.
- Stay in this position for at least 10 minutes or as long as you can tolerate it.
- Repeat this process twice a day until your condition has cleared away.
A similar effect can be produced by soaking a towel in hot water, ringing out the excess and placing it over your face for 5 minutes or so.
Honey has an incredible amount of health benefits especially for the skin including milia because of its antibacterial and antioxidant nature. Remember that honey varies in quality and therapeutic benefits so make sure that you buy a raw, organic honey.
Manuka honey has especially powerful health properties but it will hit you in the pocket more than most. You can either combine your organic honey with some other ingredients to make an exfoliating scrub or apply it neat.
- Apply your raw honey to the affected areas of your face and leave it in place for at least 20 minutes before rinsing it away.
- An alternative is to mix your honey with a tablespoon of virgin coconut oil before applying it to your face. Coconut oil is a wonderful skin treatment in its own right; it contains antimicrobial and anti-inflammatory properties that are easily absorbed and work to great effect on the skin.
- You can also make an effective facial scrub by adding some oatmeal and granulated sugar to your honey. Use your homemade honey scrub daily until your symptoms improve.
3. Castor oil
Castor oil can also be put to good use on the skin; it has antibacterial abilities that can effectively treat many skin complaints including milia. Castor oil also helps your skin regulate is production of oil so follow one of these methods if you would like to try it out.
- The easiest way to use it is to just apply the castor oil to the affected areas of your face and allow it to fully absorb.
- Another option is to combine your castor oil with olive oil or coconut oil before applying it to the skin.
4. Tea tree essential oil
While many essential oils have properties ideal for treating the skin, tea tree oil is especially effective with regard to a number of complaints including milia. Tea tree essential oil has extremely powerful antibacterial properties and is also an excellent treatment for fungi.
Don’t forget that essential oils are very powerful and you will need to dilute it properly before you apply it to the skin.
- Soak a cotton ball in water and add a drop or 2 of tea tree oil to the ball then apply it to your milia cysts twice a day.
- Alternatively you can dilute 2 drops of tea tree oil in a tablespoon of coconut oil and apply the blend to your skin twice a day.
5. Aloe vera
Aloe vera is commonly used for a number of skin issues and it might be worth trying on your milia. Aloe has natural anti-inflammatory and antimicrobial activities which help soothe irritation and defeat infection.
- Cut an aloe vera leaf lengthways to extract its gel and apply it directly to your milia lumps. You can do this each night before bed and allow it to work into your skin overnight. It is a safe and effective treatment so you can repeat as long as you feel it is necessary.
6. Egg, yogurt and almond oil mask
I have no idea if this remedy will work but it sounds pleasant enough and it is recommended as a treatment for milia in internet testimonials. If it interests you, then follow these simple instructions.
- Take an egg white from a single egg, half a teaspoon of almond oil and a teaspoon each of raw honey and natural yogurt.
- Mix these ingredients together well then apply it to your face.
- Let it work on your skin for half an hour or so before you wash it off.
This one takes a little more effort but it might well be worth the extra leg work because pomegranate has antioxidant properties as well as exfoliating abilities that can help treat your milia as well as other skin conditions.
- Peel some pomegranates and roast the peels until they are nice and brown.
- Chop or grind the peel into a fine powder.
- Add a few teaspoons of water to your ground peels and mix it well into a smooth paste.
- Apply he finished paste to your milia and leave it work your skin for at least 20 minutes before rinsing it off.
Fenugreek is a popular Ayurvedic ingredient where it is used extensively to treat skin conditions including acne, eczema and milia. Fenugreek leaves are a natural antioxidant and they also possess anti-inflammatory compounds. Again, you will need to grind your leaves into a paste before using them.
- Take a handful of fenugreek leaves and chop them up and grind them as finely as you can.
- Add sufficient water to the ground leaves and mix it up into a smooth paste.
- Apply the paste to the affected parts of your face and leave it on your skin for around 20 minutes before rinsing it off.
9. Sugar and lemon scrub
It is easy to make a therapeutic exfoliating scrub using just granulated sugar and lemon juice and a little olive oil. Treating your skin with this natural scrub should help ease your milia lumps while also removing any dead skin cells.
- Extract the juice from a medium sized lemon and throw in a few tablespoons of granulated sugar and a teaspoon or so of olive oil.
- Mix it up then use it to scrub your skin.
- Repeat every other day until your symptoms have cleared up.
How to Prevent Milia
Certain types of milia can not be prevented such as the neonatal milia that occurs in newborn babies. However, milia caused by trauma or milia resulting from another skin condition can be prevented with swift treatment.
The following tips may help prevent milia from occurring :
- Avoid exposing your skin excessively to direct sunlight.
- Do not use oil-based skin products or thick topical creams.
- Exfoliate your skin several times each week.
- In rare cases, milia occurs after a chemical peel. To reduce the risk of this happening, you could apply a topical retinoid prior to the procedure. However, topical retinoids are known to cause irritation and dark spots when they are used in conjunction with a chemical peel.
Frequently Asked Questions
How can I treat milia at home?
While milia usually resolves without treatment, there are a few things you can do to speed up the healing process. A steam facial bath is a tried and trusted home remedy while others include aloe vera, honey, tea tree essential oil and fenugreek.
What causes milia?
There are different types of milia. The most common cause of milia in adults is the pres becoming clogged with dead skin. Milia may also be related to other skin conditions, skin injury or certain medications.
Can a dermatologist remove milia?
If there are multiple milia present or if it is otherwise necessary, your doctor may recommend treatment. This can include topical retinoids while other procedures can be effective including cryotherapy, heat or neeedle treatment.
Can you pop milia?
You should resist any temptation to pop, scratch or pick at your bumps. Picking at the milia or trying to scrape them away can cause them to bleed, scab and scar. It can also increase the risk of infection.
Milia is usually a harmless skin condition that will resolve of its own accord in a fairly short time.
There are however a number of things you can do at home to speed up the healing process. Some of the most effective include steam facial baths, aloe vera gel and tea tree essential oil.
Have you ever tried one of the home remedies in our list and did you find it to be effective? Please let us know in the comments section.