Milia Removal

In adults and older children, milia cysts are typically caused by damage to the skin.

Things that may cause damage to the skin, prompting milia to develop, include:

• Blistering due to a skin condition, such as epidermolysis bullosa (EB), cicatricial pemphigoid, or porphyria cutanea tarda (PCT)
• Blistering injuries, caused by poisonous plants
• Burns
• Sun damage
• Long-term use of steroid creams
• Skin resurfacing procedures, such as dermabrasion or laser resurfacing

Some ingredients in skincare products and make-up can trigger milia in some people. A person who has milia-prone skin may want to try and avoid the following ingredients in beauty products:

• Liquid paraffin
• Liquid petroleum
• Paraffin oil
• Paraffinum liquidum
• Petrolatum liquid
• Petroleum oil

These are all types of mineral oil that may cause milia. Lanolin, a waxy substance used to treat or prevent dry, rough, scaly, itchy skin and minor skin irritations such as nappy rash and cracked nipples caused by breastfeeding, may also increase the formation of milia.

Milia can also develop if the skin loses its natural ability to exfoliate. This can happen as a result of aging when the skin’s collagen levels deplete. Milia can also be a side effect of chemical peels, although measures can be taken to lessen the likelihood of this occurring.

Babies who have milia cysts are usually born with the condition. These milia are believed to be caused by sweat glands that aren't fully developed or mature.

These are harmless and usually go away within a few weeks of birth. 

There are no effective home remedies for the treatment of milia.

Although milia are found in the outer layers of skin, they are difficult to remove without the correct tools. You should never attempt to squeeze or pick milia cysts. Milia are hard little bumps and because they form under a thin layer of skin and not in the pore like acne blemishes, they do not have an opening onto the skin’s surface from which to escape. Any attempt to ‘pop’ milia cysts could result in infection and permanent scarring. We don’t recommend trying to prick milia cysts with a needle or pin yourself as this also presents a high risk of infection, particularly if the pin or needle used is not sterile. 

The best way to rid yourself of milia is by cryotherapy or excision removal by a medical professional in a clinical setting. We offer both these milia removal treatments here at the Cadogan Clinic.

Excision removal is perhaps one of the most effective treatments for milia removal. This sees the milia carefully removed from the body with a surgical scalpel following the administration of a local anesthetic. This process is quick and painless. Patients can return to their day-to-day routine immediately after this treatment.

Cryotherapy is also an option for milia removal. In cryotherapy, liquid nitrogen is applied to the affected area for a few seconds to freeze and destroy the affected skin cells. After treatment, a sore blister will form, followed by a scab, which will fall off a few days after the treatment.

A session of cryotherapy is quick, with patients able to leave the clinic and carry on with their day immediately after milia removal treatment. However some people can find cryotherapy treatment painful, although it is usually well-tolerated.

There are two different cryotherapy methods. Liquid nitrogen may be sprayed directly onto the affected area, or it may be applied to the milia using a stick with cotton wool on the tip. Potential side effects include localised pain, blistering and the skin may become darker (hyperpigmentation) or lighter (hypopigmentation). This risk is higher for patients with black skin.

Cryotherapy is considered a safe milia removal treatment for pregnant women.

The type of milia removal treatment will depend on whereabouts on the body the milia is located and the size of the affected area. Book a consultation with one of the Cadogan Clinic’s expert dermatologists to discuss the best treatment option for you.

There are various milia removal treatments available, including topical retinoids which help to exfoliate the skin, chemical peels, laser ablation, diathermy, which utilises extreme heat to destroy the cyst, and a surgical scrape and cauterisation. 

However, we do not offer these treatments here at the Cadogan Clinic because we believe these methods are either too harsh on the skin or simply not effective. We carry out cryotherapy and excision removal as we believe these are by far the most effective milia removal treatments and pose the lowest risk of any skin damage.

Milia should not be squeezed or pricked with a pin. You could cause some serious skin damage, particularly around the delicate eye area where the skin is thinner. 

We do not recommend treating milia at home.

Primary milia can't be prevented, nor can secondary milia from causes which cannot be avoided, for example blistering injuries.

However there are steps which can be taken to lessen the likelihood of developing secondary milia.

• Protect skin from excessive exposure to the sun. Use a high-protection sunscreen.
• Thoroughly remove all traces of make-up before going to bed. Oily eye make-up removers are best avoided if possible. A micellar water may be a more gentle option.
• Exfoliate two or three times a week to help clear away dead skin cells.
• Clean the affected area daily. Use a mild soap to prevent skin irritation.

There are also certain lifestyle factors which could make a person more prone to developing secondary milia. These include a lack of sleep and smoking. Some experts have suggested that limiting intake of cholesterol-rich foods and incorporating vitamin D supplements into your diet may help to reduce the likelihood of milia developing. Even if these measures don’t ultimately protect you from developing milia, we would always advocate a healthier diet, good quality sleep and quitting smoking to improve overall health.

There has been some research that suggests that extracts of rose, cinnamon, and honey have antibacterial properties that can tackle some skin problems. However, there has been no research on their effectiveness with milia.

Do not try to pick or squeeze milia with your hands or use any tools or objects in an attempt to remove these tiny cysts. By doing so, you are increasing the risk of infection and could potentially be left with some nasty scars. 

Here at the Cadogan Clinic, we treat thousands of skin lumps and bumps cases each year, including milia. Our team of nine highly experienced specialist dermatologists have been handpicked to form one of the best independent dermatology units in the country. Our purpose-built dermatology clinic is conveniently located off Sloane Square.

The Cadogan Clinic’s team of experts will be happy to talk you through the treatment options open to you. Get in touch today to book a consultation with one of our dermatologists for an in-person assessment of your skin.