A tiny white ball on the face is characteristic of a milia.

MILIA

A milia is a tiny epidermal inclusion cyst. It is very common on the faces of women--but not so much men.

Clinical

The classic milia present as 1-2 mm white dots on the face--usually of a woman. Some patients may have multiple lesions, particularly about the eyes. Milia may occur virtually anywhere and are not uncommonly seen in recent scars. Milia en plaque is the presence of multiple grouped milia within an erythematous plaque.

Treatment

• Solitary lesions on the face are easily popped out with a large, e.g., 19 gauge, needle.
• Sometimes the blunt side if a curette is helpful after the mini incision.
• Some tell women not to scrub.
  
• A retinoid, e.g. tretinoin QHS is thought to prevent.

Milia may be ignored and will often "pop out" after several months. Some however, may last for years. They may be simply removed by the use of a 19 gauge needle. After cleansing the area with alcohol, the needle is inserted just under the lesion. Small movements to either side and then directly up usually loosen the milium. The blunt end of a curette is helpful in fully removing the lesion. Aluminum chloride may then be applied to stop the bleeding.

Additional Photographs

Multiple milia

A milia in a healed scar after a big tear on the arm.

RegionalDerm

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