Milium

Milium
Other names	Milia (plural)
File:Milium.jpg
Close-up of a milium on the skin
Specialty	Dermatology
Symptoms	Small, white, keratin-filled cysts
Causes	Keratin trapped beneath the skin surface
Treatment	Exfoliation, extraction, retinoids

Milium (plural: milia) is a small, white, keratin-filled cyst that typically appears on the skin, particularly on the face. These cysts are common in individuals of all ages, including newborns, and are often found around the eyes, nose, and cheeks. Milia are benign and usually resolve without treatment, although they can be removed for cosmetic reasons.

Pathophysiology

Milia form when keratin, a protein found in the skin, becomes trapped beneath the outer layer of the skin, the epidermis. This entrapment leads to the formation of a small cyst. Milia are often associated with skin damage, such as burns or blistering, but can also occur spontaneously.

Types of Milia

Milia can be classified into several types based on their cause and location:

• Primary Milia: These occur spontaneously and are common in newborns. They usually appear on the face and resolve on their own within a few weeks.
• Secondary Milia: These develop after skin trauma, such as burns, blistering, or dermabrasion. They can also occur as a result of long-term use of topical steroids.
• Juvenile Milia: Associated with genetic conditions such as basal cell nevus syndrome or Gardner syndrome.
• Milia en plaque: A rare form that presents as a plaque of milia, often on the eyelids or behind the ears.

Diagnosis

Milia are diagnosed based on their characteristic appearance. They are small, white, dome-shaped papules that are firm to the touch. A dermatologist can usually diagnose milia by visual examination. In rare cases, a skin biopsy may be performed to confirm the diagnosis.

Treatment

While milia are harmless and often resolve on their own, treatment may be sought for cosmetic reasons. Treatment options include:

• Exfoliation: Regular exfoliation can help prevent the formation of milia by removing dead skin cells and promoting cell turnover.
• Extraction: A dermatologist can perform a simple procedure to remove milia using a sterile needle or blade.
• Topical Retinoids: These can help reduce the formation of milia by promoting skin cell turnover.

Prevention

Preventive measures include maintaining a regular skincare routine with gentle exfoliation, avoiding heavy creams that can clog pores, and protecting the skin from sun damage.

Prognosis

The prognosis for milia is excellent, as they are benign and often resolve without intervention. However, they can recur, especially if the underlying cause is not addressed.

Also see

• Comedo
• Sebaceous cyst
• Epidermoid cyst
• Dermatology

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