What should you know about facial milia removal?

Milia are firm, tiny cysts formed when keratin becomes trapped beneath the skin surface. They commonly appear around the eyes, cheeks or forehead and are different from inflamed acne. A clinician can distinguish them from whiteheads, other skin bumps and lesions that need a different approach.

Some milia settle without treatment, while others remain and bother a person because of their position or appearance. Diagnosis is usually made by looking at the skin. Trying to pierce or squeeze one can cause inflammation, infection or a lasting mark, especially on thin eyelid skin.

A dermatologist may use a sterile instrument to make a tiny opening and lift out the contents. For selected or recurrent lesions, curettage and cautery or another office treatment may be considered. Topical retinoids can sometimes be useful when several bumps recur, but they may irritate the skin and are not suitable for everyone.

Use gentle cleansing and non-scratching skincare. Keep active products away from the eyes unless prescribed there, and ask whether a rich occlusive cream or an irritating product could be contributing. Follow the aftercare instructions and use sun protection while a treated area heals.

Arrange a skin assessment if a bump bleeds, grows, changes colour, becomes painful, develops crusting or does not resemble your previous milia. Seek prompt care for spreading redness, warmth, pus or swelling after an attempted removal. Any lesion close to the eye that affects vision or causes marked swelling needs urgent attention.

Ask whether the bump is definitely milia, whether it can be left alone, which removal method suits its location, what irritation to expect, and whether a retinoid is appropriate for your skin and circumstances.