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Milia – Care and Prevention

So you have these hard, tiny bumps under your skin and you just can’t seem to get them to go away.  You try to extract them yourself and can’t.  You try a scrub, and it doesn’t work.  Neither do any of your AHA, BHA, or retinol creams.  You’re about to put a needle to your face and cut them out…but, please, don’t do that.

So what are these little buggers and why are they so difficult to extract?

What Are Milia?

A milia (plural, milium) is a bit of keratin (skin cells) and oil stuck under several layers of your epidermis.  The reason you can see it is the same reason you can see a tattoo where the ink is deposited in the dermis. And, like a tattoo, you can’t remove milium manually.

They are often found around the eyes and on the eyelids; although they can appear anywhere on the face and body.

What Causes Milia?

To function optimally our skin needs hydration (water) and moisturization (oil).  The oil mainly comes from our diet in the form of polyunsaturated fatty acids (or Essential Fatty Acids).  We have a bilayer system in our epidermis that holds the water and essential fatty acids.  This bilayer system works with our skin’s barrier to help prevent our skin from drying out too quickly via Trans Epidermal Water Loss, or TEWL.  

Image showing two diagrams of skin. On the left healthy skin cells, on the right are damaged skin cells
Image courtesy Skin Deep Magazine, Spring 2023 issue

Can I Exfoliate Them?

If they are close to the surface, perhaps.  Most of the time they are too deep for any sort of exfoliation.  Scrubs, chemical peels, microdermabrasion, even light laser treatments often won’t touch milia.  They exist under the skin, not in your pores, and they are deeper than they appear to be.

How to Treat Milia

I’ve seen the best results by treating from the inside out (our diet) and the outside in (the products we put on our skin). 

Inside Out:

Ensure you’re getting the right amount of water.  Too much water is just as bad as not enough because you flush out the minerals your body needs to absorb the water you drink. 

Second, ensure you’re consuming healthy fats because your body needs those polyunsaturated fatty acids.

Outside In:

Cleanse: Make sure you’re using a cleanser suited to your skin type.  Get help determining your skin type here.

Gentle exfoliation:  Enzymes are my go-to in this situation because they are gentle.  Make sure you’re gently exfoliating only once per week because too much exfoliation can throw the water/oil content out of balance.

Serum:  I love the Tuel Hydrate serum with two forms of hyaluronic acid.

Moisturizing cream:  Utilize a moisturizer for your skin type.  Even oily skin needs a moisturizing cream to ensure it stays in balance.

Other Causes of Milia

Other reasons for milia include:

  • Eye creams that are contain too much oil and not enough water.
  • Skin that is overly dry due to astringents
  • Damaged skin barrier from chronic excessive exfoliation

Don’t Try This At Home

Don’t try to extract these at home.  First, it likely won’t work.  The bigger issue is you could unintentionally cause scabbing, scarring, or an infection.  If you experience an infection, see your doctor immediately.

Bottom Line

If you’re on the struggle bus with milia, I’m here to help.  Schedule a consultation or New Client facial and we’ll work together to clear your skin.  I’ll customize your treatment and provide you with an easy-to-follow home care routine that won’t take forever and a day to do each night.

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