MILIA WHITEHEADS Treatment Guide
WHAT CAUSES MILIA?
Milia occur when dead skin cells clump together and get trapped under the skin’s surface, forming small, hard cysts. It’s estimated that nearly 50% of infants in the United States get milia, in part because their young skin is still “learning” to exfoliate. As their skin matures, the milia will disappear on their own, no treatment necessary. Doctors don’t consider infant milia a problem, and rarely prescribe treatment for it. Parents may fnd the bumps unsightly, but the baby isn’t bothered by them, and they have no impact on the
Adults can get two forms of milia, most often seen on the cheeks and forehead: primary and secondary. Primary is the same type seen in babies, caused by skin cells that build up in the pore lining because they just didn’t shed properly. Secondary milia occur when a skin condition or infection (such as herpes) that leads to blistering actually damages the pore lining. Burns or severe rashes can increase the number of skin cells trapped under the skin’s surface, resulting in milia that form even after the trigger has faded.
Sun damage is a contributing factor to milia because it makes skin rough and leathery, so it’s more dificult for dead cells to rise to the skin’s surface and shed normally. Clogs will ensure milia show up, and as mentioned they tend to stick around.
Many people believe heavy moisturizers, foundations, or makeup in general are responsible for the problem, but that’s highly unlikely. Given that 50% of all babies get milia, and men do as well, it clearly isn’t related to skincare or makeup products.Of course, if you’re still concerned, you can experiment with changing your product selection or application method to see what works for you.
Because milia often go away on their own without treatment, being patient and waiting it out is an option—but waiting is defnitely not for everyone!
Because milia form when the skin’s natural exfoliation process malfunctions, using a targeted exfoliating treatment with salicylic acid on a regular basis will immediately improve exfoliation. It may also allow the bump to dissolve on its own (relatively quickly, too) and prevent new ones from forming.
If using a leave-on BHA exfoliant doesn’t help, then you might consider seeing a dermatologist who can tell you which type of milia you have and perhaps even remove them right there in the ofce. Using a needle or a tiny lancing utensil, a dermatologist can easily remove the milia, leaving very little damage to skin and ensuring a fast healing time.
SKINCARE FOR TREATING MILIA
Although there’s not much you can do to prevent milia, maintaining a suitable skincare routine certainly helps minimize the chance of them appearing. Because deeper or larger milia can be caused by sun damage, always use a daytime moisturizer with SPF 30 or greater to protect your skin every day.
This will give those annoying white bumps less of a reason to set up shop
on your face!
Milia are a real pain to put up with, but there are things you can do to treat these white bumps. Remember: Patience, daily exfoliation, sun protection, and resisting the temptation to (literally) take matters into your own hands (unless you follow our suggestions) can go a long way toward having clearer, bump-free skin sooner!
REMOVING MILIA AT HOME
Removing milia at home is not for the faint of heart, or for those who tend to be overly aggressive with their skin. It also isn’t something we encourage, but knowing that some of you will try it anyway, we fgured we might as well explain how to do it the right way. Removing milia yourself is not like “popping” a pimple.Popping a pimple the right way (emphasis on the right way) not only gets rid of the unsightly red swelling and white sac, but also reduces the inﬂammation by releasing the pressure inside, and speeds up healing.
Milia are not pimples; in fact, in many ways they are completely unrelated. Unlike pimples, which for the most part can release somewhat easily on their own, milia actually need to be excised and that is more risky to your skin than popping a pimple, which is why doing it the right way is even more important.
There is only minimal beneft to be gained from removing milia, other than the aesthetics, of course. If aesthetics is important to you, we understand why you want to remove milia, and, just as with pimples, it’s not always realistic to see a physician every time you get one. So, for those of you who aren’t going to spend the money to see a physician to remove milia and are determined to do it yourself, here are the steps you need to take to do it the right way and minimize the risk to skin.
One important caveat: Our strong warning is that if you have many milia all at the same time, as opposed to just one or two that occur intermittently, don’t even begin to do it yourself; it is best to see a physician. The risk of trying to remove lots of them all at once by yourself is just too great. Again, you really could make a mess of things.
Excise means you need to make a tiny tear in skin, directly on top of or near the milia, and then literally lift it out of skin with tweezers or use a comedone extractor with only slight pressure. Here are the steps to follow:
» Make sure you have on hand a sharp needle, very pointed tweezers (ﬂat-ended tweezers will not work!), and/or a comedone extractor. You can buy a comedone extractor from Paula’s Choice or at Sephora. Here’s what it looks like:
» Cleanse your face with a gentle water-soluble cleanser. Use tepid to warm water (not hot or cold, both of which are damaging to skin).
» Before rinsing, lightly massage skin with a soft, wet washcloth or a Clarisonic to remove dead skin cells from the surface to make excision and removing the milia easier. Do NOT over-scrub because that can damage your skin even before you’ve started.
» Dry skin gently. Do not do anything before you’ve dried your skin because skin is more vulnerable to tearing and creating a scab when it is wet.
» Rub the pointed needle, tweezers, and/or comedone extractor with alcohol to prevent infection.
» Then, gently, with either the needle or tweezers, make the teeniest tear in skin, either on top of the milia or right next to it. That should give you enough access to remove the milia.
» If you’ve made the teeny tear next to the milia, then, with very little pressure, use the comedone extractor to gently (and we mean really gently) coax the milia out through the small opening. If you’ve made the teeny tear on top of the milia, use the tweezers to lift it out. That should release the contents.
» Do NOT repeat this process over the same bump more than once or you will damage your skin, so be very, very careful, and go slowly.
» Remember to be gentle and make the teeniest possible tear in skin; the goal is to remove the whitehead without creating a scab or damaging the surrounding skin (scabs are not any better to look at than milia).
» When you’re done, use a cotton swab with hydrogen peroxide or alcohol to disinfect the area. This is the only time we will ever recommend using either of those two skin damaging products on your face (hydrogen peroxide generates free-radical damage and alcohol causes inﬂammation).
» You can then follow up with your usual skincare routine.
RECOMMENDED PRODUCTS FOR MILIA:
Other than a skincare routine that’s best for your skin type and other concerns, as we explain in previous posts, treating milia is really about adding a more potent salicylic acid exfoliant to your routine and using it as a spot treatment. Unfortunately, the list of products that stand a good chance of reducing and potentially eliminating milia is very short, largely because milia are unresponsive to most skincare products.
In our experience, and the experience of others who’ve tried these products, we believe they are among the best options. Once you get your milia under control, you can use other types of exfoliants mentioned before. Of course, daily sun protection and treating skin gently remain vitally important, but that’s true for everyone!