Have you noticed that you are getting a lot of white bumps on your face and you don't know what to do about it? Possibly what you have are milliary cysts and they are a purely aesthetic problem that does not affect your health. However, if you want to get rid of them, there are ways to prevent and treat them.
Milia cysts are also called closed comedones or milia and occur with great frequency in the general population. They are a frequent reason for my dermatological consultation and occur more frequently in the general population. frequently in patients with oily skin and/or who use very occlusive creams.
Table of Contents
What is a millium cyst?
A millium forms at the base of a hair follicle or sweat gland. They are formed when keratin (a substance produced by the skin) is trapped under the outer layer of the skin, forming a small cyst that is hard to the touch and looks like a small white ball.
These cysts occur spontaneously (primary) and others in response to a skin lesion (secondary).
- Primary millium cysts are formed directly from trapped keratin and usually appear on the face of infants and adults. In this article I will only discuss adult millium cysts, which typically develop on the eyelids, cheeks, forehead and even genitalia.
- Secondary millium cysts are also tiny cysts and look similar, but develop after something blocks the ducts leading to the surface of the skin, such as after a wound, burn or blister on the skin.
How to prevent millenium cysts from appearing?
There are many things we can do to prevent new millium cysts from appearing or even treat the ones we already have on our skin. If we see that these measures are not enough you will have to request a visit with your favorite dermatologist to remove them with an aseptic method.
1- Do not squeeze!
First things first, never try to burst or squeeze a milium!
Unlike the typical pustule of acne, the millium is a small cyst that has a capsule inside the skin. This is why the small white lump inside the milium is very hard. It is formed by a plug of dead keratinized (hardened) skin cells that have become trapped just below the surface of the skin.
No matter how hard you try, squeezing the milios will get you nowhere. That little bump is too hard, almost like a grain of sand. Since the little white balls form under a thin layer of skin and not in the pore (as is the case with acne pimples), there is no opening in the skin through which the plug can escape.
If you keep squeezing, you will only inflame the skin and even leave scars for life!
2- Protect yourself from the sun
In the case of adults, chronic overexposure to the sun can be a very important factor in the development of these cysts. As a result, the skin has difficulty in expelling the keratin scales to the surface and these little white balls will form.
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3- Avoid "greasy" creams
It is very important to avoid creams that can leave the face very oily and greasy. It is also important to avoid very dense foundations that can worsen the problem.
If you have skin prone to the formation of millium cysts, avoid the following ingredients in creams:
- Liquid kerosene wax
- Liquid petroleum
- Kerosene oil
- Paraffinum liquidum
- Liquid petroleum jelly
- Petroleum oil
How to treat millium cysts?
In the case of infants that present millium cysts will not require any treatment, as they will go away on their own within a few weeks.
In the case of primary or secondary milliary cysts in adults It is more difficult for them to disappear on their own and treatment is often necessary.
1- Creams to eliminate millium cysts
Instead of trying (unsuccessfully) to pull out a milium, you can start with an over-the-counter salicylic acid, glycolic acid or retinoid product.. These products help exfoliate the skin and help release pores that have become occluded by treating and preventing new milia from appearing. But be careful, these products cannot be used on the eyelids. In this case it is best to consult your dermatologist so that they can be removed.
However, be prepared for long-term use. Milia are very resistant and it may take months before you see any improvement.
Exfoliating creams
The retinoids are very effective in exfoliating the skin and accelerating cell renewal. Retinol can irritate the skin at first, so start using these products gradually.
How to use it: Apply every night before going to sleep. Start a few times a week and then increase the frequency progressively until every night.
My favorites:
- Retinol Serum B3
- Neostrata high potency R
- Redermic [R] - La Roche Posay
- Wrinkle and texture repair ZO Skin (only under medical supervision)
Sebo-regulating soaps
If you also have oily or greasy skin, it will be necessary to include a sebum-regulating soap in your skin care routine.
How to use it: Apply every morning and evening with a light massage on the face and then rinse with water.
My favorites:
2- Manual removal of cysts
If you have many millennials and they:
- They have remained for a long time
- Have not gone away with over-the-counter treatments
- They are in a place that is difficult to treat (such as the eyelid).
The next step is to see a dermatologist!
Normally in our practice we make an incision in the skin over the milium with a sterile needle or with a lancet with a #11 scalpel. Then we remove the cyst with the help of a comedone extractor to perform in a non-traumatic way.
Although millium cysts are found in the outer layers of the skin, they are difficult to remove without the proper material. Do not attempt to remove them at home, as you may leave a scar.
3- CO2 laser for milliums
The CO2 laser is another very effective method to remove millioma cysts. It is one of my favorite methods because it allows me to perform the removal with great precision and with the advantage that the millioma cysts do not reappear. It also allows us to safely treat delicate areas such as the eyelids.
If the patient has few lesions it will be possible to do it without anesthesia and in the case of having many we put an anesthetic cream on the affected area before.
4-Peelings and dermabrasion
Peels and dermabrasion have also been described for the treatment of milli cysts. It has worse response rates compared to previous treatments so it is not what I indicate in the first instance. They are usually reserved for when the extent and amount of millium is very high.
Conclusions
If you are a person prone to developing white bumps on your face, you can try using the creams I recommend in this post. If, in spite of the correct prevention, the millimetric cysts persist, it will be necessary to go to your dermatologist for a professional extraction of the same.
48 Responses
Good morning,
Yesterday I had cold applied to remove three millium cysts that I have on my face and I was not at all convinced with the treatment. I do not hear or read anywhere that this is the correct treatment to remove them. At the moment it has caused me some kind of blisters in the area due to the burns..... Am I right? What I have read is that they should be removed after pricking them.
Hello Covadonga, cryotherapy treatment has been described, but it does not seem to me the most appropriate procedure. It is better the ones I discuss in the blog.
Hello I have too many on my nose and I have had them for 2 years and I use glycolic and salicylic acids, nothing helps to reduce them and I am in treatment with the dermatologist I am fed up I want them to go away from my nose.
Hello I have milium cysts in my nose and it is something very annoying in the aspect of the sensation of having them already eh acudido to be more than with laser tried about 3 cysts but even so they could not what can I do I'm sick of this ?????
Hi Robert. I hope you are doing well. Have you seen a dermatologist? If you haven't, I recommend it.
hello, I had a fat puton and I tried to exploit it believing that it is a pimple and it has remained very red, I've been there for years and I wanted to know if it has a solution or not.
Thank you!!!
Dear Dario, We would have to see what it is about and surely it can be improved.
Hello, can they appear on the legs ?
It is rare but it can happen on a scar for example. What you are asking is probably another diagnosis. I recommend you to have it evaluated by your dermatologist.
Hi. I have a lot of them and I have had them since I was a little girl. I get them on my eyelids and they are annoying. Then I have them on my cheeks, but I have never had them treated.
Hi Yanet,
I hope you are doing very well. It is important that you see a dermatologist because with good treatment they can be removed and greatly improved.
I am getting these white spots and I notice that they are getting smaller. I am told that the vitamin niacinamide cleans the irregularities of the skin.
Hello Nancy,
If you have a lot of millium cysts, ideally you should be seen by a specialist to remove them and recommend a specific treatment. Niacinamide is a good treatment but it will certainly not remove these cysts.
A bump appeared on my pinky finger on my left hand. Out of desperation, I pricked it with a needle, but after doing that, a small bump of skin formed on that spot 😭.
Hello,
It is probably not a milliary cyst from what you tell me. I recommend you to have it checked by a specialist.
Best regards
My 5 year old son has had it since birth on his cheeks and arms...they always told me it was keratosis ☹️
Indeed, what your son has may be another condition called keratosis pilaris. To make a diagnosis you should visit a dermatologist.
Best regards
Hello, I often get them on my cheeks but also in some places like the chest, also very close to the anus and the pelvic area I have two small ones, how can I remove them in those areas? Thank you
Hi Eric,
They need to be evaluated in person but can certainly be removed with a simple procedure.
Thanks for the information, it was a relief to know that it wasn't something else. I think I got them from a very oily cream I am using (I have combination skin), also from the sun (I have sensitive skin) and from the use of the mask because my face sweats a lot when I use it and I have noticed blackheads and acne....
Can I apply the recommended products if my milliary cyst is about two centimeters below where my eye ends?
Hi Henna. I'm sure there are no problems. Start with the products with a small amount and if it does not irritate the skin you can increase the amount and frequency.
About 8 years ago I had a millium removed and there is a scar like a hole, I feel like it grows and it gets like a black spot frequently. Will I have any hope of closing that pore with something?
Hello Carmen,
It is probably a small epidermal cyst that will require a small outpatient surgery to remove the capsule inside the skin.
Best regards
Hello, I have a lump of fat that is soft and I have been told to put a gauze with apple cider vinegar that goes very well, do you advise me to do so?
Hello Alfonso,
It is not recommended at all. What is necessary is to make a proper diagnosis in a dermatological consultation and depending on this, choose the correct treatment.
Hi! I am using a Paula's choice scrub with 2% from BHA liquid exfoliant and salicylic acid and then retinol from theinkeylist, are they good products? Greetings!
Hello!
A week ago I had some milia removed from my eyelid with an electric scalpel, the dermatologist didn't do any extraction, he just burned. Now the scabs are falling off and they seem to be smaller but many are still there, is it normal?
Is the laser procedure more effective?
Best regards!
Anna
Hello Anna,
I hope you are doing very well. To know better what to answer I would like to see your milli cysts. There are many treatments to remove them and one of them is the electric scalpel. For me it is not the preferred method since I remove them with needle or laser but also doing the removal of the millium.
Hi, what do you recommend for my daughter. She is 9 years old and a few months ago many of these appeared in one of her cheeks. What treatment can she do for her age. Thank you
Hello Vanina, in this blog I do not recommend specific treatments without first making an assessment of each patient. My recommendation in this case is that you take your little one to a dermatologist or let's make an online visit to get a better look at what it is. Not all white spots on the face are millium cysts.
I have millium cysts on my eye lids what would you recommend.
Hi Leydi, if you have them on your eyelid I would recommend you to see a dermatologist so that they can be removed manually.
Hello, I had a large millenium cyst and I pricked it with a needle, because in my country it is very difficult to make an appointment with the doctor and I got a tiny white piece. Now I am pricking it and nothing, it does not come out. If I leave it, will it continue to grow?
Hi Isabela, indeed, if we leave part of the millium cyst inside it is possible that it can grow back. You can imagine, but I do not recommend that patients do home procedures because of the risk of scarring and infection with non-sterile tools.
Hello,
Will I be able to remove my millium cysts with any wart supplements? There are only three of them and I had applied garlic and they got a little bigger, but I didn't apply anything anymore.
Hello Ana,
The treatment of millium cysts should be done with a professional dermatologist, as there are many risks to try to remove lesions on our skin without knowing the diagnosis. In the following article I summarize why you should not do it..
- Anti-wart liquids are only intended for palmar and plantar warts. They should not be used on other parts of the body as they may "burn" the skin.
- Garlic can produce significant skin inflammation that can leave spots on our skin known as post-inflammatory hyperpigmentation.
Therefore, the recommendation to remove them is to go to a dermatologist specialist.
How can I remove the milliums from my skin?
Does high frequency work for miliums or LED masks?
Thank you
Hello Ana,
If you have many milliomas I recommend that you go to the dermatologist so that they can perform a manual removal of them. Once this is done, they will recommend special creams to prevent the appearance of more in the future. Regarding ultrasound or LED masks, there is no evidence that they can be used to remove millioma cysts.
Best regards
I suffer from millium cysts and have had to have them removed several times. I will try the creams to see if I can prevent them. Good afternoon.
Perfect Camila,
I hope it works out very well for you
Hello,
My question is whether they grow with time
Thank you
Generally they do not grow but more may appear.
Hi, I have milium under my eyelids. I went to the doctor and he told me that nothing happens, but I am uncomfortable to see me like that with those little balls. I would like to know what I can do in this case, could they be removed with laser?
Hi Claribel, Yes! Laser is a good option to remove millioma cysts. It can also be done with a special extractor for this that we have in the dermatology office.
Best regards
I am interested I would like to communicate with you. Where are you located...I live in Huesca ...what cream do you recommend I use the nívea cellular lumious I feel that I have appeared more little balls under the eyelids that I am using it....
If they grow, well, they grew for me; they were super small and with time they grew considerably.
If they grow very large, they may not be millimetrial cysts.