Milia are small benign little cysts that typically appear on the skin of the face and around the eyes. They occur when old cells are not sloughed off and become trapped in the base of a hair or sweat gland on the surface of the skin. I actually have one on my eyelid, a common location.
There are two types of milia: primary, which commonly occur in newborns but can appear in children or adults and secondary milia, that can occur anywhere on the body as a result of a skin trauma such as a burn, blister or other disease. Primary milia are thought to erupt in immature sebaceous (sweat) glands, which is why they are so common in infants. Interesting, milia can also develop on the roof of a newborn’s mouth, called Epstein pearls, which luckily go away on their own.
Why milia form?
Besides in newborns, milia can develop in those who have had episodes of dermatitis such as after a case of poison ivy. People who have been on long term steroid creams may develop milia. Certain blistering diseases such as bullous pemphigoid (an autoimmune disease) or porphyria cutanea tarda (a disease that causes blistering due to a missing enzyme) can cause milia to form. Sometimes milia occur after a laser resurfacing procedure or having dermabrasion. Lastly, milia can develop as the result of chronic sun damage because the skin becomes thickened and resists natural exfoliation; another good reason to wear sunscreen.
In infants, milia that appear at birth will disappear in the early weeks of life without any treatment. In children and adults, milia usually do not go away so easily. However, no treatment is needed unless milia cause skin irritation from being rubbed against or seem unsightly to the individual. The one on my eyelid is far enough up to not get in the way of my putting on eyeliner so I have not looked into having it removed.
Topical creams are not usually successful in getting rid of milia. A dermatologist will instead use a scalpel and make an incision to remove them or he can pierce them with a sterile needle. Anesthetic shouldn’t be needed. It is best to let a doctor do this procedure though, to avoid scarring or infection.