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Milia are small, raised, pearly-white or yellowish bumps on the skin. They are most often seen on the skin around the cheeks, nose, eyes and eyelids, forehead and chest but they can occur anywhere on the body. Milia are very common in newborn babies but can affect people of any age. In babies, milia clear by themselves and no treatment is needed. In other people, they may take longer to clear and, in persistent cases, treatment may be suggested.

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What are milia and what do they look like?

A milium is a small, raised bump on the skin. It is a type of tiny skin cyst filled with a protein called keratin. Many are usually found together and so they are called milia (the plural of milium). As can be seen in the picture, milia are usually each about 1 or 2 millimetres across and are pearly-white or yellowish. They are most often seen on the skin around the cheeks, nose, eyes and eyelids, forehead and chest but they can occur anywhere on the body.

Do milia cause any symptoms?

Milia do not usually cause any symptoms but, in some people, they can become itchy.

How are milia diagnosed?

Milia are usually diagnosed by their typical appearance and generally no investigations are needed. However, in a few cases, if the diagnosis is uncertain or if milia en plaque are suspected, your doctor may suggest a skin biopsy.

During a skin biopsy, a small piece of skin is removed so that it can be examined under a microscope. There are different ways that a skin biopsy can be carried out. For example, by shaving away a small piece of skin or by using a special instrument to punch a tiny hole in the skin.

Is any treatment needed?

Milia are harmless and, in most cases, they will eventually clear by themselves. In babies, they clear after a few weeks but, in some people, milia can persist for months or sometimes longer. Secondary milia are sometimes permanent.

Because they normally clear by themselves, milia do not usually need any treatment. However, some people find milia unsightly and so opt for treatment. Milia may be removed using a fine needle and then squeezing, or pricking, out the contents. No anaesthetic is needed. However, it is not recommended to squeeze or try to treat milia yourself. This can lead to skin damage and scarring or infection.

If milia become very widespread and persistent, various other treatments may be suggested, usually by a Aesthetic Doctor. They include:

• Cryotherapy (a type of treatment that freezes skin lesions - a skin lesion is where a patch of skin has changed in appearance).
• Laser treatment.
• Dermabrasion (a procedure that removes the topmost layers of the affected skin).
• Chemical peeling (a treatment where a chemical is applied to the face to burn off skin lesions).

In the rare type of milia called milia en plaque, certain creams such as isotretinoin or tretinoin are sometimes suggested as treatment, or the antibiotic tablet, minocycline.