What should you know about dermatology milia removal?

Milia are tiny, firm, pearly or white cysts formed when keratin becomes trapped beneath the skin’s surface. They commonly appear around the eyes, cheeks, or nose and are different from inflamed acne. A clinician should check an unusual, changing, bleeding, or persistent bump because skin bumps and whiteheads can have other causes. The diagnosis is often made by examining the skin; testing is not usually needed for a typical lesion.

Removal may involve a small sterile opening followed by gentle extraction. Curettage and cautery is another clinician-performed option in selected cases. A topical retinoid may be discussed when milia are recurrent or widespread, but it can irritate delicate skin and should be used exactly as prescribed.

Do not pierce, scrape, or squeeze milia, especially near the eyelids. These actions can cause infection, bleeding, scarring, or prolonged inflammation. Use mild cleanser and non-comedogenic moisturiser, and avoid harsh scrubs. At an appointment, mention sensitive skin, eye-area products, pregnancy or breastfeeding, and any retinoid use. After removal, keep the area clean and follow instructions about ointment, makeup, and sun protection. A new lesion can appear even after an earlier one has been removed.

Arrange a skin assessment if a bump is painful, rapidly enlarging, red, crusted, bleeding, or associated with vision changes. After removal, contact the clinic for increasing pain, spreading redness, pus, fever, or swelling around the eye. Seek urgent care for severe eye pain or a sudden change in vision.

Ask whether the lesion is definitely milia, whether removal is suitable for its location, what aftercare is needed, and whether a topical retinoid could help prevent new lesions. If it is near the eye, ask how the clinician will protect the eyelid and what symptoms require prompt review.