Milia

Milia are small, keratin-filled cysts that form just under the skin. They differ from pimples or whiteheads because they are non-inflammatory and do not spontaneously drain.

Characteristics include:

• Size and texture: 1–2 mm, firm and slightly raised.
• Colour: White or yellowish due to keratin content.
• Location: Most commonly around the eyes, eyelids, cheeks, forehead, and nose, though they can appear anywhere.
• Persistence: Milia often remain for months unless treated professionally.

Types of milia:

• Primary milia: Form spontaneously in healthy skin, particularly around the eyes.
• Secondary milia: Develop following skin trauma, burns, blisters, long-term steroid use, or heavy cosmetic products.

Milia develop when keratin becomes trapped under the skin’s surface. Key contributing factors include:

1. Skin Trauma:
Burns, rashes, blisters, or dermatological procedures can cause secondary milia, particularly in sensitive areas like around the eyes.

2. Blocked Pores and Occlusive Products:
Heavy creams, petroleum-based ointments, and thick eye products can trap keratin, preventing normal shedding of skin cells.

3. Ageing Skin:
As we age, cell turnover slows, and the skin’s ability to shed dead cells naturally decreases. This increases the risk of keratin entrapment.

4. Sun Damage:
Chronic UV exposure thickens the epidermis, disrupts normal keratinisation, and predisposes to cyst formation.

5. Genetic Predisposition:
Some people are naturally more prone due to skin structure or sebaceous gland activity.

6. Medical Conditions or Medications:
Long-term steroid use, certain skin diseases like epidermolysis bullosa, or prolonged use of heavy topical medications can contribute to milia formation.

Prevention focuses on maintaining healthy skin turnover, gentle care, and avoiding occlusive products:

1. Gentle Cleansing:

• Use non-comedogenic, pH-balanced cleansers to keep pores clear.
• Avoid harsh scrubbing, which can cause micro-trauma and secondary milia.

2. Exfoliation:

• Incorporate chemical exfoliants such as AHAs (glycolic or lactic acid) and BHAs (salicylic acid).
• Promote natural keratin shedding, preventing cyst formation.
• Start with low concentrations to avoid irritation, especially around sensitive areas.

3. Avoid Heavy Products:

• Steer clear of occlusive creams around the eyes or cheeks.
• Opt for lightweight moisturisers or serums that allow the skin to breathe.

4. Sun Protection:

• Daily SPF protects against epidermal thickening and premature ageing, reducing risk of secondary milia.

5. Professional Care:

• Regular consultations with a dermatologist or aesthetic practitioner can catch early milia and prevent clusters.

6. Lifestyle Support:

• Stay hydrated, maintain a balanced diet rich in antioxidants, and avoid smoking to support skin resilience.

Milia can be stubborn, and while they are harmless, professional treatments can remove them safely and reduce recurrence. Here are the main options:

1. Medical-Grade Skincare

Using medical-grade skincare is a foundational step. These products are formulated with higher concentrations of clinically proven ingredients that gently accelerate cell turnover and prevent keratin from becoming trapped.

Key benefits include:

• Promoting natural exfoliation
• Improving skin texture and radiance
• Reducing the likelihood of new milia forming

Best ingredients to look for: retinoids, AHAs, and BHAs. With consistent use, visible improvement can be seen within 4–6 weeks. Downtime is minimal, though some redness may occur with stronger retinoids.

2. Chemical Skin Peels

Superficial chemical peels are highly effective for softening existing milia and enhancing overall skin smoothness. A controlled chemical solution removes the outer layer of skin, encouraging cell regeneration.

Benefits:

• Softens and gradually reduces milia
• Enhances absorption of other skincare products
• Brightens and evens skin tone

Common options:

• Glycolic or lactic acid peels for gentle exfoliation
• Salicylic acid peels for deeper pore cleansing

Peels often require a series of 3–6 treatments for optimal results, with mild redness or peeling for 1–3 days.

3. Microneedling

Microneedling is a minimally invasive procedure where tiny needles create controlled micro-injuries in the skin. This stimulates collagen production and can help release trapped keratin, improving both texture and tone.

Why it works:

• Stimulates collagen and elastin
• Smooths uneven skin texture
• Supports better absorption of active skincare

Ideal for: stubborn clusters of milia and improving overall skin resilience. Some redness may occur for 1–2 days, but downtime is generally minimal.

4. Professional Extraction

For immediate cosmetic improvement, professional extraction is the gold standard. A trained clinician uses sterile tools to safely open and remove the keratin cyst, minimising the risk of scarring or infection.

Benefits:

• Instant visible results
• Reduces risk of future infection
• Can be combined with skincare to prevent recurrence

5. Skin Boosters

Injectable skin boosters hydrate the skin and improve texture, making it less prone to keratin buildup. Soft hyaluronic acid and bioactive ingredients enhance skin elasticity and promote healthy cell turnover.

Ideal for:

• Dry or crepey skin
• Loss of radiance
• Supporting long-term prevention of milia

Results: typically appear within 2–4 weeks, with minor redness or swelling for a day or two.

• Milia are small keratin-filled cysts that are harmless but can be stubborn.
• Prevention relies on maintaining healthy skin turnover, gentle care, and sun protection.
• Medical-grade skincare and chemical peels gradually reduce milia and enhance skin texture.
• Professional extraction provides instant, safe results.
• Skin boosters and microneedling improve skin resilience and reduce recurrence.

Milia are common, benign cysts, but persistent or clustered milia can affect confidence and facial aesthetics. Understanding why they form is the first step to preventing them. Milia develop when keratin becomes trapped beneath the skin due to slow cell turnover, trauma, or heavy skincare products.

Prevention is achievable through gentle cleansing, regular exfoliation, and sun protection, which support healthy skin renewal. When milia do occur, professional treatments such as medical-grade skincare, chemical peels, microneedling, and professional extraction offer safe and effective solutions.

At Dr Hass Clinic, we take a holistic approach, combining professional extraction with advanced skincare and skin boosters to remove milia, improve overall texture, and prevent new cysts from forming, giving natural and long-lasting results.