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Laser Ablation Of Milia
What Is A Milium Cyst?
What Is A Milium Cyst?

A milium cyst is a small white bump that typically appears on the nose and cheeks. These cysts are often found in groups and are called "milia". The milia cysts occur when keratin gets trapped beneath the skin's surface. Keratin is a strong protein that is typically found in skin tissues, hair and nail cells.

What Causes Milia?
What Causes Milia?

Milia is often mistaken for baby acne, which is trigerred by hormones from the mother.

Unlike baby acne, milia does not cause inflammation (swelling). Infants are born with milia while baby acne does not appear for a few weeks after birth.

In older children and adults, milia are typically associated with some kind of skin damage, such as:

  • blistering due to a skin condition
  • burns
  • blistering injuries, e.g. due to poison ivy
  • long term use of steroids
  • long term sun damage
What Are The Different Types Of Milia Existing?

There are different types of milia which are classified as per age of occurence or injury causing the cysts to develop.

  • Neonatal Milia: these develop in newborns and heal within a few weeks. The cysts are typically seen on the face, scalp and upper torso. Neonatal milia occurs in around 40 % of newborn babies. 
  • Juvenile Milia: these are caused by genetic disorders, which include the following: 
    • nevoid basal cell carcinoma syndrome
    • pachyonychia congenita
    • Gardner's syndrome
    • Bazex-Dupré-Christol Syndrome
  • Primary Milia In Children & Adults: these are caused by keratin trapped beneath the skin surface. Such milia cysts can be found around the eyelids, forehead and on the genitalia, and may disappear in a few weeks or last several months.
  • Milia En Plaque: these are commonly associated with genetic or auto-immune skin disorders, such as discoid lupus or lichen planus. Milia en plaque can affect the eyelids, ears, cheeks or jaw. The cysts can be several cm in diameter. This condition is primarily seen in middle-aged women, but it can occur in children and adults of all genders and ages.
  • Multiple Eruptive Milia: these consist of itchy areas appearing on the face, upper arms, and torso. The cysts often appear over a span of time ranging from a few weks toa few months. 
  • Traumatic Milia: these cysts occur where injury to the skin has occurred, e.g. in areas of severe burns and rashes. The traumatic milia can become irritated, making them red along the edges and white in the center.
  • Milia Associated With Drugs: the use of steroid creams can lead to milia on the skin where the cream has been regularly applied. However, such side effects from topical medications are rather rare.

Laser Ablation Of Milia

The most promising and most effective method of treatment today is laser ablation of milia where a focused high power laser beam is used to destroy the cysts.

Other less effective treatment methods include the following:

  1. medications - topical retinoids, creams that contain vitamin A compounds
  2. chemical peels
  3. deroofing - using a sterile needle to pick out the contents of the milia cysts
  4. destruction curettage - surgical scraping and cauterization for milia cysts destruction
  5. cryotherapy - freezing to destroy the cysts
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