Tinea

Who is at risk?

• Milia can occur in men and women of all ages and of any ethnicity.
• Milia often occurs in newborn babies.
• However, it also occurs in people of any age.
• In infants, these appear as tiny, firm and pale bumps on the cheeks or around the nose and eyes. 50% of all infants are at risk of developing milia.
• Adults develop milia on the face as well, especially on the area surrounding their eyes. The arms and hands are susceptible as well.
• Especially in the case of older patients as their skin faces more exposure to the sun.
• Even individuals that use heavy makeup are at risk.

Causes of Milia

1. Comedogenic or pore-clogging skincare products: They prevent the skin from naturally exfoliating.
2. Sun damage: It is a major contributor to milia. This is because it thickens the epidermis. Thus, it becomes more difficult for skin cells to find their way out of the glands.
3. Certain skin diseases: particularly blistering disorders such as Porphyria Cutanea Tarda may be a causative factor.
4. Genetic predisposition
5. Overconsumption of dairy

Types of Milia

There are different types of milia:

• Neonatal milia:

This type is seen in young babies. They are quite common. One sees this type of milia around the nose area. It may also occur on the scalp, cheeks, upper body and inside the mouth.

• Primary milia:

This type of milia can occur in both adults and children.

• Secondary milia:

These occur usually as a result of injury to the skin in form of burn, cut, blister etc.

• Milia en plaque:

This type of milia is extremely rare. It usually develops on a raised and inflamed patch of skin known as a plaque. This plaque may be several centimetres across. Milia en plaque generally occurs behind the ears, on the eyelids, the cheeks or jaw area. Middle-aged women have a higher tendency to develop this type of milia.

• Multiple eruptive milia:

The milia appear in patches that develop over a period of weeks or months. The patches usually appear on the face, the upper arms and the upper trunk. Milia of this type are also extremely rare.

Treatments for Milia

Since milia normally clear by themselves. They usually do not need any treatment. However, some people find milia unsightly. Therefore, they may want to treat it to improve cosmetic appearance. One shouldn't squeeze Milia. This could result in skin damage, scarring or infection. 

Here are some of the treatments for Milia: 

• Topical applications:

Topical applications such as retinol and retinoid creams may be prescribed by the doctor. Retinol creams cause less irritation to the skin. However, they are less effective than retinoid creams. Retinoic acid is the active ingredient responsible for exfoliation. These creams increase susceptibility to sun damage. Therefore, one must use them either at night or with a sunblock (SPF>30). 

• Minocycline:

This is an oral antibiotic. One uses it to treat certain types of milia, such as milia en plaque.

• Exfoliation:

Exfoliation removes the dead skin cells, unclogs pores and promotes cell turnover. Therefore, this keeps the skin smooth and thin. Moreover, this helps to remove milia and prevents them from recurring. In fact, dermatologists may prescribe products that contain retinol and alpha hydroxy acids (AHA). Glycolic acid is the most common AHA. They improve the skin's general condition, texture and tone. Chemical peels can also effectively exfoliate milia. 

• Extraction: 

Extraction is a quicker solution than exfoliation. Dermatologists do a manual extraction with a sterile needle and comedone extractor or tweezer. In factm they combine it with cryotherapy sometimes. Moreover, it is important for a dermatologist to do this procedure. This helps prevent scarring & hyperpigmentation. 

• Microdermabrasion: 

Microdermabrasion is a process in which a device abrades the top layers of skin. This method gently sloughs off the offending layer of skin, releasing clogged oil. Therefore, this encourages cysts to pop out & promotes cell rejuvenation and creates new, flawless skin. 

• Electrolysis:

This is a painless, non-invasive procedure in which a fine probe sends a current into the milia. In fact, this breaks down the fatty tissue or keratin build-up so that it can be reabsorbed into the skin. It is a quick and easy procedure. However, only a dermatologist should conduct it. It is effective for permanent milia removal. 

• Laser therapy:

Laser therapy breaks down the fatty tissue and allows it to be reabsorbed into the skin using an intense beam of focused light.

• Cryotherapy:

In this treatment, dermatologists freeze the milia off with liquid nitrogen. This may cause blistering or swelling. However, this should disappear within a few days.

• De-roofing:

In this treatment, dermatologists use a sterile needle or blade to remove the milia. Moreover, a dermatologist must do this procedure. 

• Curettage:

In this treatment, dermatologists numb the area of milia. Then, they scrap or scoop off the milia. After this, they seal the skin with a hot wire.