Milia: Causes, How to Get Rid of Them

Milia are accumulations of keratin, horny mass and sebum located on the skin. Other names: millet, whitehead, lipoma. Dense in structure, the formations have a whitish-yellow color. They are no more than 3 mm in size. They are not a serious medical condition, but they cause discomfort from the aesthetic side.

милиумы form in people of any age, and are found in adults and children. Whiteheads often form in children at birth and in adolescents during puberty. Women are most susceptible to the appearance of millet. Milia on the face are mainly located in the T-zone, but can be localized on the eyes, under the eyes, on the eyelids, and rarely on the stomach, back, genitals.

Causes and risk factors

The sebaceous glands are formed in the third month of embryonic development. They abundantly cover the baby’s skin with a wax-like lubricant. The glands perform their functions most actively in the first 2-3 months of a newborn’s life and during puberty. Impaired sebum secretion provokes the formation of милиумы.

Most often, acne is formed due to the active work of the sebaceous glands and the production of sebum. This occurs for various reasons, including hormonal imbalance, gastrointestinal diseases, poor nutrition, deficiency of vitamins and microelements, and imbalance in the nervous system.

Excessive consumption of sweet foods, canned food, spicy and fried foods provokes changes in metabolic processes and an increase in bad cholesterol in the blood. Excess sugar, salt and spices in the diet lead to disruption of the pancreas, liver and other organs. This affects the secretion of sebum and the function of the sebaceous glands.

The main causes of milia:

• the use of low-quality decorative cosmetics, which causes clogged pores, dries out the skin , and disrupts sebum secretion processes;
• incorrectly selected skin care procedures;
• abuse of mechanical peeling and chemical cleaning;
• disruption of the endocrine system during pregnancy and lactation;
• genetic factor;
• damage to the upper layer of the dermis due to the aggressive effects of a solarium, sunlight;
• taking certain medications, such as corticosteroids.

A history of hyperkeratosis and vitamin A deficiency increases the risk of developing milia on the skin. A sedentary lifestyle and thyroid disorders also increase the chances of developing whiteheads.

Classification

In modern cosmetology, several types of whiteheads are distinguished depending on the etiology:

1. Primary ones are formed from epidermal cells in the presence of a hereditary predisposition. They are presented as small white tubercles with a diameter of 1–2 mm, which are located on the skin of the face, eyelids, cheeks, forehead, and less often on other parts of the body.
2. Secondary, or Balser’s pseudomiliums, occur as a result of various dermatological diseases, the action of aggressive factors on the skin, for example, after laser cleaning, mechanical peeling. They appear as small white bumps, but can be larger in size and located in the deep layers of the dermis.

According to the nature of the manifestation, milia are of 4 types:

• epidermal – the most common type, which occurs due to contamination of the pores of the skin by keratin cells in the upper layers of the epidermis;
• dermal – located in the deep layers of the dermis, may have a yellowish color, and are formed due to the accumulation of collagen in the skin;
• miliary (multiple) – small whiteheads measuring 1 to 2 mm, which usually appear in the eye area and on the cheeks;
• sebaceous – small yellow or white formations that are localized near the eyes and are formed due to excess secretion of sebum.

Depending on the time of formation on the skin, milia are of 2 types:

• temporary (transient), which are characterized by the presence of a thin horny capsule. Such acne is most often found in newborns, localized on the wings of the nose, and goes away on its own;
• permanent, which can appear at any age due to hormonal imbalance, genetic predisposition, metabolic disorders. This type of milia requires removal in a cosmetology clinic.

Symptoms

Milia develops gradually. Patients do not feel pain or discomfort in the affected areas of the skin. Acne usually forms in groups, but can appear as single elements.

It is quite easy to identify milia by the following symptoms:

• have a small size from 0.5 mm to 3 mm and clear boundaries;
• do not cause discomfort;
• do not have any inflammatory manifestations around them;
• can be white, yellow or transparent;
• are not transmitted from one person to another;
• are not an infectious disease;
• may reappear after removal if the underlying cause is eliminated.

Complications

After formation, milia do not change in size for a long time. Skin bumps rarely become inflamed, but if the integrity of the whitehead capsule is damaged, dust and dirt that a person brings in when scratching their face can get into them. In this case, suppuration can develop. Attempts to independently remove fluid from the milia lead to traumatization of the skin around it and the formation of scars.

Incorrect diagnosis is fraught with the development of a serious disease. This is due to the fact that at the initial stage of formation, skin bumps are very similar to basalioma . This is a slowly progressing skin cancer that is life-threatening for the patient and requires treatment.

Diagnostics

A dermatologist diagnoses whiteheads . At the initial appointment, the doctor will conduct a physical examination of the patient’s skin and prescribe the necessary laboratory tests and examinations. The basic list of examinations includes:

• general blood test;
• general urine analysis;
• biochemical blood test;
• immunogram;
• skin biopsy;
• histological examination;
• dermoscopy;
• culture of microorganisms.

If necessary, the doctor will refer the patient with milia for consultation with specialized specialists: a cosmetologist , an allergist  , and others, who will conduct diagnostics and prescribe a specific examination.

Treatment

Patients who have encountered milia are interested in the question of how to get rid of them. Doctors strongly advise against squeezing acne at home, using aggressive scrubs and cleansing. Such actions lead to traumatization of the sebaceous glands and hair follicles, which subsequently provokes infection and scar formation. It is almost impossible to remove milia with external creams, lotions and ointments, so you should not select such products on your own.

Therapy involves opening the acne capsule and removing its contents. A qualified dermatologist is engaged in the treatment of milia and the selection of the necessary technique.

The choice of a method for cleansing a cyst from fluid depends on several factors:

• locations;
• quantities;
• size;
• location in the layers of the epidermis.

In case of single formations, mechanical drainage with a needle and curettage is recommended. To prevent infection from penetrating the open wound, the skin is treated with an antiseptic before and after the procedure.

In case of a large accumulation of whiteheads, other methods are used, such as electrocoagulation, laser exposure or radio wave removal. In one session, the doctor can remove no more than 10 elements. Otherwise, this may lead to multiple damage to the upper layer of the dermis and dysfunction of the sebaceous glands.

Prevention

In order to prevent милиумы, you should follow the rules for performing skin care procedures. Cleansing and moisturizing products should be selected depending on the skin type. It is not recommended to overuse peels, scrubs, masks, which can disrupt the secretion of sebum.

In addition, it is important to eat right, saturate the diet with healthy foods: vegetables, fiber, greens, fruits, which normalize metabolic processes and support the production of sebum.

To avoid the formation of милиумы on the face, you should regularly carry out procedures such as ultrasonic cleansing and vacuum grinding (as prescribed by a cosmetologist).