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Eye Milia Treatment, Causes, and Fixes

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Ever see little raised bumps underneath your eyes? Fear not — they’re not clogged pores or whiteheads or acne — they’re milia, tiny white bumps caused by trapped keratin compacted in the pore. The major difference between eye milia and acne is that there is no bacteria or oil involved with the formation of milia.

What Causes Milia?

Milia is a case of keratin-obstructed pores, caused by skin that isn’t shedding normally ([easyazon_link identifier=”1416586970″ locale=”US” tag=”cosmeticswiki-20″]Simple Skin Beauty[/easyazon_link]). It occurs more frequently as we age, with cases generally showing up in your thirties. It also is more common in those with dry skin types.

Milia is often also seen as an unwanted side effect of laser resurfacing, because the skin is growing at an unprecedented rate and can trap keratin within the pores as it heals.

How to Be Sure It’s Milia

Milia is often mistaken for other tiny white spots called seborrheic kerotoses or syringomas. Seborrehic kerotoses are actually dry, raised, wart-like growths that appear suddenly. Like milia, seborrheic kerotoses are tiny, smooth bumps, but they can come in irregular shapes as well, and can have a multitude of colors (DermNet). On the other hand, milia are almost always white and fairly regular. Seborrheic kerotoses need to be removed with liquid nitrogen treatments.

On the other hand, syringomas are benign sweat duct cysts that cluster on the eyelids or beneath the eyes. Typically laser treatments are used to eliminate them.

It’s often difficult to tell syringoma from milia. One telltale sign is that syringoma is permanent, whereas milia are fleeting. Another way to tell is that syringoma often occur in clusters, whereas milia can be more singular, although sometimes milia are found in clusters as well, so this is not a slam-dunk. Honestly, it’s best to see a derm and to be evaluated on a case-by-case basis in this case.

How Can You Treat Milia at Home?

Two things: Regular exfoliation and the use of retinoids. It is worthy to note that retinoids not only slough off rough skin cells, but also help to regulate the collagen-producing process. Once per week, you may choose to use an AHA like glycolic acid instead of retinoids.

Because the undereye area has less oil glands than the rest of the face, but is also susceptible to more movement, you often will be recommended specialty undereye products with a lesser concentration of effective ingredients, but more hydrating ingredients.

The best eye creams for treating milia are [easyazon_link identifier=”B017UO2D1C” locale=”US” tag=”cosmeticswiki-20″]Replenix All-Trans Retinol Enriched Eye Repair[/easyazon_link] for six nights per week, and using a glycolic acid treatment one night per week in lieu of the retinol eye cream. If you have dry undereye skin, I would recommend a specially-formulated undereye treatment that is gentle, like [easyazon_link identifier=”B0015ZAOGO” locale=”US” tag=”cosmeticswiki-20″]Mario Badescu Glycolic Eye Cream[/easyazon_link]. On the other hand, if your undereye skin is normal to oily and/or much like the rest of your face, I would go ahead and try a 10% glycolic acid treatment like [easyazon_link identifier=”B0006BDO5Q” locale=”US” tag=”cosmeticswiki-20″]Peter Thomas Roth Glycolic Acid 10% Hydrating Gel[/easyazon_link]. Test to be sure it is well-tolerated.

How Do Dermatologists Treat Milia?

If you choose to see a dermatologist, a prescription retinoid medication plus a 20-30% TCA chemical peel and/or microdermabrasion treatment is usually what is recommended ([easyazon_link identifier=”1416586970″ locale=”US” tag=”cosmeticswiki-20″]Simple Skin Beauty[/easyazon_link]). Chemical peels of this strength typically slough off the top layer of skin completely and get rid of the milia in one fell swoop, whereas microdermabrasion sloughs away any remaining dead, rough skin.

In some cases, if prescription retinoids and/or chemical peels and microdermabrasion has not eliminated the milia, a dermatologist can extract them. According to Dr. Ellen Marmur, M.D., the area is numbed with a topical anesthetic, and then the cyst is pierced with a needle. The keratin is extracted with a comedone extractor. Once the convex side of the surface is pressed over the comedone, the keratin is released ([easyazon_link identifier=”1416586970″ locale=”US” tag=”cosmeticswiki-20″]Simple Skin Beauty[/easyazon_link]).

Yet another option is electrocautery, which extracts larger cysts and allows the smaller milia to heal by themselves.

Bottom Line

Milia can be tricky to diagnose and treat, and it is best to see a dermatologist to differentiate milia between seborrheic kerotoses or syringomas. That said, if you insist on at-home treatment first, it is a good rule of thumb to use a retinoid eye cream six nights per week, and alternate with a glycolic acid treatment one night per week. I personally recommend [easyazon_link identifier=”B017UO2D1C” locale=”US” tag=”cosmeticswiki-20″]Replenix All-Trans Retinol Enriched Eye Repair[/easyazon_link] for six nights per week, and [easyazon_link identifier=”B0015ZAOGO” locale=”US” tag=”cosmeticswiki-20″]Mario Badescu Glycolic Eye Cream[/easyazon_link] (if your skin is sensitive) OR [easyazon_link identifier=”B0006BDO5Q” locale=”US” tag=”cosmeticswiki-20″]Peter Thomas Roth Glycolic Acid 10% Hydrating Gel[/easyazon_link] (if your undereye skin is more resistant) one night per week in lieu of the retinol eye cream.

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