Babies with White Bumps on Nose and Cheeks – How It’s Treated?
Any blemish or acne that appears on the skin, especially on the face is frightening for many. There are certain skin problems which look like acne but they are not actually acne. Milia is one such skin condition which affects people of every age. Let’s know what causes the skin to appear unsightly and how the condition is treated.
A milia is a group of white bumps or cysts that appear on the face. A single white bump is called as milium. The condition should not be confused with typical red or inflamed pimples, they are different. Milia looks like grains of sand trapped beneath the surface of the skin.
How common is milia?
Milia is an incredibly common condition. It can affect people of any age but it’s most common in newborns. About 50 percent of newborns are affected by this disorder. Milia are not painful and they don’t even cause itching. While they may appear annoying, they are totally harmless.
What causes milia? Is it different in newborns, children and adults?
Milia typically occur when the skin cell plugs known as keratin gets trapped below the skin surface. The white color that appears on the skin is the keratin plug. Milia occur when skin is unable to exfoliate or shed the dead skin cells properly. The causes of this condition can be different in newborns, children, and adults.
Milia in infants – How is it different from newborn acne?
The exact cause of milia in the neonatal is not clear. The condition is often mistaken for newborn acne which is actually triggered by hormones released by the mother. Also, milia don’t cause swelling or inflammation, unlike acne.
Infants with milia are often born with it while newborn acne does not show up until 2-4 weeks after birth.
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Milia in older children and adults
In the older children and adults, this condition is often associated with some kind of damage to the skin. These include:
- Blistering as a result of skin conditions such as cicatricial pemphigoid and epidermolysis bullosa (EB)
- Prolonged usage of steroid creams
- Some types of skin resurfacing procedure such as dermabrasion
- Loss of natural ability of the skin to exfoliate as a result of aging
Signs and symptoms of milia – Does it cause discomfort?
People with blackheads and acne would probably have milia as well. These are tiny, dome-shaped bumps often in white or yellow in appearance. They are typically not painful or itchy, however can be a source of discomfort for some people.
Size and appearance of milia
These cysts are usually small, around 1-2 mm in diameter; however, they can sometimes grow bigger. Milia commonly appear on nose, cheeks, eyelids and forehead, but can occur anywhere on the body including torso and genitals.
Are there any categories of milia?
Milia are classified on the basis of age and the cause. These include:
As the name denotes, the condition occurs in the newborn and go away within a few weeks of time. The bumps usually appear on the face, upper torso and scalp.
This type of milia typically affects older children and adults. The cysts appear around the eyelids, foreheads and the genitals. Primary milia might clear in a few weeks or may last for several months.
Milia en plaque
This type of milia is often associated with some genetic or autoimmune skin condition such as lichen planus or discoid lupus. Usually, ear, cheeks, eyelids or jaw are affected. Milia en plaque is often seen in mid-age women, however, can also affect people of any age group or sex.
Multiple eruptive milia
This kind of milia involves various bumps appearing in the same area for over several weeks and months. The affected area may also cause itchiness and appear on face, upper arms, and trunk.
Milia occurring from injuries to the skin such as rashes or severe burn, is called as traumatic milia. These kinds of cysts can become irritated, often resulting in redness along the edges and white coloration in the center.
Milia associated with medications and skin products
People using steroid creams may experience milia, however, the side effects are rare. In some other cases, certain ingredients in the skin products can cause milia. These include liquid petroleum, paraffin oil, petroleum oil, etc.
Diagnosis of milia – Does it need any specific testing?
The skin expert or dermatologist can easily diagnose the condition merely by spotting the bumps. Although there is no specific testing needed, in rare cases, skin lesion biopsies can be conducted. A sample of the affected skin is taken for lab testing.
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Treatment of milia – Medical and Surgical remedies
Generally, milia don’t require any treatment. The white bumps can fade away or completely clear up within a few weeks of time. However, if the cysts are causing any discomfort such as itching, there are effective treatments available. These include both medical and home-based remedies.
Below are the surgical procedures for treating milia:
This is the most commonly used method. The cysts are frozen off using nitrogen.
The area of the bumps is numbed and then scraped and cauterized (sealed) using a hot wire.
The sterile needle is used to pick out or remove the cyst. This method should not be conducted at home. This may cause infection.
This method peels off the first layer of the skin, revealing the new skin.
Extreme heat is applied on the bumps that destroy them.
The affected area is targeted using small laser to remove the bumps.
There are topical and oral medicines which can help restore your skin. These include:
- Topical retinoids containing vitamin A
- Oral antibiotic such as minocycline
One can also try following home-based remedies to make the skin look best.
- Wash your skin or your baby’s skin with warm water and using mild soap
- Do not pinch or scrub the cysts, it may cause infection or irritation
- Dry the baby’s face gently
- Avoid using oils or lotions
Milia is not a condition that is associated with long-term problems. The condition, especially in the newborns clears away within a few weeks after birth. Though milia can take time to clear in older children and adults, it isn’t harmful. Check with a dermatologist if your condition doesn’t improve within a few weeks or months. The doctor can rule out other skin condition.
1. Newborn rashes and birthmarks (2018, March 19). seattle children's read more
2. Milium (2009). DermNet NZ read more
3. Autoimmune blistering diseases (2015). NORD read more
4. Milia (2017, May 14). MedlinePlus read more