Gainesville Dermatology & Skin Surgery is your trusted source for dermatologist skin care, providing individualized treatments for improving skin health and appearance. If you have tiny, white bumps on your nose, chin, cheeks, or another part of your face, likely, they are not acne but milia. Contact a dermatologist in Gainesville with our clinic for professional milia treatment and removal.

Contact us today to schedule a dermatologist appointment and to learn more about our available treatments for a wide range of different skin conditions.

What Are Milia?

Milia are small, white, or yellow bumps or cysts that typically develop on facial skin, such as the forehead, nose, and cheeks, but they can also develop on the eyelids and genitals. This skin condition, commonly referred to as “milk spots,” is commonly associated with newborns, but it can likewise occur in children and adults. In most cases, these bumps do not occur alone but in clusters of multiple milia. A milium (the singular of milia) is formed at the base of a hair follicle or sweat gland. Often mistaken for whiteheads or other types of acne, milia are keratin-filled cysts that form just beneath the epidermis (the uppermost skin layer). The five prevalent types of milia include neonatal, primary, secondary, en plaque, and multiple eruptive.

Neonatal Milia

As the name suggests, milia in babies is referred to as neonatal milia. They are very common and are usually found in small babies soon after birth. Approximately half of all babies develop neonatal milia at some point following delivery. Neonatal milia develop around the nose area but may occur on the scalp, cheeks, upper body, and inside the mouth. These milia are thought to arise from sweat glands that have not yet fully matured. 

Primary Milia

Primary milia can occur in both children and adults. The most common type of milia, primary milia, may appear on the eyelids, forehead, cheeks, or genitals, but it may also develop elsewhere. Primary milia are not associated with trauma to the skin, and, like neonatal milia, they usually clear up on their own, but it may take multiple months. Should primary milia fail to clear up, professional dermatology treatment is often recommended.

Secondary Milia

Traumatic milia, or secondary milia, occur secondary to an injury to the skin caused by certain health conditions affecting the skin, skin burns, excessive exposure to sunlight, or even following surgical or radiation procedures. In secondary milia, the milia develop as the skin heals. In addition to skin trauma, this type of milia may also be caused by a skin reaction to heavy skin creams and ointments. 

Milia En Plaque (MEP)

Milia en plaque is an unusual condition that mostly, but not exclusively, affects middle-aged women. These milia varieties clump or cluster together on broad, flat, raised patches of skin raised above the rest of the skin. They are typically located behind the ears, or on the eyelids, cheeks, or jaw. MEP may be associated with other skin conditions, such as lichen planus and pseudoxanthoma elasticum.

Multiple Eruptive Milia (MEM)

Multiple eruptive milia is another rare skin condition in which the milia appear in patches or crops that develop over weeks or months at a time. These patches typically appear on the face, the upper arms, and the upper trunk, among other areas of the body. The lesions are generally asymptomatic, but may be cosmetically troublesome and difficult to get rid of, particularly without treatment.

What Causes Milia?

Several factors cause milia in adults. Most commonly, milia occur due to the accumulation and build-up of dead skin, which gets trapped in the pores near the skin’s surface. If the build-up does not expel naturally, a small cyst (a milium) can form. When it comes to the eye area, skincare that does not properly penetrate can cause milia to manifest, as the skin around the eyes does not contain oil glands, and it has limited blood circulation. Another reason for what causes milia can include anything that clogs the skin’s sweat ducts, usually due to skin trauma or infection, such as laser treatments, chemical peels, and herpes. Milia may likewise manifest due to contributing lifestyle factors, including smoking, lack of sleep, poor personal hygiene, the use of oil-based beauty and skin care products in excess, and long-term steroid use.

What Is Inside A Milium Cyst?

The first thing patients with a milium cyst or multiple milia should know is that milia are not susceptible to squeezing or popping as zits are. The contents of milia are not fluid like the contents of pustules or other types of whiteheads. Unlike pustules, a milium is not an acne pimple but rather a tiny cyst. The small, white lumps that comprise milia are made up of keratinized, or hardened, dead skin cells that have become trapped under the skin’s surface. 

How Are Milia Diagnosed?

In the majority of cases, and especially when the patient is a child or infant, our dermatologists may diagnose milia by visual observation of the affected skin alone. If it is unclear whether the cysts are, in fact, milia or another type of skin condition, a skin biopsy (a test in which a small piece of skin is removed and examined under a microscope) may be useful in determining the diagnosis. There are multiple ways in which a skin biopsy may be performed, such as shaving away a small piece of skin or by using a special instrument to punch a tiny hole into the skin and extract the tissue. To schedule an appointment, contact our dermatology clinic today!

Milia Treatment

In most cases, milia are harmless and they eventually clear up on their own. In babies, they clear after a few weeks. In some cases, however, milia can persist for months or sometimes longer. Secondary milia can be permanent, requiring removal by a dermatologist. Those who find their milia unsightly may seek treatment. Backed by our trusted approach to dermatology, patients trust Gainesville Dermatology & Skin Surgery for their skin care needs, including milia extraction. Dermatology professionals often remove these cysts using a fine milia removal tool (milia removal needle). Patients should avoid squeezing or trying to treat milia on their own, as this can lead to skin damage, scarring, or infection. If milia become widespread and persistent, various other treatments, including cryotherapy, laser treatment, dermabrasion, or chemical peels may be recommended by our dermatologists in order to treat the milia and restore the affected skin.

How To Prevent Milia

In some cases, milia is not preventable. Certain steps, however, can help reduce the likelihood of developing milia. In order to achieve and maintain optimal skin health and a glowing, even skin surface, we recommend patients consider the following tips.

  • Consult your dermatologist about your skin care products
  • Avoid skin creams and products that are too heavy or rich
  • Avoid certain oil-based beauty products
  • Avoid excessive exposure to sunlight
  • Start using an exfoliating treatment
  • Wear broad-spectrum sun protection every day
  • Try manuka honey or a retinol to help prevent milia formation
  • See your dermatologist regularly for skin check-ups and treatment

When To Call Your Gainesville Dermatologist

Since milia affects a patient’s appearance, but not their health, the urgency of treating milia depends on the degree to which it bothers the patient. Adults with milia should contact our Gainesville dermatologists for treatment if exfoliating treatments and preventative methods at home do not seem to be helping. Patients may also discuss concerns about milia during regular skin check-ups. If prenatal milia seem to persist, or if you are concerned for another reason, discuss this with your dermatologist during your next visit.