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General Practice 2023

Milium on the skin: what é, symptoms and how to remove

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Milium on the skin: what é, symptoms and how to remove
Milium on the skin: what é, symptoms and how to remove

Sebaceous milium, also called milia, or simply milium, is a skin disorder in which small white or yellowish keratin cysts or papules appear, affecting the most superficial layer of the skin. This change can be caused by excessive sun exposure, use of petroleum-based skin care products, or can appear in babies due to heat.

Generally, milium appears in the regions of the face, such as the nose, eyes, cheeks and behind the ear, but it can appear on the neck, hands, back and, in rarer cases, on the scalp, inside the mouth and in the private parts. Millium papules can be itchy, however in most cases they do not cause other symptoms or other he alth problems.

To confirm the diagnosis, exclude the possibility of another type of lesion, caused by allergies for example, and to remove milium cysts, it is important to consult a dermatologist, as it is the most suitable for puncturing papules and indicate the most appropriate treatment.


Main signs and symptoms

Milium is a type of skin change in which it is possible to see papules, popularly known as polka dots, which may or may not itch and have the following characteristics:

  • Like a cyst;
  • Size between 1 to 3 mm;
  • Transparent or yellowish.

These papules are filled with a gelatinous liquid, called keratin, which is a natural protein of the skin, and appear mainly on the nose, forehead, cheeks, eyelids or behind the ear, and may appear in some cases in the genital and on the roof of the mouth.

Possible causes

The causes of milium are not yet fully known, but it is believed that it arises due to a degeneration of the elastic fibers of the skin and the cells that produce keratin caused by excessive exposure to the sun's ultraviolet rays. In newborn babies, milium is a very common condition that can appear at birth or because of heat, in which case the papules tend to disappear on their own.

Some types of milium can appear on the skin because of burns that form blisters, use of ointments with substances such as hydroquinone, corticosteroids and petroleum, and other associated diseases such as pemphigus, porphyria, lupus erythematosus and lichen planus. Learn more about what lichen planus is and what its symptoms are.

What are the types

There are some types of milium that change according to the causes and location of the papules, which can be:

  • Milium neonatal: appears in approximately half of newborn babies, it is characterized by very small cysts on the skin, which disappear over the days and appear on the nose, cheeks and even inside the mouth;
  • Primary milium: occurs in adults, and small papules can be seen around the eyelids, cheeks, forehead and, in rarer cases, in the private parts;
  • Juvenile milium: this type may be associated with Rombo syndrome, basal cell nevus syndrome, Bazex-Dupre-Christol syndrome, paronychia, Gardner syndrome, and other genetic disorders;
  • Milium plaque: it happens when several milium cysts appear in the same place, forming an inflamed plaque on the skin, being found behind the ear or on the cheek;
  • Traumatic milium: this is when milium papules appear on the part of the skin that is healing or when there are blisters caused by burns;

In addition, prolonged use of skin care products such as creams, ointments and makeup based on petroleum, lanolin, corticosteroids and hydroquinone can lead to the appearance of the type of milium known as substance use-associated milium.

Baby with neonatal milium
Baby with neonatal milium

Baby with neonatal milium

What to do to remove

To remove the papules caused by milium, it is important to consult a dermatologist, as he is the recommended professional to perform the removal with needles and who may indicate other treatment methods, which can be:

1. Cleansing the skin

The best way to remove milium from the skin, which are small and in small amounts, is to do a deep skin cleaning with the help of a beautician, as this will naturally cause the papules to burst and be eliminated. It is not recommended to try to remove milium cysts as if they were pimples or blackheads or with a needle at home, due to the risk of cuts, wounds and infection, which can worsen skin lesions.

Day care should also be maintained, such as cleaning the skin with warm water and anti-oil soap, using tonic and moisturizing lotions, in addition to applying sunscreen daily, as these measures can help reduce milium and prevent to increase. Learn more about how to take care of your skin daily according to type.

2. Ointments and Medicines

The doctor may recommend the use of antibiotic ointments, such as Nebacetin, if together with milium you have any skin infection, but ointments based on retinoids or retinoic acid may be indicated to eliminate milium cysts. See other indications for the use of tiroic acid.

Medicines are rarely prescribed for the treatment of milium, however, some types of antibiotics, such as minocycline, are indicated by the doctor only in situations where the skin lesions cause very large infections, leading to redness and swelling in the skin of the face, for example. In some cases, the doctor may still recommend laser treatments or cryotherapy.

What is the treatment of milium in babies

White milium dots are also common in newborn babies, due to fat retention in the skin layer, but they disappear within a few days, without the need for any specific treatment.

In babies, milium grains, as they are also known, usually appear in the summer or on very hot days in the first few weeks of the baby's life, or during an episode of fever. As sweat cannot pass through these pores, areas of the skin, such as the nose and cheeks, can appear blistered, filled with fluid, and easily ruptured.

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