Milia: How to treat those pesky white bumps on your face

There isn’t ever a good time to pick or pop those pimples that always seem to pop up prominently on your forehead and nose, but if your well-intentioned fiddling isn’t making them budge either, there is a good chance that there are deeper skincare issues at play. Those spots could be milia, which are tiny white bumps that you need to be vigilant about. While we’ve all got the usual drill about acne, blackheads and whiteheads down pat, milia doesn’t play by the usual rules, and even a conscientious skincare routine won’t make them disappear overnight. The road to recovery starts with an informed diagnosis, which is why we brought in the top dermatologists to help you decode the whats, whys and hows of milia. Here’s what we learned.

What is milia and why is it caused?

“Milia are white, painless bumps that can commonly be seen on the cheeks, nose, under the eyes, and sometimes, on other parts of the face too. These can usually occur anytime across different age groups, from babies to adults, and are generally painless and asymptomatic. While there isn’t any one decisive catalyst, certain trigger factors include sun exposure, environmental damage, usage of certain cosmetics and makeup products,” explains Mumbai-based dermatologist Dr Madhuri Agarwal. “Milia are basically a collection of keratin inside a cyst or a closed space arising from within the skin. Keratin is produced in our skin and gradually travels up to the surface layers. At times, when it gets stuck in between, it forms a cyst,” she says. Celebrity dermatologist Dr Rashmi Shetty further adds, “It can be formed due to excessive sweat and sebum that gets clogged in the skin, which is especially common if you live in a city where the ambient weather contains high levels of humidity.”

What is the difference between milia and ordinary zits?

Dr Agarwal elaborates, “Milia is a solid, closed cyst that doesn’t ooze pus or oily secretions when popped. The major difference is that zits are open on the surface of skin and can be manipulated, but milia is within the skin and not connected to the surface, so no amount of fiddling or popping will make any impact.”

What are the skincare precautions to be observed with milia?

“It is important that you do not attempt to remove the milia. Avoid picking or popping it, and stay away from home remedies, especially those that involve lemon or acidic ingredients as this may lead to allergic reactions, infection of the milia and scarring,” she says. Dr Shetty further adds, “A cooling pack is sometimes used to reduce the temperature of the inflamed skin. It is essential to avoid touching or aggravating the infected skin. However, bear in mind that this doesn’t give you a hall pass from your everyday skincare routine. Cleansing with a good face wash is essential, so ensure that you get one recommended by your dermatologist for your specific skin type.”

What are the options for treating milia?

“Milia usually clear up on their own with time, but for stubborn cases, it is advisable to visit a dermatologist who will treat it by breaking open the milia with a sterile needle. In case you are anxious, a numbing cream is applied before the removal is done. If the milia is bigger in diameter, it can also be removed with electrocautery, which may cause scabs for five to seven days before the skin goes back to normal. It is essential to remember there is no permanent cure for milia, so new ones may recur again. Use a good sunscreen and keep your skin healthy with treatments, such as medifacials and peels, to minimise the recurrence,” Dr Agarwal advises.

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