Treating and getting rid of milia(also known as white bumps that won’t pop) is not as straightforward as one would think it is. It takes some time, patience, consistency, and using the right products to treat it.
In this post, we are going to talk about what is milia, the causes, and treatment of milia, what products to use, when to see a dermatologist, as well as how to prevent milia from reappearing.
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You can treat milia at home but you can also go to a dermatologist or aesthetician to get it removed from your face or body.
Milia needs to be treated differently from whiteheads and blackheads and can also be removed differently. Squeezing milia will only irritate your skin, the cyst won’t pop up.
What is milia?
Milia are tiny cists (little bumps) under the surface of the skin that won’t pop if you try to squeeze them.
Milia actually is comprised of protein-filled with keratin. The white bumps appear when the dead skin cells get trapped under the skin. Milia is non-inflammatory and can appear not only on the face but also on the scalp or your neck even though they rarely appear somewhere else other than the face.
What causes milia?
Milia in adults is caused by several factors:
- Occlusive skincare
Petrolatum and Mineral Oil products can cause milia especially if added to the eyes area. Now, these ingredients in themselves are not bad, not at all, but they can cause milia because they are occlusive and sit on the surface of the skin, not letting it breathe enough. People with dry skin might not have an issue with this, but oily and combination skin people might be more prone to getting it. The issue is what these ingredients do to the skin, not the ingredients in themselves. And yes, for those wondering, SLUGGING can cause milia because it’s usually done with occlusives. For example, for people with oily skin slugging with olive oil might cause milia and breakouts. That happens because olive oil is high in oleic acid and oils higher in oleic acid have a higher chance of causing clogged pores because they are thicker and heavier on the skin.
Slugging with Rosehip Seed Oil might be better for oily skin because it’s an oil higher in linoleic acid. Rosehip seed oil is lightweight and fast-absorbing making it better but this doesn’t mean it won’t still cause breakouts.
- Lack of exfoliation
Lack of exfoliation or not exfoliating enough can cause milia for some people –our skin naturally exfoliates but with time this process might get slower and we need to help it.
- Genetics
Sometimes this happens because of genetics or because of your skin type – but genetics have an influence only in the secondary milia, described below, not the normal one.
- Sun Damage
Excessive sun damage can be a factor in the apparition of milia.
There are two types of milia:
Primary milia appear when keratin buildup of dead skin cells get trapped under the surface of your skin, and the skin can’t regenerate.
Secondary milia can appear from some type of trauma or blistering diseases (like herpes), or some laser treatments.
Usually, milia appears under or close to your eyes or on your checks, but milia can appear on eyelids as well or on the nose, or even in your hair.
Can you safely remove milia at home?
I don’t consider home removal of milia safe if you are using a needle. Even more, if you have it on your eyelids or under-eye area, where the skin is very sensitive. If you go to a professional, they will get it cleaned for you:
- They will have to make sure that everything is sterile – your extractor will get sanitized and they will open you a sterile needle
- They will you cleanse your face
- Will put your face in a steam bath
- Then they will make a tiny incision with a needle
- With an extractor or with tweezers they will remove milia completely
- In the end, they will apply some antiseptic to your incision so that it won’t get inflamed.
My opinion is if you don’t have the money for a dermatologist, try to go to an aesthetician in your area, most probably they are more skilled in doing this than you are.
Unless you are a dermatologist or an aesthetician, I wouldn’t recommend you to try removing it yourself.
That being said, there are ways for you to treat your milia at home, but it will take some time for it to completely be treated.
Treatments for milia
As I’ve said before, if you want to remove milia with a needle or extraction tools I wouldn’t suggest you do it yourself, especially if it’s close to the eye area. It could lead to skin scarring and damage, so best to leave it to the pros with extraction tools.
You can remove milia at home even without extraction tools, it will just take a little more time to get rid of milia completely. There are certain products that can help you get rid of milia altogether, as it was in my case. Of course, if you don’t follow the prevention tips that I will describe below there is a huge chance of milia appearing again.
The best products that I have found out to be game-changers when it comes to getting rid of milia at home are:
Cleansers
You should cleanse your face every night. I would actually say to double cleanse with micellar water or an oil-based cleanser and then follow-up with a gentle cleanser like Cetaphil Daily Facial Cleanser. Once or twice a week I would recommend you go in with a cleanser with salicylic acid like Cerave Renewing SA Cleanser. Cerave SA Cleanser is a great face wash for milia-prone skin.
If your skin is really oily you could probably use the salicylic acid wash even more often. When you go in with the second cleanse it’s better if you try to remove all dead skin cells and cleanse your face deeper and better using a cleansing brush. You can do this with something like a silicone cleansing brush if you are on a budget or a cleansing tool from PMD Clean if you have more money to splurge and you want a better cleansing device with more functionalities.
Exfoliators
You should exfoliate at least two times a week with an AHAs exfoliator. Exfoliation is a must if you want to get rid of milia. It is best to start having a habit of regularly exfoliating your skin. In my experience, exfoliators with Alpha Hydroxy Acids perform better for milia than those with Beta Hydroxy Acids like salicylic acid. An Alpha Hydroxy Acid exfoliator will help in removing the dead skin cells on the surface of the skin and clearing the pores.
Lactic Acid has a larger molecule than Glycolic Acid, which means it won’t penetrate the skin as deep, but it also will not sensitize it as much as Glycolic Acid. If you are new to acids, go first with a Lactic Acid exfoliator.
If after several weeks this won’t get the desired results or at least improve the appearance of the milia, you could go in with a Glycolic Acid one. Start with a small percentage of glycolic acid in the exfoliator like in Pixi Glow Tonic with Aloe Vera & Ginseng and increase to a 7% like in The Ordinary Glycolic Acid 7% Toning Solution. I personally consider The Ordinary Glycolic Acid the best AHA cleanser for milia.
Make sure at the beginning you start off with a small concentration one. You could start up with exfoliating once a week for a few weeks and then gradually increase the number of exfoliations per week. After your skin gets accustomed to exfoliants you can also increase the percentage of the active ingredient for better results.
Be careful to not over-exfoliate your skin, as it will damage your skin barrier causing other skin concerns. You should try to exfoliate at most 4 times a week. But this number might be too high for some people, like sensitive people or people with dry skin.
- I recommend only exfoliate your face in the evening, at night it will do a better job of trying to repair itself.
- A very important aspect to keep in mind is to not use your exfoliating acids in the same skincare routine as your retinol or other derivatives. Getting to do this without sensitizing your skin will take at least a few months to a year. So, it’s better to just not do it. Use your exfoliation acids and at the nights you are not using them, you can use your vitamin A derivatives.
- Do not use exfoliating products very close to the eyes as it might irritate them or worse.
Retinol and Vitamin A derivatives
Retinol and Retin-A derivatives are a game-changer when it comes to removing milia.
If you have milia in the eyes area, the best way to remove it is using a retinol-based eye cream to help the process of regeneration of the skin in that area. The eyelids( and in general, eye area) are very sensitive and the skin is not that thick there. That’s why I would highly recommend you use an eye cream with retinol or at least a retinol that was also tested for the sensitive eye area. Going so close to the eyes with a regular, normal retinoid cream might cause irritation. Tretinoin should never get very close to the eye because it’s very potent.
What I used and liked in treating milia is Paula’s Choice Barrier Repair Moisturizer with Retinol. It’s light, for normal to dry skin people and it’s also recommended on their website to be used also on the eye area. You can check up on their site as well, what I like about Paula’s Choice is that they will inform you if you can use a product in the eye area. This product is the best exfoliating moisturizer for milia for any skin type. Any product with retinol should help in getting rid of milia.
Do not use Retinoids or Exfoliants if you are pregnant. Always check this with your doctor first.
It’s very important to only use retinoids at night and ALWAYS use sunscreen during the day as it sensitizes your skin.
Niacinamide
Another important aspect in a skincare routine for treating milia is using a niacinamide cream. This cream should be used on the nights when you are using exfoliating products. That means, when you use an exfoliating toner you will follow up with a niacinamide-based product. Niacinamide, also known as Vitamin B3 helps regulate sebum production and helps your skin restore its barrier.
Daily sunscreen use
When you are using retinol products and chemical exfoliants with AHAs and BHAs, make sure you use a sunscreen with a broad-spectrum SPF level of at least 30. If you spend a lot of your time in the sun, then a 50 SPF level sun protection cream is a must.
If you want to know more about why you should use sunscreen daily and the best sunscreen recommendations for your skin then check my post. It will also explain the types of sunscreens, why mineral sunscreens are better, and what is the one ingredient in sunscreen you should avoid because it was found out to be harmful to you.
How to prevent more milia?
You can keep milia from coming back, you just need to stick to a skincare routine that follows these essential tips:
- Cleanse your face every night with a gentle cleanser and twice a week you can also cleanse it with a cleanser that contains exfoliating ingredients
- Exfoliation with AHAs (Alpha Hydroxy Acids) and BHAs(Beta Hydroxy Acids) at least 1-2 times a week. For AHAs I have found out that products with Lactic Acid and with Glycolic Acid work best. You can check above in the Exfoliators part of Milia Removal Products which are the products I absolutely recommend when dealing with milia.
- Usage of products with Vitamin A derivatives like retinol or tretinoin products work amazing in keeping the skin fresh, exfoliated, and helping it regenerate. You might be able to get rid of milia by only using exfoliants regularly but if not, vitamin A in skincare products is your friend in treating milia. Again, see above my choice of Retinol product, but you can also try others on your own. Any good Retinol-based product should do the trick and help you treat and prevent milia. You can see quicker results with a high-percentage retinol product but it might cause peeling and can sensitize your skin too much.
Does milia go away on its own?
Sometimes, milia can disappear on their own with the skin’s natural cell turnover, but sometimes they don’t, especially if it’s because of a product and you continue using it. Skincare products can cause milia if they are occlusive. That’s why it’s better to always introduce products one of a time and see how your skin reacts to them.
It might still take a while until you get rid of it on its own even if you are no longer doing something to help it appear (I’m talking months maybe). Using the at-home treatment of milia that I suggested above should be enough for most people. If you need to get rid of it ASAP, then a dermatologist or aesthetician is your best choice.
To conclude, you can get rid of milia at home, it just takes time to follow all the steps. Milia is in no way harmful, it’s just an aesthetic nuisance. If you have it on the eyelids, it’s better to go to a dermatologist. Never use exfoliants in the eye area.
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