Symptoms
Milia (from Latin , millet) are small, whitish-yellow, asymptomatic papules 1-3 mm in size. The single or numerous skin lesions often occur on the face, eyelids, and around the eyes, but can occur all over the body. Milia are very common in newborns (up to 50%) and can develop at any age.
Causes
They are noninfectious subepithelial keratin cysts in the epidermis with no connection to the skin surface. Primary milia occur spontaneously with no apparent cause; secondary milia form after skin diseases with blistering (e.g., burns, herpes zoster, dermatitis herpetiformis, bullous pemphigoid, epidermolysis bullosa), other skin diseases, injury, or after drug administration. For a detailed classification, see Berk and Bayliss (2008).
Diagnosis
Diagnosis is made by medical treatment on the basis of the clinical picture. Other skin disorders, such as acne vulgaris, infectious diseases, or warts, must be excluded at diagnosis and possible underlying diseases identified.
Treatment
In newborns, milia disappear on their own within a few weeks and are not treated. In children and adults, they are more likely to persist. Usually, no treatment is necessary because benign milia do not cause complications. Since they can be cosmetically disturbing, they are also opened and drained with a slight incision of a needle or lancet. Other methods, such as laser treatment, are also mentioned in the literature. Medications such as retinoids and tetracyclines are rarely used. For secondary milia, treatment of the underlying disease may be indicated, depending on the cause.
