What is Milia Extraction? What to Expect Before Treatment?

Quick Summary

• Milia extraction is a professional treatment used to treat milia that are caused by small cysts filled with the protein keratin that become trapped beneath the skin, and cannot be safely squeezed like acne.
• A provider first reviews the bump to determine that it's milia and not some other skin condition, so that the most suitable treatment approach can be utilized.
• Prior to the appointment, it's advisable to maintain a mild skincare regimen, refrain from picking or squeezing the bumps, and avoid using harsh exfoliants or irritating products.
• Some milia will go away on their own, but some are more persistent and can safely and effectively be removed by a professional. This is especially important if the milia are in the sensitive area around the eyes.
• Home extraction is not recommended. In contrast to pimples, milia are not open pores, and squeezing them can cause them to become red, scarred, infected or damaged.

What Is Milia Extraction?

A milia extraction is a simple skin procedure to remove the small whitish-yellow bumps that are under the skin's surface. Many people associate these bumps with acne and tend to squeeze them, which may result in some actual harm, particularly around the eyes.

Milia are little cysts that contain keratin, a protein that is naturally present in the skin. Most often found around the eyes, cheeks, nose, and forehead, although they can grow anywhere on the face.

Milia should not be treated as whiteheads, as usually there is no open pore. When they're squeezed, they frequently result in only redness, bruising, scabbing or scarring. There is no racial or sex predilection for primary or secondary milia; milia en plaque has been reported to be more common in females (StatPearls).

Who Usually Needs Milia Extraction?

However, not all milia bumps will need to be removed. Milia usually resolves spontaneously in infants. However, they are more persistent in adults and can last for weeks, months or even longer. Milia are present in approximately 40% to 50% of healthy newborns, as noted in a neonatal skin study that found milia in 51.12% of male full-term newborns.

If you have milia, you might want to consider milia extraction when:

• The bump has not gone away
• It's easily noticeable and is a cosmetic issue
• It's near the eyes and must be removed safely and carefully.
• There has been no improvement with skin care products.
• You don't know if it's milia, acne, or something else on your skin

Before removing any bump, especially if it is changing in size, shape, or color, is painful, bleeding, inflamed, or growing, it is always advisable to get a proper skin assessment. Milia are very small, usually approximately 1-2 mm in diameter.

What Happens Before Milia Extraction?

1. The Skin Is Examined First

The provider looks closely at the bump prior to treatment. This is crucial because not all small white bumps are milia, and some may resemble closed comedones, syringomas, sebaceous hyperplasia, or other forms of cysts. If this assessment is not done, the wrong treatment could be given, which will irritate the skin or leave behind marks.

2. Your Skin History May Be Reviewed

A comprehensive provider will inquire regarding your skin care routine, any new treatments, medications you are taking, skin sensitivities, and if you have heavy creams or oils on your skin. This information can help in recognizing potential triggers. Milia can grow after the use of heavy eye creams or after the use of heavy moisturizers; some people get milia because of sun damage, skin trauma, or because of procedures affecting skin turnover.

3. The Area Is Cleaned

Before the extraction, the skin is cleaned to reduce the likelihood of irritation or infection. When milia are found near the eyes, where the skin is particularly thin and delicate, special care is taken.

4. The Provider Explains the Method

The provider will use a sterile needle, blade, or lancet to make a small incision in the skin and then gently extract the trapped keratin for less complicated cases.

If the milia are multiple or especially tough, other treatments may be considered: topical retinoids, chemical exfoliation, electrocautery, cryotherapy or laser treatment. The best method for treatment depends on the skin type, sensitivity, the number of bumps and where they are located.

5. You May Be Told What to Avoid Before Treatment

Before you see us, you might be asked not to use certain products or participate in certain activities, particularly if your skin is already sensitive. Some of the more common items to avoid are:

• Harsh physical scrubs
• Strong exfoliating acids
• Retinoids the day before or the day of the treatment
• Picking or squeezing the bumps.
• Behaviors such as waxing or doing intensive facial treatments in the vicinity of the affected area

Any heavy makeup on the treatment area

It's also important to avoid trying to extract the area by yourself prior to your appointment, as damaged or irritated skin is harder to treat safely and effectively.

What Is Included in Milia Extraction?

Professional milia removal is a multi-step process, more thought-out than just "popping" a bump.

The milia extraction process usually involves the following:

• Skin examination to be sure that the bump is milia.
• The treatment area is cleansed.
• Application of a sterile needle, a lancet, or a blade to make a small, accurate opening
• Gentle removal of the trapped keratin plug
• Re-cleansing after the extraction of the area
• If necessary, use a calming or protective product
• Simple aftercare guidelines for the healing process

The provider refrains from squeezing aggressively throughout the process. Rather, a small, controlled opening is created to safely remove the trapped keratin, minimizing the risk of bruising, scarring, infection, or damage to the skin.

If the milia are near the eyes, the development is slower and more delicate. The eyelids and skin around the eyes are more delicate and sensitive than other areas of the face and should always be treated by a trained professional.

Another thing to note is that the extraction of milia will not prevent them from recurring. Your provider may thus suggest that you make some skin care changes using lighter products, adding gentle exfoliation, or using better sun protection, to lower the risk of future milia.

Is Milia Extraction Painful?

Milia extraction usually takes only a few minutes; however, there may be a slight pinch, pressure, or sting. The degree of discomfort will vary according to the area being treated; milia around the eyes can be more sensitive because of the thinner skin in this area.

If you have sensitive skin or if you're nervous about the procedure, consult your provider first of all as to whether or not numbing is necessary. In most of the cases of milia, the procedure is a short process and is not painful.

How Long Does the Treatment Take?

Milia extraction can take just a few minutes per treatment. If more than one milia is being treated, the appointment will last longer as each bump must be treated with care.

Never rush the procedure, particularly around the eyelids or under the eyes. Slow and careful extraction is always safer than aggressive extraction.

What Should Your Skin Look Like Before Treatment?

If possible, your skin should be calm and settled prior to extraction. Treatment may need to be delayed if the area is sunburned, irritated, infected, peeling, or inflamed.

It's a lot easier to work with healthy skin, and it heals better. Let your provider know if you've recently used any potent products containing retinol, tretinoin, glycolic acid, or salicylic acid.

Can You Remove Milia at Home Before Seeing a Professional?

This is not recommended and is potentially dangerous. Milia are underneath the skin, and squeezing will not usually make a difference, and may result in bruising, scarring, infection, or darkening.

There is an even higher risk around the eyes. The professional treatment is a much safer option if the bump of milia is near the eyelid.

How to Prepare Before Milia Extraction

The following is a simple list of things to prepare before your appointment:

• Maintain a gentle skin care regimen for the days prior to treatment.
• Don't pick, squeeze, or scratch the bumps
• If you have sensitive skin, stop using tough scrubs a few days prior to your appointment.

Come clean when possible

Let your provider know if you are using any retinoids, acne products, or have recently used any skin treatments.

Note any tendency to scarring or post-inflammatory pigmentation

Consult regarding post-treatment needs prior to the treatment.

It may also be useful to have a clear photograph of the area prior to treatment, which can then be used to monitor the healing process after treatment.

Questions to Ask Before Treatment

If you are thinking about extracting your milia, you may want to ask your provider:

• Does this for sure look like milia?
• Does this bump need to be taken out?
• Is the skin in a suitable condition to be treated today?
• What is the tool or technique to use?
• Will there be any redness, scabbing, or downtime?
• What to avoid after treatment?
• Is it possible for this milia to come back?
• What are some ways to lessen the chance of milia developing?

These questions are to help set realistic expectations and to feel informed and confident about your procedure.

What Results Should You Expect?

Once extracted, the milia bump is usually removed right away. But the skin may look red, a little swollen, or mildly irritated for a brief time later.

It is essential to realize that extraction eliminates current milia, but it does not help to avoid the appearance of new ones. The development of new milia will depend on the skin care routine, skin type, sun protection, and the natural efficiency of skin to shed dead cells.

When You Should Not Get Milia Extraction

Treatment might need to be postponed if:

• There are indications of infection in the area
• Skin is sunburned or damaged
• The bump is painful or is growing quickly
• You are not sure what the lesion is
• Have recently had a deep chemical peel, laser therapy, or harsh facial treatment.
• You have a history of poor wound healing or keloid scarring

If in any doubt, it's always better to have the bump properly assessed before attempting any removal.

Final Thoughts

The extraction of milia is a relatively simple and fast process, but there is a lot of preparation that should be done before the extraction. Prior to the treatment, it is advisable to ensure that the bump is indeed milia, find out the condition of the skin, and clean the area so that you can be told exactly what the safest way is to remove it.

Milia is never to be considered acne and should not be squeezed at home. Professional extraction is safer, cleaner, and more precise, especially if the milia are around the eyes. A proper skin consultation is always the most sensible first step when your milia are persistent, visible, or concerning from a cosmetic standpoint.

Frequently Asked Questions (FAQs): Milia Extraction Before Treatment

How to get rid of milia at home?

At home, milia removal is not advised. Because milia are stuck under the top layer of skin, squeezing won't always help and can lead to redness, bleeding, infection, scarring, and dark spots.

Why not pop Milia like a Whitehead?

Milia are not acne. A whitehead develops within a pore, while milia are tiny cysts filled with keratin, located just below the surface of the skin. Usually, they do not open up on their own and need to be professionally extracted.

Does Milia Extraction hurt?

Extracting milia typically takes only a few minutes and isn't particularly painful. There may be a slight prick, pressure, or stinging during the procedure. The skin around the eyes is thinner and may feel more sensitive.

Do I Need to Have Milia under My Eyes Professionally Removed?

Yes, getting rid of the milia under your eyes professionally is safer. The skin around the eyes is very fragile, and you could cause injury, scarring, or irritation if you try to cut or squeeze it yourself.

Does Can Thick Eye Cream Lead to Milia?

There are some individuals who may develop milia from heavy or occlusive eye creams, as well as those that are too thick and heavy for their skin type. If milia occurs after applying a heavy eye cream, consider trying a lighter, non-greasy eye cream.

Can Vaseline Cause Milia?

Although Vaseline doesn't produce milia for everyone, it can seem too heavy for some people who are susceptible to developing milia. The first step is to discontinue use of occlusive products around the area of concern and watch to see if there is improvement.

Does Retinol help get rid of milia?

Retinol can help prevent new milia from developing since it promotes healthy skin cell turnover, but may not resolve existing milia. Retinol should be used close to the eyes with caution and only those special formulations created for this sensitive area.

Will Milia go away by themselves?

In babies, some milia will resolve on their own. They are usually more persistent in adults and can last for months. When a bump doesn't subside or is a cosmetic issue, professional extraction is probably the best alternative.

What NOT to do before Milia Extraction?

To prepare for your appointment, do not pick, squeeze, use harsh physical scrubs, strong exfoliating acids, or any other irritating skin care products. A calm and clean environment helps the provider to treat the skin as safely and effectively as possible.

How long does Milia Extraction Take?

Some milia bumps can be extracted in as little as a few minutes. If several bumps are being treated, it will take longer, as each bump will have to be treated individually.

Will Milia Reappear After Their Removal?

The milia that is removed is usually cured; however, new ones may occur over time. To minimize the risk of recurrence, choose lighter skincare products, steer clear of heavy on prone areas, scrub gently, and always safeguard skin from the sun's harmful effects.

When to Consult a Dermatologist for Milia?

If the bump is near the eye or causing pain, is changing in appearance, or is inflamed, bleeding or growing, a dermatologist should be consulted. Correct skin evaluation guarantees that you're treating the proper skin problem with the correct treatment.