Understanding Milia: Causes, Treatment, and Prevention

 What is Milia?

Milia (plural: milium) are small, dome-shaped bumps that are usually between one and two millimeters in size. They usually appear on the forehead, around the eyes, cheeks and nose, but they can also appear anywhere else on the body. 

Milia is caused when keratin, a protein found in the skin, hair and nails, gets trapped under the skin's surface, resulting in a small cyst. These cysts are usually white or yellow in color. There are several types of milia each with unclear causes:

Milia prima: It can appear on the nose, scalp and cheeks and infants are the most affected. In most cases, they disappear on their own within a few weeks.

Milia secondary: These can occur at any age and are often associated with certain skin conditions or damage, such as burns, blisters, prolonged sun exposure, heavy skin creams, or topical steroids.

Neonatal milia: These are small white bumps that appear on an infant's face, often within the first long period of life. They are usually brief and do not require treatment.

Treatment of milia

Treatment options found are usually self-limiting, especially in infants. Nevertheless, on the off chance that milia are persistent or bothersome, treatment options may include:

Extraction: Using a sterile lancet or needle, a dermatologist or trained skin care professional can safely remove the mole.

Retinols for the skin: These vitamin A derivatives can help exfoliate the skin and promote cell turnover, which can aid in the evacuation of milia.

Chemical peels: Alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs) can be used in mild chemical peels to remove dead skin cells and encourage new skin growth.

Cryotherapy: Freezing the moles with liquid nitrogen can force them to die in some cases.

Laser therapy: Milia can sometimes be removed with lasers, especially if they are deeply embedded.

It is important to keep in mind that trying to squeeze or pop milia at home can damage the skin, so it should not be attempted. A dermatologist should be consulted for proper diagnosis and treatment.

Pharmacotherapy of milia

No doubt! Regarding the pharmacotherapy (medical treatment) of milia, there are a few approaches that health care professionals may consider, especially for stable or remote cases. For a closer look at pharmaceutical options, consider the following:

1. Mechanism of action of topical retinoids: By stimulating skin cell turnover and exfoliation, topical retinoids such as tretinoin (Retin-A), adapalene (Differin), and tazarotene (Tazorac) are effective. The formation of milia can be reduced and the pores can be opened with it.

Application: A thin layer of retinoid cream or gel is applied directly to the affected areas once a day, usually at night.

Precautions: Some people may experience skin irritation, dryness, or increased sensitivity to sunlight after several weeks of treatment. When using retinoids, it is important to wear sun protection.

2. Mechanism of Topical Alpha Hydroxy Acids (AHAs): AHAs, for example, glycolic corrosive and lactic corrosive, are exfoliating agents that help remove dead skin cells and promote skin recharging.

Application: Skin care products such as serums, creams, and peels often contain AHAs. They are applied to the skin once daily or topically.

Precautions: Initial stinging, redness, or mild irritation may be caused by AHAs. Use them with caution if you have sensitive skin.

3. Effective steroids

Instrument: Effective corticosteroids, such as hydrocortisone, may be indicated for incendiary milia or when milia are associated with specific skin conditions such as hypersensitivity reactions or dermatitis.

Application: These are usually applied sparingly to the affected area once or twice daily, as directed by a healthcare provider.

Precautions: Due to the potential for thinning of the skin and other side effects, long-term use of topical steroids on the face should be closely monitored. Generally, they are used for a short period of time under medical supervision.

4. Mechanism of action of keratolytic agents: Keratin buildup in milia can be facilitated by keratolytics such as salicylic acid.

Application: Acne treatments and wart removers, for example, often contain these ingredients. They should be used as directed, usually once a day.

Precautions: Keratolytics can dry or irritate the skin, especially if they are used excessively or on sensitive skin.

5. Oral Retinoids (Isotretinoin) Procedure: When milia are associated with underlying skin conditions such as acne, oral retinoids such as isotretinoin (Accutane) may be considered in severe or resistant cases.

Administration: These medications are taken orally as recommended by a dermatologist. They regulate sebum production and skin cell turnover in a systematic manner.

Precautions: Because of their potency, oral retinoids may cause dry skin and mucous membranes, increased sensitivity to sunlight, and, in rare cases, more serious systemic effects. They require close observation by a medical care provider.

Tips for preventing milia 

         Although they cannot be completely prevented, the following can help reduce their incidence.

Skin Care: Use gentle skin care products that are not pore-clogging or comedogenic.

Avoid heavy makeup: To reduce the chances of pore clogging, use light and oil-free cosmetics. as we know that there are many harmful chemicals used in the fairness creams.

Sunscreen: Apply sunscreen regularly to protect your skin from sunburn, which can cause milia.

Hydration: Keep your skin hydrated by drinking plenty of water.

Avoid stress: Be careful when using harsh skin care products or procedures that can damage the skin barrier.

Conclusion

Finally, milia are common, usually harmless, and they usually go away on their own without the need for treatment. In any case, persistent or bothersome milia can really be dealt with by a dermatologist through various strategies such as extractions, skin medications, or laser treatments. Milia can be managed and skin health can be maintained by knowing the causes and preventive measures.

Pharmacotherapy for milia focuses primarily on stimulating skin exfoliation, reducing keratin buildup, and addressing underlying causes such as excessive oil production or inflammation. In mild cases, over-the-counter options such as AHAs and keratolytics may be helpful. However, for more severe or persistent milia, prescription treatments such as topical retinoids or, in rare cases, oral retinoids may be necessary. It is important to consult a dermatologist for an accurate diagnosis and customized treatment plan based on your skin type and severity of the condition.

It is recommended that you consult a healthcare professional for proper diagnosis and treatment of milia if you are concerned about the condition or notice any unusual skin changes.