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The Tiny Bumps On Your Face May Not Be Whiteheads

They're also not pimples.
PHOTO: istockphoto

When you get a blackhead, a whitehead, or a pimple, it's easy to identify them once they appear on your face. But what if they're small, numerous, don't have pus-filled centers or dark marks, and mainly appear on your eyelids and cheeks? Well, you might have milia. To explain this skin issue and the treatments that can be done to get rid of them, we spoke to Karen Javier Jusay, M.D. of SkinStation.

What are milia?

Unlike pimples, milia can be found in groups and are "usually not itchy or painful." In fact, they are just benign keratin-filled cysts that do not swell and become a fully developed acne. They occur when keratin—a protein found in skin tissues, hair, and nails—becomes trapped beneath the surface of the skin.

Milia are common among newborns, in older children and adults. They are usually caused by damage to the skin like burns, rashes, sun damage, and chemical peels.

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Are there different types?

Yes, according to Dr. Jusay, there are seven.

  1. Neonatal Milia
    This develops in newborns—the causes of which are unknown—but usually heal and disappear after a few weeks.
  2. Juvenile Milia
    This is caused by genetic disorders like Gardner syndrome, where non-cancerous tumors form in different organs, and Bazex-Dupré-Christol syndrome, where the early onset of abnormal hair loss (hypotrichosis), diminished sweating (hypohidrosis), and skin lesions (basal cell carcinoma) occur.
  3. Primary Milia in Children and Adults
    This is the most common type of milia that develops in children and adults. In addition to appearing on the eyelids and forehead, it can also appear on the genitalia. If it doesn't disappear in a few weeks to several months, Dr. Jusay suggested that you have them checked by your dermatologist, just to be safe.
  4. Milia en Plaque
    Primarily seen in middle-aged women, Dr. Jusay said that it can occur in both males and females of all ages. It affects the eyelids, ears, cheeks, and jaw, and the milia may be several centimeters in diameter. Also, this type is commonly associated with genetic or autoimmune skin disorders such as discoid lupus or lichen planus.
  5. Multiple Eruptive Milia
    If yours appear in multiples on your face, upper arms, and butt, this type is what you might have.
  6. Traumatic Milia
    This happens when you recently suffered an "injury to the skin," like blisters and rashes. They manifest as irritated and red along the edges with a white center—kind of like a pimple.
  7. Milia Associated with Drugs
    If you use steroid creams on a specific area of your face or body, it can eventually lead to milia, but it rarely happens!
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How can you treat it?

For infant milia, Dr. Jusay said that treatment isn't necessary because it will clear up in a few weeks. For children and adults, on the other hand, it will go away within a few months. But if you can’t wait that long to have your skin back to its smooth, pristine state, she recommended several treatments: Pricking and extraction, Glycolic Peel, tretinoin cream, surgical scraping, and cauterization to destroy the cysts.

For mild cases, she advised that one should get the Glycolic Peel treatment with 0.05% tretinoin cream (this costs about P2,000.), but the ~gold standard~ for zapping milia away is cauterization.  This procedure's rate starts at P3,500, depending on the number of milia you want to be removed.

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