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Notes on Milia

Often misidentified as whiteheads, milia are small, harmless cysts under the skin’s surface that appear as tiny white bumps on the nose, cheeks, forehead, and around the eyes. Unlike whiteheads, which are the result of clogged pores filled with dead skin cells, bacteria and sebum (oil), milia form when keratin – a protein naturally found on the skin’s outermost layer – builds up, hardens and becomes trapped beneath the skin. 

Primary milia, which occurs frequently in newborns as well as adults, is the most common type of milia. It can crop up as if out of nowhere but usually heals itself within a few months. Secondary milia, on the other hand, are the result of skin trauma (such as chemical peels) or infection (such as herpes). This type of milia can be more stubborn. As with all skin conditions, lifestyle factors including diet, excessive sun exposure and lack of sleep can all contribute to the likelihood of developing milia.

While they don’t present any medical concerns or come with any painful side effects, it’s understandably something those experiencing it would want to treat especially if it appears in prominent spots. I’d recommend seeing a dermatologist who can perform in-clinic treatments to manually remove the spots using a comedone extractor, lancing tool or sterile equipment. Word of advice: please don’t squeeze them at home. Not only will this be ineffective, but it can also damage the skin and lead to scarring. Below are a few of my tips for managing milia:

Double cleanse
Use your first cleanse (oil or balm) in the evening to remove leftover makeup, sunscreen and sebum and your second cleanse (gel or milk) to clear out pores.

Exfoliate a few times a week
Use a gentle chemical exfoliator, an AHA or BHA, up to three times a week, taking care to apply directly to the areas of milia. 

Chemical peels
Both professional and at-home chemical peels are a great way to help to reduce the appearance and remove them from the skin. 

Try a low dose of retinol
Retinol speeds up cell turnover, both sloughing away dead skin cells and preventing them from accumulating to begin with.

Use a well-formulated eye treatment
Milia often appears around the eye. The eye area is the only area of the face that doesn’t contain sebaceous glands, which produce sebum that keeps the skin hydrated. There’s also limited blood flow to this area, so it’s prone to clogging. Often our moisturisers are too rich for this delicate skin and can exacerbate skin conditions like milia so it’s key to use cream or serum specifically formulated for the eye area. 

Non-comedogenic products
If you are susceptible to milia I would recommend swapping to oil-free and non-comedogenic products to help prevent the pores from clogging further.

Wear SPF every day!
Milia is more prevalent in those with sun-damaged skin, so be sure to protect yourself from harmful UV rays with the daily application of a broad spectrum SPF50.