In this article you will learn about milia - the small hard bumps on your face, their causes and how to get rid of them. It is not a skin condition we see frequently in salons, but it's not uncommon. People with this skin condition often express frustration as these tiny bumps can be persistent and distracting.

Milia can occur at any age and any skin type. Often found on newborn skin around the nose and cheeks and disappear after a few weeks. In clinics, we see it in adult men and women.

It is a harmless skin condition, but it can be sometimes mistaken for other skin conditions like acne, whiteheads or syringomas. In this episode, I will cover the symptoms, causes and treatment options for milia.

So, What Exactly is Milia?

Milia are tiny, white cysts that feel quite spiky to the touch. They are usually the size of a grain of sand, but can sometimes be larger.

The milia cysts are made up of keratin, a protein that is what the skin cells, hair and nails are made up of, and occur when keratin buildup becomes trapped beneath the surface of the skin. 

It is a sign of local keratinisation malfunction. The tiny spiky bumps usually occur around the eyes, cheeks, and nose. 

A single bump is called milium, but they usually form in clusters and the clusters of the tiny cysts are called milia.

What are milia caused by?

The actual cause of milia varies from person to person and there are several theories for the causes of milia. It may be related to sunburn or other trauma to the skin.

I have seen milia on people with a history of long-term sun damage. The research I have read indicates that milia may also be the result of:

• local injury to the skin
• rashes such as rosacea and seborrheic dermatitis
• allergic reactions and irritation from harsh products
• long-term use of steroid creams
• and sometimes attributed to products being too rich, particularly eyes creams.

I found synthetic oils and waxes such as paraffin, petroleum, and petrolatum can cause milia.

Natural plant oils such as jojoba, almond oil, evening primrose oil, argan oil, grapeseed oil and shea butter are fine.

When I was training as a beauty therapist, I sat in on a lecture by a naturopath and he said that milia often occur in people with dairy intolerances or allergies. This may be something you may wish to explore with your health care professional.

More recent studies show that mechanical injury to the skin can cause milia, such as harsh scrubbing and rubbing, too many or aggressive microdermabrasion treatments and even ablative lasers.

Some people just have more of a tendency toward developing them than others do.

Can you squeeze milia out?

Milia are often trapped under the top layers of the skin and are difficult to squeeze out. The best thing you can do is to leave it alone. If your skin is dry or irritated, you want to avoid using harsh chemicals in this sensitive area.

It is not recommended to try to squeeze milia out at home. This can cause injury to surrounding tissue and scarring. If you want to remove milia, consult with a beauty therapist. 

A professional skin therapist will be able to extract it using sterile instruments if needed. You must find a qualified beauty therapist who specializes in skin care procedures such as extractions, chemical peels and microdermabrasion.

How do you get rid of milia?

The treatment for milia depends on how deep it is. Often it is too deep, and people have created ugly scars trying to squeeze milia out.

Using a spot treatment to dissolve the top skin cell layers will help to work the cyst to the surface where it will often pop out on its own.

If it is nearly ready to pop out, your beauty therapist can use a sterile lancet to gently ease it out, but it must be worked up to the surface first.

Can I get rid of milia without squeezing? 

Yes, you can work milia out of the skin gently with a combined glycolic and salicylic acid serum. Every night after cleansing and moisturising, apply a small amount of the serum directly over the milia and leave it to work overnight. 

Glycolic & Salicylic Acid Serum

The glycolic acid will remove the top dead skin layers and salicylic acid will help to "dissolve" or break up the milia because salicylic acid is keratolytic, which means it is attracted to the keratin in the milia and it helps to break it down.

Be sure to consult with your beauty therapist to ensure your skin is suited for this treatment, some people may find this serum too strong or should not be using hydroxy acids. If you're pregnant, breastfeeding or have an allergy to aspirin, avoid using these type of serums. 

Enzyme-based Exfoliants

Enzyme-based serums and exfoliants are a good option if you can't use hydroxy acids. These are gentler on the skin but may take longer to see results. Enzymes help to break down the top layers of the skin, allowing the milia to be released and eliminated from the skin. Enzymes are also keratolytic which help to breakdown the milia cysts. 

Retinol Serums & Creams

Retinol is a form of vitamin A and an excellent ingredient to help regulate skin cell turnover and eliminate excess dead cell buildup. It's a great option for the treatment and prevention of milia, however, you need to consult with your beauty therapist as this ingredient can't be used by some people in their skincare routine.If you're pregnant, breastfeeding, or your skin is very thin and sensitive you should avoid using retinol based products. 

Conclusion

Milia usually go away on their own within a few months. If they don't, you can try applying some of the products we discussed to help get rid of the milia. However, milia tend to recur if you keep squeezing them, so avoid picking at your skin or using harsh scrubs on your skin.

Once the milia have cleared, prevention involves skin care products that encourage healthy cell turnover. Gentle and regular exfoliation once or twice a week together with a good enzymatic cleanser will help to keep it at bay.

Staying out of the sun and not overdoing it with harsh resurfacing treatments will help.

Be gentle with your skin, and avoid using harsh or poor-quality products that may cause rashes and allergic reactions. Always use the best quality skin care products you can afford for healthy, glowing skin. 

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