Milia (singular milium, Latin “millet (grain)”; synonyms: Hautgries; semolina grains; Hautmilien, semolina grains; ICD-10 L72.0) are small white cysts filled with whitish horny beads. They have no overt connection to the skin surface.
Milia are harmless skin lesions. However, they are often perceived as a cosmetic problem.
They occur in young adults, especially women.
Infants can also be affected in the first months of life. They occur mainly on the face, but also on the gums (eruptive milia). Milia usually disappear by themselves in infants.
Spontaneous regression is also possible with secondary milia.
Symptoms – Complaints
Milia are small cysts, only about 1-3 millimeters in size, which appear as white nodules.They are located under the skin. Their consistency is soft.Location:Primary milia are most commonly found on the face, especially under the eyes and on the cheeks. They can occur both sporadically and in groups.However, semolina nodules can also occur on other parts of the body (including the genital area.Secondary milia occur in relation to the localization depending on the primary lesion.
Pathogenesis (disease development) – etiology (causes)
Primary milia develop spontaneously from the interfollicular epidermis, follicles of the vellus hair, also called intermediate hair or intermediate hair, or from excretory ducts of eccrine sweat glands.
Secondary milia result from dermatoses (skin diseases), injuries, burns, or damage from excessive sun exposure.
Diagnosis
Milia are identified by visual diagnosis.
Therapy
Removal in adults should be done as early as possible because milia become progressively more solid.
To remove the milia, the skin is incised with a cannula, for example, and the contents of the cyst are squeezed out. Opening can also be done by laser. The CO2 laser or the erbium Yag laser are used for this purpose.
Alternatively, therapy can be attempted with local retinoids such as 0.05% tretinoin cream.Usually, no scars remain after the removal of the semolina.