Milium, milia

Author: Monisha Gupta FACD, Dermatologist, Sydney, Australia; Amanda Oakley FRACP, Dermatologist, Hamilton, New Zealand, 2009

What are milia?

A milium is a small cyst containing keratin (skin protein); they are usually multiple and are then known as milia. These harmless cysts present as tiny pearly-white bumps just under the surface of the skin.

Clinical features of milia

Milia are common in all ages and both sexes. They most often arise on the face, and are particularly prominent on the eyelids and cheeks, but they may occur elsewhere.

There are various kinds of milia.

Neonatal milia

Primary milia in children and adults

Juvenile milia

Milia en plaque

Multiple eruptive milia

Traumatic milia

Milia associated with drugs

More images of milia ...

How is the diagnosis made?

Milia have a characteristic appearance. However, on occasion, a skin biopsy may be performed. This shows a small epidermoid cyst coming from a vellus hair follicle.

Milia should be distinguished from other types of cyst, comedones, xanthelasma and syringomas. Colloid milia are golden coloured bumps on cheeks and temples associated with excessive exposure to sunlight.

They should also be distinguished from milia-like cysts noted on dermoscopy in seborrhoeic keratoses, papillomatous moles and some basal cell carcinomas.

Treatment

Milia do not need to be treated unless they are a cause for concern for the patient. They often clear up by themselves within a few months. Where possible, further trauma should be minimised to reduce development of new lesions.

Related information

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