Best Milia Treatment?

I'm a 16 year old girl that has been diagnosed with milia. What do you recommend for treatment? I have very small pores and they get clogged quickly, making bumps on my face that I can only get rid of by getting them extracted. 

Doctor Answers 3

Milia or blackheads?

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It sounds like you are describing closed comedones and blackheads or "open" comedones, which are associated with acne. I would start with a form of prescription topical retinoid, matching its strength with your skin type. A secondary option would be monthly salicylic acid peels.

Milia are small keratin filled cysts and are not associated with acne. There are various techniques to physically remove them, depending on what your physician is comfortable with. The procedure should be relatively painless, complete, and not leave any scars. By complete, I mean the whole milium should be removed or it can recur.

Most importantly, you have to receive the correct diagnosis because there are clinical mimickers, which affect the treatment plan.

Hope this helps.


Long Island Dermatologist

Milia Management

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Milia are trapped whitish material (keratin) beneath the skin often following eyelid surgery. These tiny cysts have a thin almost translucent skin covering which is usually opened, unroofed, with the tip of a needle allowing the contents to be removed. A simple and often painless office procedure.
Consult with a dermatologist regarding why you have this problem and make sure it is milia and not a different cause such as cholesterol deposits, a sign of hyperlipidemia (too high cholesterol in the blood) requiring treatment. In general prevention consists of not using thick greasy ointments, thorough frequent cleaning and using a retinoid such as Retin-A.

Retinoid and extraction

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Milia ( sing. milium from Latin Millet seed) are small cysts, filled with keratin. They can be extracted quite easily by poking a hole in them, expressing the contents with either a comedone extractor or forceps and then trying to squeeze the whole thing out of the skin.

To prevent them, you should be prescribed a Retinoid, a vitamin A derivative such as Retin A. Something that aesthetilcians do quite nicely is a deep pore cleanser with extraction. You might call your local spa for this treatment.

Beta peels using salicylic acid would also help prevent milia formation.

I trust these are not on the back of the hands. There is a relatively rare condition called colloid milia in which lesions, which look somewhat like the above, can develop. However, they have an entirely different basis of origin and treatment. Milia can also result after scar formation.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.