MILIA - How to treat and prevent them | Dermatologist Perspective

Doctorly
15 Nov 202107:50
EducationalLearning
32 Likes 10 Comments

TLDRIn this informative video, Dr. Lee and Dr. Maxwell discuss milia, small white cysts commonly found under the eyes. They explain that milia are caused by trapped keratin and are not fully understood. The doctors suggest prevention through sun protection and retinoid use, and treatment options including extraction and exfoliation. They also caution against mistaking milia for serengomas, which require different treatment, and note that invasive procedures like laser treatments can both cause and cure milia.

Takeaways
  • 📌 Milia are small white bumps that appear usually under the eye area, caused by collections of keratin cysts trapped under the skin.
  • 🔍 The exact cause of milia is unknown, but it may be related to a disorder of keratinization or occlusion of the skin, possibly exacerbated by sun damage.
  • 🛠️ Treatment for milia often involves extraction, where a dermatologist or esthetician carefully removes the keratin plugs.
  • 🌞 Sun protection is a key preventative measure, as UV damage is known to contribute to the formation of milia.
  • 🧴 Using non-comedogenic, lightweight sunscreens can help prevent milia by protecting the skin from sun damage.
  • 🍃 Retinoids are recommended for prevention and treatment due to their ability to increase skin cell turnover and make skin cells less sticky.
  • 🧹 Regular exfoliation with products containing glycolic acid, salicylic acid, or lactic acid can prevent milia by keeping the stratum corneum from trapping keratin.
  • 👨‍⚕️ Dr. Maxwell's preferred method for milia extraction involves using an 11 blade to nick the skin surface and then using q-tips to remove the keratin plugs.
  • 🤔 Differentiating milia from other skin conditions like serengomas is crucial for proper treatment; misdiagnosis can lead to ineffective or harmful treatments.
  • 🔥 Invasive procedures like CO2 lasers or deep chemical peels can remove milia but may also cause scarring and subsequent milia formation in some cases.
Q & A

  • What are milia and how do they typically appear on the skin?

    -Milia are small, white dots or bumps that are often noticed under the eye area. They are collections of keratin cysts trapped just under the skin's surface, appearing like pimples but not going away or coming to a head.

  • What factors are believed to contribute to the formation of milia?

    -The exact cause of milia is not known, but it is thought to be related to a disorder of keratinization, where skin cells become occluded. Sun damage is also known to play a role, with people who have chronic sun exposure often developing milia on their temples.

  • How can one prevent the formation of milia?

    -Prevention includes maintaining a skincare routine that avoids trapping keratin collections under the skin. This can be achieved through sun protection using a lightweight, non-comedogenic sunscreen, and using retinoids to increase skin cell turnover and exfoliating regularly with products like glycolic acid, salicylic acid, or lactic acid.

  • What are the treatment options for existing milia?

    -Treatment options include extraction by a professional, such as a dermatologist or esthetician. At-home treatments can involve exfoliating to bring milia closer to the surface, allowing the body to clear them out or making them easier for extraction.

  • How does extraction of milia differ from extraction of syringomas?

    -Milia extraction involves releasing keratin trapped under the skin, while syringomas, which originate from sweat ducts, require a different treatment involving an electric needle to destroy them as there is no material to extract.

  • What is the role of retinoids in managing milia?

    -Retinoids help increase skin cell turnover and make skin cells less sticky, reducing the likelihood of keratin getting trapped under the skin. This can both prevent milia formation and make existing milia easier to extract.

  • How do invasive procedures like CO2 lasers and deep chemical peels affect milia?

    -Invasive procedures can remove milia due to their depth, but they can also cause milia to form as part of the scarring process in conditions like porphyria, where keratin balls become trapped under the skin.

  • Why is it important to have a proper diagnosis before treating bumps around the eyes?

    -Proper diagnosis is crucial to ensure the correct treatment is applied. Mistakenly treating syringomas as milia with aggressive extraction can be unsuccessful and potentially harmful.

  • What are the similarities between milia and epidermal inclusion cysts?

    -Both milia and epidermal inclusion cysts are related to the buildup of keratin and dead skin cell debris. However, milia are more superficial and occur closer to the skin's surface, while epidermal inclusion cysts are much deeper.

  • How can you tell the difference between milia and serengomas?

    -Milia are typically white and result from keratinized cells, while serengomas have a more yellowish appearance and originate from sweat ducts. A dermatologist can accurately diagnose the type of bump.

  • What is the role of sun protection in preventing milia?

    -Sun protection is a key part of prevention because sun damage is believed to contribute to milia formation. Using a lightweight sunscreen that is consistent and non-comedogenic can help protect against sun damage and thus prevent milia.

Outlines
00:00
🧪 Introduction to Milia and Its Treatment

The video begins with Dr. Maxfield and Dr. Shop welcoming viewers back to their skincare and dermatology channel. They discuss the common topic of milia, which are small white bumps often found under the eye area. These are keratin cysts trapped under the skin, appearing like pimples that never come to a head. The doctors explain that the cause of milia is not fully understood, but it may be related to a disorder of keratinization or occlusion of the skin, possibly exacerbated by sun damage. They emphasize the importance of prevention through a proper skincare routine, including sun protection and the use of retinoids and exfoliants. The video also reacts to a viral milia extraction video, highlighting the satisfaction of removing milia and the effectiveness of extraction as a treatment method.

05:01
👁️ Differentiating Milia from Other Eye Area Bumps

In the second paragraph, the doctors continue their discussion on milia by differentiating it from other similar skin conditions, particularly serengomas. They explain that serengomas have a different origin, stemming from sweat ducts, and appear more yellow in color. The treatment for serengomas involves using an electric needle, unlike milia which are extracted. The video also touches on the potential for more invasive procedures like CO2 lasers or deep chemical peels to remove milia, but caution that these can sometimes cause milia as a side effect, especially in conditions like porphyria. The doctors stress the importance of accurate diagnosis before undergoing aggressive treatments and encourage viewers to seek professional help from dermatologists or aestheticians for milia extraction.

Mindmap
Keywords
💡Milia
Milia are small, white, keratin-filled cysts that form just beneath the skin, often around the eye area. They are benign and appear as tiny white bumps or dots. In the video, milia are the central topic, with the hosts discussing their nature, causes, and treatment options. The hosts mention that milia are caused by trapped keratin and are similar to epidermal inclusion cysts, but they are more superficial.
💡Keratin
Keratin is a type of protein that is a key component in the structure of hair, nails, and the outer layer of skin. In the context of the video, keratin plays a role in the formation of milia as it accumulates and becomes trapped under the skin, leading to the development of these small cysts. The hosts discuss how certain treatments can help to release or prevent the buildup of keratin.
💡Extraction
Extraction is a process used in dermatology and skincare to remove foreign substances or growths from the skin. In the video, extraction is discussed as a common method for treating milia, where a healthcare professional uses a blade or other tool to carefully puncture the skin and remove the keratin buildup. The hosts share their positive experiences with milia extraction, emphasizing its immediate and gratifying results.
💡Sun Damage
Sun damage refers to the harmful effects on the skin caused by exposure to the sun's ultraviolet (UV) rays. In the video, sun damage is identified as a contributing factor in the development of milia, particularly along the temples where there is chronic sun exposure. The hosts recommend using sun protection as part of a skincare routine to help prevent milia formation.
💡Retinoids
Retinoids are a class of compounds derived from vitamin A that are used in skincare for their ability to increase cell turnover and reduce the stickiness of skin cells. In the video, retinoids are discussed as a preventative measure against milia formation by helping to prevent keratin from becoming trapped under the skin. They also contribute to the treatment of existing milia by making them easier to extract.
💡Exfoliation
Exfoliation is the process of removing dead skin cells from the surface of the skin, which can help to prevent clogged pores and improve skin texture. In the video, exfoliating is recommended as a way to prevent milia by keeping the stratum corneum from trapping keratin. Specific exfoliants like glycolic acid, salicylic acid, or lactic acid are mentioned as effective in preventing milia formation.
💡Syringomas
Syringomas are small, benign sweat gland tumors that can appear as yellowish bumps around the eyes, distinct from milia. In the video, the hosts differentiate syringomas from milia, noting that they originate from sweat ducts rather than keratinized cells. The treatment for syringomas involves using an electric needle to destroy them, as opposed to the extraction method used for milia.
💡Dermatologists
Dermatologists are medical doctors who specialize in the diagnosis and treatment of conditions affecting the skin, hair, and nails. In the video, dermatologists are mentioned as professionals who can accurately diagnose and treat milia and syringomas, emphasizing the importance of seeking professional care for these conditions.
💡CO2 Laser
CO2 laser is a type of laser treatment that uses carbon dioxide to remove layers of skin, often used for skin resurfacing and treating various skin conditions. In the video, CO2 laser is discussed as an invasive procedure that can both remove milia and potentially cause milia as part of the healing process after treatment.
💡Chemical Peel
A chemical peel is a treatment that involves applying a chemical solution to the skin, causing it to exfoliate and eventually peel off. The video mentions deep chemical peels that reach the mid-reticular dermis, which can help in shedding milia. However, it also warns that milia can form as a result of scarring from such procedures.
💡Skincare Routine
A skincare routine refers to the regular regimen of products and procedures used to maintain and improve skin health. In the video, the hosts emphasize the importance of a proper skincare routine in preventing milia, including sun protection, exfoliation, and the use of retinoids. A well-crafted skincare routine can help manage skin conditions and prevent the formation of skin issues like milia.
Highlights

Reacting to a viral skincare video related to milia.

Milia are collections of keratin cysts trapped under the skin, often appearing as little white dots or bumps.

Milia are usually found under the eye area and resemble pimples that never come to a head.

The cause of milia is not known, but it may be related to a disorder of keratinization or occlusion of the skin.

Sun damage is believed to play a role in the formation of milia, especially around the temples.

Prevention of milia involves a skincare routine that prevents keratin from getting trapped under the skin.

Using a lightweight, non-comedogenic sunscreen is part of the prevention strategy against milia.

Retinoids increase skin cell turnover and make skin cells less sticky, preventing keratin buildup.

Regular exfoliation with glycolic acid, salicylic acid, or lactic acid helps prevent milia formation.

Once milia form, exfoliation can help bring them closer to the surface for easier extraction.

Milia extraction can be done by dermatologists or estheticians.

Seringomas are similar-looking bumps that come from sweat ducts and require different treatment from milia.

Invasive procedures like CO2 lasers or deep chemical peels can remove milia but may also cause them as part of the scarring process.

Milia can form as a consequence of scarring from certain skin treatments.

Distinguishing between milia and seringomas is crucial for proper treatment.

The video provides insights into the nature, causes, and treatments of milia, emphasizing the importance of proper skincare routines and treatments.

Transcripts

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