I have very small, flat, white things under the skin that are visible. They look like flat whiteheads. I thought from descriptions I've read that they were milia, but they do not look like any of the photos of milia that I've seen because they do not protrude. Are these milia, or could they just be pores clogged by rich eye creams? What treatment can I have to get rid of these?
Milia or Just Clogged Pores?
Doctor Answers 1
Milia are clogged pores
Milia ( sing. milium meaning millet seed in Latin) are clogged pores. They are actually small epidermal cysts ( sometimes called sebaceous cysts which contends for the label of greatest misnomer with pyogenic granuloma).
They may be primary, due to an immature duct, so-called, "milk bumps" in babies. They may result from irritation from makeup or excessive sun exposure. They may be secondary to another dermatologic condition such as bullous lilchen planus, porphyria cutanea tarda ( I think I had a case of that Friday, the lab work is pending), a type of blistering disease called epidermolysis bullosa and occasionally in lichen sclerosus atrophicus. Milia are actually routine following dermabrasion.
If you have a milia that persist, they can be treated by incising the overlying epidermis so that the contents can be extruded using gentle pressure with a comedone extractor. I personally use a trick where I make a small incision with an #11 blade and squeeze out the contents with a forceps. Other dermatologists juse electrocautery or electrosurgery.
There is generally not a charge for this procedure.