Milia or a milium cyst (singular) is a non-contagious, harmless condition that can be mostly seen to be affecting newborn babies (though not restricted to newborns only). A characteristic feature of Milia is the appearance of tiny white spots (often milky white) on the body, especially across the cheeks, nose, mouth, and chin.
What causes Milia in babies?
Keratin is a structural fibrous protein of the skin, nails, and hair. It plays a significant and protective role in shielding the epithelial cells from severe damage. The tiny white spots that appear in milia are nothing but a keratin-filled non-cancerous cyst. The appearance of these milia cysts is an outcome of the entrapment of the keratin proteins in small pockets underneath the skin surface. The entrapment of the keratin proteins can result from:
1. The use of baby products such as baby creams, lotions, soaps, to name a few.
2. Bathing the baby with hot water can be an underlying factor triggering milia in babies and newborns.
Types of Milia
Based on the underlying factors as well as the age group being affected, milia can be of the following types:
1. Neonatal Milia: As the name suggests, Neonatal Milia affects newborn babies whereby tiny white cysts appear mainly on the face (nose, cheeks, chin) and the scalp. Neonatal Milia is harmless and seldom requires any treatments as the condition heals by itself within a week or two.
2. Juvenile Milia: The condition is often found to be a genetic predisposition triggered by medical conditions such as:
(a) Gardner syndrome (it is a subtype of Familial Adenomatous Polyposis, characterized by the formation of non-cancerous tumours in different body organs)
(b) Nevoid Basal Cell Carcinoma Syndrome or Gorlin syndrome (a genetic condition characterized by multiple basal cell carcinomas, facial dysmorphism, skeletal deformities and abnormalities to name a few)
(c) Bazex-Dupré-Christol syndrome or Bazex syndrome (characterized by milia, multiple basal cell carcinomas affecting the face, Hypotrichosis, to name a few)
(d) Pachyonychia Congenita (a genetic condition, an autosomal dominant skin disorder whereby mutation takes place in one of the keratin genes).
3. Milia en Plaque: The trigger in the case of Milia en Plaque is found to be an autoimmune skin disorder such as Lichen Planus mostly affecting the ears, jaws, cheeks or eyelids. Though the condition can affect anyone, irrespective of their age and sex, middle-aged women are more susceptible to Milia en Plaque.
4. Primary Milia in Children and Adults: Here, the tiny white cysts appear mainly on the forehead, genitalia or the eyelids.
5. Milia Associated with Drugs: A rare condition whereby milia appears due to the application of certain creams and lotions such as steroid creams.
More than often, milia heals by itself and requires no treatment. However, in the case of discomfort, the doctor may:
1. Destroy the cyst using a procedure known as Diathermy (the use of a high-frequency electric current to heat the target body tissues).
2. The milia cysts can also be destroyed using
(a) Laser ablation (the use of highly focussed laser to get rid of the cyst).
(b) Cryotherapy (the use of freezing temperatures to destroy the cyst).
(c) Medicated creams and lotions containing Retinoids.
(d) Deroofing (a minimally invasive procedure to destroy the cyst)
3. Further, one should refrain from using baby creams, lotions, soaps, or oils unless advised by the doctor to do so.
4. Make sure that the baby’s face is always clean. Do not be harsh while cleaning the baby. Have patience and be gentle as the baby’s skin is soft and sensitive.