Milia on a scar: what to know

A milium is usually a firm, smooth, white or skin-coloured bump. On scarred skin it can appear after an injury, procedure or inflammation has changed the normal shedding of skin cells. It is different from pus, an open wound or a deep infection, although a photo or examination may be needed to tell these apart.

Do not treat every white bump as milia. A group of small bumps can also reflect blocked follicles or another skin condition. A scar that is becoming hot, increasingly painful, swollen or wet needs a different assessment.

Keep the scar clean and moisturised with products that do not sting, and avoid squeezing, piercing or scraping the bump. Picking can reopen fragile skin, introduce bacteria and make the scar more noticeable.

If the bump persists or bothers you, a dermatologist can confirm the diagnosis and choose an approach suited to the scar's age, thickness and location. Options may include careful release of the cyst or a prescribed topical treatment; removal should be performed with clean technique and controlled pressure.

Arrange a clinical review if the bump is changing, bleeding, ulcerating, painful, itchy or multiplying, or if you are unsure whether it is part of the scar. Seek prompt care for spreading redness, warmth, drainage, fever or rapidly increasing tenderness, because these features can signal infection or another problem.

Could this be milia or a change within the scar? Would treatment risk altering the scar colour or texture? Should I use a topical retinoid, and how should it be kept away from broken skin? If removal is suitable, which method gives the gentlest result for this scar?