Milia removal in London
Milia removal in London at Centre for Surgery. Milia, also known as milk spots are very small, raised, pearly-white or yellowish bumps on the skin. Milia are completely benign and usually measure less than 3mm in width. Centre for Surgery in London are leading specialists for milia removal using state of the art Erbium YAG laser technology.
Milia usually occur spontaneously with obvious cause. They are most commonly seen on the skin around the cheeks, nose, eyes and eyelids, forehead and chest. However, they can occur anywhere on the body. Although very common in newborn babies, Milia but can affect people of any age. In adults, milia take much longer to clear. In persistent cases, milia removal may be warranted. The tiny cysts occur when keratin becomes trapped beneath the surface of the skin. Keratin is a strong protein that is typically normally found in skin tissues, hair, and nail cells.
Causes of Milia
The following are recognised causes of milia and milia often form following some level of damage to the skin:
- laser resurfacing procedures
- long-term sun damage
- steroid cream usage over many years
- skin burns
- skin conditions with a blistering component such as pemphigus
- ageing and dehydrated skin
Milia removal suitability
Anyone who suffers from milia whether it’s just a single one or many, regardless of size is a candidate for milia removal.
Contra-indications to milia removal using laser include:
- Blood borne viruses
- Heart conditions, especially when taking blood thinners such as warfarin.
- Skin diseases and allergies
- Uncontrolled Diabetes (skin is slower to heal)
- Sun burn
- Blood thinners
- Pregnancy and breastfeeding
Types of milia
Primary milia occur in both adults and children and most commonly appear on areas of skin that have not undergone any previous skin treatment or incurred any injury.
Secondary milia most commonly occur in parts of the skin that have been subjected to medical treatment such as laser resurfacing or sustained an injury to the skin for example from a skin burn. In these cases the milia cysts may appear red along the edges often as a result of acute inflammatory changes. These types of milia develop during the healing phase and there is thought to be a link to injury of sweat glands as a possible cause. The application of topical steroid creams on a medium to long-term basis may also increase the risk of secondary milia formation.
Milia occurring in babies are also known as ‘milk spots’ and are most commonly found in newborn babies. These types of milia are extremely common and although they most commonly occur over the nose they may also occur over other parts of the face and body. It is thought that nearly half of all babies have some form of milia or milk spots. Fortunately these types of milia rapidly resolve on their own without any active treatment.
Milia removal treatments
Most Milia often disappear after a few months however some may be persistent, particularly around the eyes. Milia on the face and eyes can make people feel very self-conscious and can often make the application of make-up more difficult. The ideal treatment technique will depend on the type of milia, the location and the number that require removal. Several treatment options exist for milia including topical tretinoin, electrocautery, manual extraction, microdermabrasion and chemical peels.
There are many drawbacks with traditional methods of treatment. Electrocautery, chemical peels and curettage and cautery have a significant risk of causing hyperpigmentation and scarring.
It can often be tempting to remove milia by squeezing the cyst or even by inserting a needle into it. The risks of the DIY approach include skin damage, infection or scarring. We would strongly recommend to avoid this and instead be seen by a medical professional in an accredited clinical environment using aseptic technique.
The Centre for Surgery method – Laser Milia removal
Centre for Surgery use short pulse Erbium YAG laser to ablate the tiny milia using very small laser spot sizes as small as 0.2mm. The treatment is quick, painless and carries a much lower risk profile compared with traditional Milia removal treatments.
After treatment, the patient should clean the treated area daily followed by application of an antibiotic ointment. Sun exposure should be avoided at all times by wearing a hat with a wide rim and sunglasses. The antibiotic ointment should be continued until the lesions start to crust after which sunscreen with SPF 30 should be applied.
Redness and swelling of the treated areas after laser milia removal is minimal
What are the causes of Milia?Milia cysts are most commonly caused by injury or damage to the skin in both adults and adolescents. There are a number of recognised causes of injury or damage to the skin which can lead to the formation of milia:
- Chronic sun damage
- Laser resurfacing (CO2 laser)
- Chronic sun damage
- Bullous skin conditions including pemphigoid, porphyria cutanea tarda or epidermolysis bullosa
Certain components of commonly used skincare products and make up can lead to the formation of milia in younger people. People who are prone to developing milia cysts are recommended to avoid the following products:
- Paraffin oil
- Paraffin liquid
- Petrolatum liquid
- Petroleum oil
- Liquid paraffin
All of the above products contain mineral oil and are well-known causes of milia formation. Lanolin is a wax like material commonly used to treat dry skin and is also a cause of milia formation. Lanolin is traditionally used to treat nappy rash in infants and cracked nipples in breastfeeding mothers.
As part of the ageing process the skin gradually begins to lose its exfoliative ability leading to the retention of dead skin cells. This is commonly due to a loss of both collagen and elastin and this increases the chances of milia formation. Laser resurfacing and chemical peels may lead to milia formation as a common side-effect of aesthetic treatment although your practitioner is able to take precautions to reduce the risk of milia formation post treatment.
Finally milia cysts are not uncommon in newborn babies and are thought to be due to undeveloped sweat glands that are still in the maturation phase. Milia cysts in babies are known to be entirely harmless and tend to resolve within 3 to 4 weeks of birth.
How can I prevent Milia?The formation of milia, whether primary or secondary from another cause cannot be completely prevented. Injuries which cause blistering such as burns may subsequently result in milia formation.
Patients can take a number of precautions however to reduce the risk of developing milia as a result of an intervention such as laser resurfacing.
- Patients should make sure to remove all make up thoroughly before bedtime and use options which are known to reduce the risk of developing milia.
- Patients should introduce an exfoliative skincare product into their skincare routine approximately 2 to 3 times a week to eliminate superficial dead skin cells
- Patients should avoid repeated sun light exposure and always use high SPF factor sunscreen when out in the sun and wear protective clothing including a wide brimmed hat.
- Patients should maintain good skin hygiene with daily skin washes using a mild non-irritant soap.
Some patients may be more likely to develop milia and common reasons include tobacco smoking and people who have a haphazard sleep routine. There is also some evidence to suggest that reducing intake of fatty foods and taking vitamin supplementation may help to reduce the risk of milia formation. Either way, eating a healthy low-fat diet coupled with a good sleep routine and not smoking will have a positive impact on one’s general health and well-being.
Patients are reminded to never try and poke their milia cysts with their hands and to avoid using any common household items such as sewing needles to try and pop the milia cysts. There is a increased risk of skin infection and subsequent scarring if patients attempt these unsafe practices.
Our dermatologists are experts in the treatment of many different types of skin lesions and remove many hundreds of skin lumps and bumps each year. For the best milia removal treatments, we would recommend a consultation with one of our dermatologists to assess you and treat milia using gold standard medical treatments for the very best outcomes.
What is the best way to get rid of my milia?Home-based milia removal treatments have been shown to be ineffective. Attempting to remove milia using common household items such as sewing needles is doomed to failure. This is despite the fact that milia are found in the uppermost layers of the skin. All patients should refrain from picking at their milia or squeezing them. Milia have a firm consistency and are formed beneath the uppermost layer of the skin and are not the same as acne lesions which arise in skin pores. Manual attempts to try and expel the contents of milia cysts have a high risk of causing skin infection and in some cases even visible permanent scars. Many people will attempt to use home sewing needles to try and pop milia cysts but this is an unsafe technique as it is most likely that the needle is not packaged sterile.
We would recommend being seen by an expert dermatologist at Centre for Surgery for proper medical-grade treatment using either erbium laser or radiosurgery for the most effective milia removal treatment.
Why is laser best for milia removal treatment?Effective laser milia removal can occur with the use of erbium laser and is one of the most precise treatments available for the removal of milia. Using just a topical anaesthetic, your dermatologist can remove milia from any part of the face quickly and effectively and without any discomfort. All patients can commence their normal activities straight away after milia removal with erbium laser.
Erbium laser is a more effective treatment when compared with cryotherapy which is an older treatment for milia removal. The disadvantage of cryotherapy is its relative inaccuracy in the depth achieved with treatment which may increase the risk of scarring in sensitive parts of the face.
Treatment with erbium laser is quick and painless with patients being able to have treatment which lasts no more than 5 to 10 minutes following which they can get on with normal activities without any restriction. Erbium laser treatment is also a safe treatment method for women who are pregnant or breastfeeding.
There are a number of potential side-effects of laser treatment which are relatively rare and these include pain, skin blistering or pigmentary changes to the skin which can be either hyperpigmentation or hypopigmentation. Patients with darker skin types may have a higher risk of pigmentary disturbance following laser treatment for milia removal.
Erbium laser Is regularly carried out by our expert dermatologists who also use erbium laser to treat a wide variety of skin lesions without the requirement for incisions or sutures.
What are the alternative treatments for milia removal?Although erbium laser or radiosurgery are the most effective milia removal treatments, there are a number of other treatments which have traditionally been used to treat milia including chemical peels and topical retinoids in addition to cryotherapy.
Our dermatologists focus on providing tried and tested treatments which have highest success rates and the lowest risks.
Always remember to never try and prick milia cysts or attempt to squeeze it to expel the contents of the cyst. By attempting this there is a high risk of causing skin infection followed by potential scarring of the skin. Attempting milia removal at home should be strongly avoided.