What is Milia En Plaque? Causes, Symptoms, and Treatment

Quick Summary

• In milia en plaque, an uncommon form of milia, numerous white or yellow bumps filled with keratin are clustered in one area of skin that is red, raised or thickened.
• It normally appears on the visible parts of the body like the eyelids, cheeks, ears, nose, forehead or jaw line and is more noticeable than the usual milia.
• In most cases the exact cause is unknown, but the following may play a role in its development: trapped keratin, skin inflammation, trauma, burns, friction, sun damage and some underlying skin disorders.
• Clusters of bumps, redness around the bumps, rough skin texture and some slight irritation are common symptoms. The condition isn't painful and won't cause any harm.
• Always seek treatment from a dermatologist and it may include monitoring, topical retinoids, professional extraction of the cysts, oral medication, laser therapy, and skin resurfacing.

What Is Milia En Plaque?

Milia en plaque is a rare type of milia that presents with a cluster of multiple white or yellowish keratin-filled cysts on a red, raised or thickened area of skin.

Milia en plaque occurs in clusters of milia, unlike common milia in which the milia are found in isolation all over the face. On the inflamed base, the bumps are found in clusters and this makes the condition more noticeable and can be more alarming to the sufferer.

While milia en plaque is far from dangerous, it can be easily confused with other skin conditions, which is why it's important to seek medical advice, especially if the patch enlarges, spreads, hurts, or grows close to the eyes.

What Causes Milia En Plaque?

Sometimes, the exact cause of milia en plaque cannot be determined. In many instances, there is no known precipitating event. The dermatologists believe that the ailment occurs when keratin becomes trapped under the skin, creating multiple small cysts concentrated in one region.

Some reasons may be:

• Inflammation of the skin or inflammatory skin diseases
• Constant rubbing or rubbing over a long period of time
• History of previous skin injury or trauma
• Burns
• Long-term sun damage
• Heavy cream or occlusive skin care products
• In rare cases, some autoimmune or genetic skin diseases.

There have been reports of some cases after cosmetic treatment or other types of skin injury. The cause and most suitable treatment will depend on the individual and will vary widely from case to case, given the limited number of cases.

Who Can Get Milia En Plaque?

Both adults and children can be affected by milia en plaque, although it is rare at any age. Occurs more often in adults and is common on sensitive or exposed parts of the face.

Common locations include:

• On and around the ears
• Eyelids
• Cheeks
• Nose
• Forehead
• Jawline

It can also occur on other parts of the body, usually where the skin has been repeatedly rubbed, irritated, or inflamed over time.

Symptoms of Milia En Plaque

The characteristic feature is a group of small white or yellowish lesions that are raised on a thickened or reddened area of skin. The bumps are usually hard and small.

Common characteristics include:

White or yellowish clusters of cysts.

An inflamed, red or pink plaque under the bumps

• Some thickening and/or elevation of the skin in the area involved.
• Rough or uneven skin surface
• Different sensations of itching in some cases
• Distress from cosmetic issues, because the patch is visible
• No or minimal pain or physical distress.

Although milia en plaque does not pose any threat, it can be confused with other skin conditions, so it is important not to diagnose or treat milia without the advice of a skin care expert.

Is Milia En Plaque the Same as Regular Milia?

No. Ordinary milia usually present as isolated white papules, usually on the cheeks, eyelids or nose, and may clear up spontaneously over time.

Milia en plaque can be differentiated from other types of milia by the presence of numerous milia grouped together in a localized area of erythema or inflammation. With this grouped presentation it becomes much more noticeable and far less common than the everyday milia.

How Is Milia En Plaque Diagnosed?

Milk spots on the skin are typically diagnosed through a careful clinical examination that considers the size, colour, location, and pattern of the affected skin.

A skin biopsy is sometimes necessary, when the dermatologist needs to rule out other conditions that look similar, such as syringomas, xanthelasma, acne-like eruptions, inflammatory skin diseases, or skin tumours.

Seek a professional assessment if:

• The bumps are growing or increasing in number
• The patch is red, painful or obviously irritated
• The area involved is around the eye(s).
• When the bumps resolve, they continue to recur.
• You're not sure if it is really milia en plaque

Skin care at home seems to be a culprit in the deterioration of the skin

Treatment Options for Milia En Plaque

Treatment is not always necessary for milia en plaque, especially if it is not causing symptoms. But with its position on such noticeable parts of the body as the face or near the ears, many look to intervention.

Dermatologist supervision should always guide all treatment. Squeezing and popping the pimples can damage the skin, cause infection and leave scars at home.

1. Observation

If the plaque isn't causing discomfort and is small and stable, it may be best to wait and watch it over time before starting any treatment, which a dermatologist can help with. In some cases, the symptoms gradually improve without any active interventions.

2. Topical Retinoids

Topical retinoids like tretinoin might be prescribed to encourage healthier skin cell turnover and help to prevent further keratin entrapment. They need to be applied with caution, especially near the eyes, and can lead to dryness, redness, peeling and irritation.

3. Manual Extraction

A dermatologist may manually remove individual milia with sterile instruments by making a small and precise opening on the skin and gently extract the trapped keratin. Never try this procedure at home, because milia will NOT respond to the pressure techniques used for acne.

4. Minocycline or Other Prescription Treatments

If inflammation is a major factor, an oral antibiotic like minocycline may be recommended by a dermatologist. Not suitable for all and only to be used under medical supervision.

5. Laser Treatment

Persistent or widespread milia en plaque can be treated with laser therapy. It can be used to correct "clustered" lesions and enhance the texture of the affected skin.

6. Dermabrasion or Other Procedures

In some instances, a skin resurfacing technique like dermabrasion may be performed to remove or improve the top layer of skin, which will decrease the amount of plaque and the number of trapped cysts in the skin.

What Not to Do?

Do NOT try to squeeze, scratch, cut or pick at milia en plaque at home. The bumps are closed under the skin and it is not advised to push them out as this can lead to infection, scarring and bleeding and may be harder to treat.

Also, it is important not to use too hard physical scrubs, too strong of a chemical acid or use too many active ingredients at once. Treating sunburned skin too much will make it worse.

Skincare Tips for Milia-Prone Skin

With a steady and mild skin care regimen, you can lower down irritation and promote healthier skin rejuvenation during time.

Helpful habits include:

Cleaning with non-stripping product

• Preventing thick and greasy creams that can lead to accumulation.
• Lot's of broad spectrum sunscreen each morning
• Steering clear of harsh physical scrubs
• Not picking at or playing with bumps
• Using exfoliating products only if tolerated by the skin well.
• Talking with a dermatologist prior to using retinoids near the eyes

These alone will not help to remove milia en plaque, but they can be beneficial in protecting the skin, reducing irritation, and providing a better environment for treatment.

When to See a Dermatologist?

Get professional evaluation if bumps are clustered together on a red or thickened area, are near the eyes, are getting worse or are not improving with gentle care over time. Milia en plaque is a rare and can have a similar appearance to other skin diseases and therefore a correct clinical diagnosis must be made before any treatment is sought.

A dermatologist will be able to diagnose the skin problem and suggest the best treatment for you, depending on the type of skin, the location of the plaque and the way it is presented.

Final Thoughts

A rare variant of milia is called milia en plaque, which is a collection of many tiny cysts filled with keratin on a red, raised or thickened area of skin. It is not harmful, but can be persistent and cosmetically noticeable, especially when it's on a visible part of the face.

The best thing to do is to refrain from picking or squeezing the bumps and to get a dermatologist's opinion. Treatment options include observation, topical retinoids, professional extraction, prescription medication, laser therapy or skin resurfacing, depending on the individual case. Milia en plaque can be safely and effectively managed with an accurate diagnosis and thoughtfully considered approach to care.

Frequently Asked Questions (FAQs): Milia En Plaque Causes and Symptoms

1. Is milia en plaque the same as regular milia?

No. Ordinary milia are single, isolated white bumps, while milia en plaque is a collection of milia in one area of the skin that is red, raised or thickened, this is a different presentation and is a much less common form of milia.

2. Can I pop milia en plaque at home?

Milai aren't pimples and can't be squeezed off. Trying to pull it out at home can cause scarring, infection and damage to the skin. Removal must be only by a dermatologist who is qualified in sterile technique.

3. Why do milia bumps often appear around the eyes?

Keratin can get trapped around the eyes and develop small cysts as the skin in this area is one of the thinnest in the body. Eye cream that is heavy or occlusive can also help cause clogged skin in those predisposed to having milia.

4. Can exfoliating acids remove milia en plaque?

Gentle exfoliants can help to prevent new milia by encouraging development of new skin cells, but they aren't going to completely address milia that are deep or in clusters. Take extra precautions when using acids around the eye.

5. Do retinoids help with milia en plaque?

In some cases topical retinoids can help, because they increase the turnover of skin cells and decrease the build up of keratin. It is recommended to use under dermatological supervision, especially on sensitive regions of the face.

6. Is milia en plaque painful?

Usually is not painful. Most people find the bumps and surrounding redness, but feel only mild itching or irritation, or are just concerned about the appearance.

7. Can milia en plaque go away on its own?

In some instances milia en plaque may resolve over time without treatment, although it is more resistant than other milia. Your dermatologist can decide if monitoring or active treatment is the better choice for you.

8. What is the best treatment for milia en plaque?

No one treatment is always best. For example, topical retinoids, professional extraction, oral drugs like minocycline, laser treatment, dermabrasion or a waiting period may be recommended.

9. Can heavy creams cause milia?

Some people may develop milia around their eyes or due to using heavy or occlusive products. Milia prone skin is best suited for lightweight, non-comedogenic formulas.

10. When should I see a dermatologist?

If the bumps are clustered on a raised or red area, progressing, around the eyes, uncomfortable, or re-appearing after seeming to improve, advice from a professional should be sought. A dermatologist is able to confirm the diagnosis and suggest the treatment plan which is most suitable and safe.