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How Do You Solve a Problem Like Milia?

Jun18

by

Darling, Wonderful, Fabulous Amy –
I have milia on my cheeks. I asked my doctor about them, and he told me to use Clearasil. It doesn’t help – my aesthetician laughed when she heard that advice. I had a (painful!!) facial and the aesthetician removed most of them, but they keep coming back. I can’t afford to get facials every month, so I need a long-term solution for these pesky things.
Thankfully mine aren’t very swollen, so they don’t look too bad and are easily covered up. On the other hand, the fact that they’re deep in the skin makes them really hard to remove. In spite of what the ‘net says, I have done it myself, particularly when they get close to the surface, by sticking a needle in my skin and squeezing. I’m getting better at it, but I worry that I’m going to get scars. Plus, I can only get at one or two at a time, which means that I always have healing spots on my face, and new ones that are becoming visible.
I don’t use a lot of crap on my face. I don’t wear make up every day. I don’t have a lot of sun damage (I’m fair and I burn easily, so I stay out of the sun and use sunscreen pretty religiously). I do, however, use St. Ives Medicated Apricot Scrub on my face almost everyday.
Here are my questions – 1) Could the scrub be causing the milia? 2) Do you know of any way to prevent them? If I could get a facial and then start using some magic potion, could I keep them away for more than a few weeks? Is there anything in my diet I could change? 3) Am I spelling aesthetician right?
Thanks, in advance, oh brilliant one!!
Another Amy

Let’s cut to the chase and get to your questions, right in order.
1) Yes. YES. YESSSSSSSSSSSSSSSSS. Lord have mercy, yes.
2) Yes. I think. Probably. We’ll see.
3) No, but you’re close. Esthetician.
Milia are not acne — I’d laugh at your doctor’s Clearasil recommendation too, because WHAT? — they’re cysts. Tiny little benign cysts filled with dead bits of skin and fluid. They are caused by sloughed-off skin getting trapped around a hair follicle or sweat gland and forming a teensy little pocket of whitehead-like joy. Very common in newborns who are prone to all kinds of skin-shedding weirdness, but pretty much anyone can get them at any time.
As they are NOT whiteheads or any type of acne, zit creams aren’t the answer. Removal by an esthetician is usually the only way to get rid of them, as otherwise they just sort of sit and stay there — not really getting bigger or worse, but not getting better without a loooooong wait. (I’m not gonna touch the spearing-them-at-home topic, because we all gotta do what our wallets allow us to do but OMG OWWWWW.) But as you’ve seen, you can get them removed over and over again until the end of time unless you figure out and correct the cause.
The main causes of adult milia are as follows: sun damage (including just one very bad burn), harsh facial scrubs, heavy comedogenic lotions and sunscreens, and overly hot showers.
So it sounds like it is DEFINITELY time for you to reassess your products. Good and proper exfoliation IS key to preventing milia, so your scrub isn’t bad simply because it’s a scrub — but I think the “medicated” (read: 2% Salicylic Acid) is too much for you. (The St. Ives also contains fake fragrance, my old skincare nemesis.) You don’t mention any other problems with blackheads and zits, and since milia ISN’T going to clear up with acne medication, I would really, really HIGHLY recommend finding a different, gentler face wash.
Personally, I’d go get that facial and extraction one last time, and switch to a wash for normal skin — something non-soap-based, non-scrubby, non-perfumed — for my regular twice-daily use, and then use a top-quality GENTLE exfoliating product on an as-needed basis. Every other day to start, and then use less if it seems like it’s doing the trick. Anything with “microdermabrasion” on the label is something worth considering — although they ARE expensive, I will warn you right up front. However, if the alternative is going in for $100 facials every few weeks, spending $75 on a cream or a peel that should last you many, many more months might not be so bad of a trade-off. Check out DERMAdoctor Physical Chemistry, Philosophy’s Microdelivery Peel, Dr. Brandt Microdermabrasion Exfoliating Cream, just to name a couple options. I’m pretty sure Olay Regenerist makes something similar, but I honestly haven’t been overly impressed with the Regenerist line in general. (Heavy on the cosmetic surgery buzzwords, light on the actual results.)
If you just plain like your daily scrubs, you can try downgrading to the regular ol’ non-medicated Apricot Scrub, although PERSONALLY, I found that Philosophy’s Microdelivery Wash to be the most gentle on my skin, while still packing a nice exfoliating punch. I like it in the summer especially, when my sweat glands are working overtime, though I only used it a few times a week, alternating with the Purity Wash. The key for you is to find yourself some BALANCE. Yes, you need to help your skin exfoliate properly but you don’t want to overdo it. So no daily scrubs PLUS a deep exfoliating treatment, particularly if your skin already tends to be oily and blemish-prone. Either find a gentler scrub and leave it at that, or do the normal-skin wash plus deep treatment routine. (Again, personally I’d recommend going with the latter, if you can.)
Annnnd it doesn’t stop with the scrub. You didn’t specify what type of sunscreen or moisturizer you use on your face. It should be something oil-free and non-comedogenic. If you aren’t sure, ditch it and switch to something that clearly makes these promises. Avoid exposing your face to very hot water, either in the sink or shower.
Hopefully — hope, hope, hopefully — a few changes in your skincare lineup will make a huge difference. I think your chances are good, since it doesn’t sound like the milia has been a life-long problem for you. (Some folks just get the short end of the genetics stick and will get the cysts no matter what they do.) If you continue to get them and remove them at home, just PROMISE ME you’re sterilizing your tools really well, and disinfect your skin afterward to prevent infection (which would be the biggest cause of any scarring). (And for anyone else reading this with non-cheek milia: do not remove your own milia from your eyelids. DO NOT. NO. BAAAD READER, STOP.) (BTW– we’re not going to berate anyone, but we can’t endorse at-home milia removal either.)


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About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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29 Responses to “How Do You Solve a Problem Like Milia?”

  1. Tracy H Jun 18 at 11:10 am Reply

    OMG I could have written this question, but alas I am lazy! I have the same problem and utilize some of the same methods (straight pin!) I have no input, I was just so excited to read a question that related to ME! I, too use the St. Ives Scrub, so maybe we’re on to something here! Thanks for the advice Amy. I’m gonna switch some stuff up too!

  2. Celia Jun 18 at 11:22 am Reply

    I just recently stopped using St. Ives apricot scrub because I was also getting little weird bumps on my forehead. I originally thought it was from my new bangs so got some harsher scrubby type stuff. I also have fair skin and it’s super dry so it was a disaster. I switched to Aveda moisturizing face wash and LOVE it. I saw results in a week of one daily washing. It’s pricier than St. Ives but it lasts a LONG time. I swear I don’t work for Aveda :)

  3. Catharina Jun 18 at 11:25 am Reply

    Wow, this was an eye-opener for me! I have seriously considered writing to you about this, but never did, because I actually have really nice skin, except for those few pesky “whiteheads” that you can barely see, so who I am to write in? I guess I will be investing in some better skin-care products, especially better exfoliator. Although I fear that I might be one of those people who just won’t get rid of them because I already use oil-free/non-comedogenic sunscreen religiously and a gentle scrub – PLUS, my brother has them, too, so I am guessing this might just be something we’ll have to live with. It’s too bad that I live in Europe and don’t have easy access to the products you recommended (I think, gotta check), but thanks for giving me a reason to procrastinate some more as I google milia and microdermabrasion and non-comedogenic.
    Thank you Amalah for answering this question and thank you to the other Amy for asking it!!

  4. Stef Jun 18 at 11:39 am Reply

    I think a big part of the problem here is the actual little scrubby bits in the St. Ives Apricot Scrub. They use these little jagged pointy rock things that exfoliate wonderfully, but are also really good at tearing tiny holes in your skin. So even if she switches to a non-medicated version of this same scrub, I think her problems will persist.
    Once upon a time, I used St. Ives Apricot Scrub religiously, and I’d get this wicked, deep, stubborn zits. Angry festering pores full of hate. Then I went to The Body Shop and begged for help. They hooked me up with a gentle cleanser and an exfoliating scrub that had little smooth beads in it. It wasn’t cheap, but a month later my face was clear and glowy.
    The Body Shop site won’t load right now, or I’d totally post links. Sigh.

  5. Megan Jun 18 at 12:55 pm Reply

    Along these lines, I have another question… I have just one little milia spot (is there a singular word for milia?) that is right below my eye. Above my lower lash line, even. Is there any way to get rid of it? I don’t think using different cleansers and whatnot will do the trick. Is there any hope for me, or am I doomed to simply wait it out??

  6. Beeeee Jun 18 at 2:04 pm Reply

    Please please please do not use the St. Ives scrub on your face – I think it’s fine for tougher skin, but it is WAY too harsh for the skin on your face – it can actually tear tiny holes in more sensitive skin.

  7. Lisa Marie Byrd Jun 18 at 2:29 pm Reply

    *Disclaimer – I am an independent beauty rep for Mary Kay.
    That being said, the microderm abrasion system by Mary Kay is PHENOMENAL. I didn’t even know there was a word for what was appearing on my chin, but the MK stuff solved it within two weeks. (They reappeared briefly within those two weeks, and now are gone for good.)
    Treat your skin nicely. It will last you a lifetime!

  8. Ashley Jun 18 at 2:38 pm Reply

    I have been told by a dermatologist that in order to get rid of milia around the eye area to use Johnson & Johnson’s baby shampoo on a q-tip and gently cleanse the area on a regular basis. It worked for me, so worth a shot.

  9. Karen Jun 18 at 2:42 pm Reply

    omg! I have wondered for YEARS about these little “whitehead” like things that seem to appear and disappear near my eyelid every so often. Thanks Megan and Amy’s for bringing this up!
    I’ve considered trying to remove them but they usually fade out in a few weeks-months. Megan, hopefully yours will too. The skin near the eyes is so delicate, I think it’s best to just leave them alone.

  10. Jess Jun 18 at 3:35 pm Reply

    I too used to use St. Ives Apricot scrub on my face until I went and got my first facial and the esthetician told me to STOP cuz it was ripping up my skin and far too harsh for the delicate face area. She said it was fine for my body, but to switch to something much gentler…I did and noticed a great change in my skin texture. I swear by ProActiv. I know what you have isn’t acne, but it does have gentle exfolating bits.

  11. Jess Jun 18 at 3:36 pm Reply

    I too used to use St. Ives Apricot scrub on my face until I went and got my first facial and the esthetician told me to STOP cuz it was ripping up my skin and far too harsh for the delicate face area. She said it was fine for my body, but to switch to something much gentler…I did and noticed a great change in my skin texture. I swear by ProActiv. I know what you have isn’t acne, but it does have gentle exfolating bits.

  12. kelly Jun 18 at 4:02 pm Reply

    I get those too, and they usually disappear after a few months.
    Geek squad: aesthetician is also an acceptable spelling.

  13. TheAmyWhoAsked Jun 18 at 4:24 pm Reply

    Megan – are you sure that’s not a sty? You might have the doctor look at it, just to be sure.
    Ashley – that’s funny. In the shower this morning I was looking around going, “well, if the scrub is off, what do I use to clean my face?” and the only thing I had on hand was J&J baby shampoo. Must be kismet! I’ll let you all know how it works on the ones on my cheek.
    Thanks for the quick answer Amalah! And thanks for all the great comments… It’s nice to know that I’m not alone.

  14. mrspooley Jun 18 at 4:30 pm Reply

    I personally love Mary Kay’s Microdermabrasion Set. You wash your skin normally, then use the Refine after, either in the shower or the sink. Then follow with the Replenish. It feels fantastic! I use it once a week, sometimes twice in the summer for all that extra sweating.
    Def keep clear of your eyes with this one. It has little beads to help scrub and you DON’T want that stuff in your eyes.
    My skin is fairly sensitive to perfumes and such in cosmetics and I don’t have any problems with this one.

  15. Pristine Jun 19 at 6:16 am Reply

    Ok…this is a silly question, but what’s milia? A lot of online definitions say it’s just another term for whitehead.
    Eg. “Small, whitish, pear like bumps in the skin due to retention of sebum. Another name for whiteheads.
    http://www.skincarecompany.net/skin-care-terms-glossary.htm
    Another one says it’s like a seed?
    I’m trying to figure out if I’ve had this problem before…

  16. Rayne of Terror Jun 19 at 8:11 am Reply

    I haven’t had this particular problem that I know of, but since my son was born 4 years ago I’ve had more skin problems than I ever had as a teenager. I tried philosophy products based on the reviews here and they tore my skin up. I tried burts bees carrot soap, dove sensitive skin bar, clinique mild, and more more more.
    For Valentine’s Day my husband bought me the Clarisonic face clearer and it has changed my skin. I too don’t wear makeup. I wash with clinique mild bar soap or cetaphil every morning with the clarisonic and my skin is perfect now. I use oil of olay sensitive skin sunscreen/moisturizer.

  17. Kate Jun 19 at 9:55 am Reply

    St. Ives FEELS great, but the exfoliator is teeny tiny litle shards of apricot shells. Their rough, jagged edges can cause micro-tears and cuts in your skin, which allows all sorts of other stuff to get in there and clog the pores, etc.
    If using an exfoliator, always go with something man-made. Man-made exfoliators will not have jagged edges and thus not cause the micro-tears. Pretty much any non-comedogenic exfoliator will work – Biore, L’Oreal, Garnier, Olay – just stay way away from cream cleansers and stuff like that.

  18. Jenny Jun 19 at 9:19 pm Reply

    My mom is a nurse in a derm office, so I always have information on this sort of stuff. Amy is obviously right that milla is not acne at all. I had some milla on my upper arms and my mom gave me some salic acid samples and told me to use that on my arms and then make sure to use a loofa in the shower. The key is getting rid of the dead skin cells that are causing the little bumps. Lotion also helps…..think about it…..you are getting the dead skin b/c it is dry.

  19. Kirsten Jun 22 at 12:59 am Reply

    Megan and Karen –
    I’ve had the above the lower lash line problem a few times before, and the only thing that I have been able to do to get them to stop is to change out and use new mascara. It tends to be that the mascara is old or that I’m not washing it all off. Make sure you’re getting all the mascara off the lashes everyday when you wash your face.

  20. I'mNotTellin'MyName! Jun 28 at 2:20 am Reply

    Ummm. I just picked at the one on my cheek. I SWEAR it’s been there for a year. I was so sick of it. I knew what it was (thanks to being a Clinique Salesperson years ago). I think I got it. But, (in case you’re wondering) I DID sterilize my cheek with BHA /Salacylic acid b4 and after and sterilized the needle w/ alcohol. I came here to see if there were any other “cures”. GREAT advice, BTW! Ok, maybe I just needed to “unload” on someone. (I feel like such a SINNER!) But I also wanted to mention a scrub that I really like: Estee Lauder So Polished Scrub. It’s $22 for a sorta-small tube, but it’s got really smooth round beads and smells nice and fresh. I know a lot of people steer clear of perfumes (Clinique is sooo not about perfume – except for their fragrance line), but I LIKE my stuff to smell good. In fact, it’s almost like I make up my mind about something before I ever give it a chance to work, based on the scent alone! Weird, I know. I used to use St, Ives, too. I thought, Oh, It’s “natural” so it MUST be good. It took a good few years before I put 2 and 2 together and figured out that it was the scrub (coupled with my intense desire to scrub my face away in order to get rid of the zits) that was CAUSING the zits. I finally ran out one time and didn’t get to the grocery store and “WHAM! Heeeeyyyy my face is clearing up…” The Patricia Wexler Line is all about letting your skin heal and NOT doing all these crazy things that we think are gonna make it better. I’ve used several things, including the scrub (now we’re talkin’ REALLY small beads) and the cleanser. Both made my skin fell really nice. (And the cleanser does have a hint of fragrance – or maybe that’s just the ingredients – but it smells ok. Oh, my mom and sister love the Mary Kay Microdermabrasion stuff. With the crappy economy, I think I’m gonna finish the Estee Lauder and try the MK. It’s usually a little better priced. Ok. I feel better, now. Thanks for listening (reading) my confession. I feel soooo much better! XOXOXO

  21. Diana Jul 02 at 4:02 am Reply

    How does AHA affect something like this? Is it bad, or is it helpful (like salicylic acid)?

  22. Khim Aug 16 at 10:02 am Reply

    What is the best soap,facial cleanser,facial scrubs etc. that is safe to use for my skin? Im only 18 year/old and i have a lot of small pimples in my forehead,sometimes, i also had a big pimples in my cheeks.what should i use? Pls help me,.tnx

  23. Gen Sep 12 at 5:15 pm Reply

    I actually started getting Milia right around the same time that I began using St. Ives Apricot Scrub. I have now tried many things to get rid of it, but have had no success until I started using AHA twice a day.

  24. alissa Feb 17 at 3:35 am Reply

    Use a Ph balanced facial cleanser, it’s gentler on the skin.. I use acure mint cleanser and acure seriously hydrating toner.. Suggested by my esthetician.. Works wonders.. You get it at whole foods

  25. alissa Feb 17 at 3:39 am Reply

    She also recommended eminece strawberry rhubarb mask ONCE a week.. It has salilic acid which help s with Melia..

  26. Anne Sep 26 at 2:43 pm Reply

    Spironolactone… It’s not originally meant for skin care but it works like a dream. It got rid of my milia (or at least they stopped coming back) and I never get any pimples, although blackheads are inevitable. I stopped using Differin, which made my skin more delicate (and I am unfortunately an impulsive skin-picker).
    My dermatologist takes it, too. The only downside that I know of is that you need to drink more water while taking it.

    I also recommend Biafine for healing, moisturizing and for the prevention or healing of scars.

  27. Louise Apr 27 at 1:34 pm Reply

    .I LOVE YOU! I usually never use scrubs, i only use a towel in hot water to scrub my face. BUT I just bought i facial scrub with salicyl acid, and Ive got so much milia!!! Thank you for clearing this out!!! 

  28. Erin Jul 01 at 11:47 pm Reply

    I have milia all over my cheeks, and I mean ALL OVER.  Hundreds of them and they are really visible in a certain light.  Disgusting!  I am so embarrassed that I never do anything that involves a social setting.  I can’t even stand for my boyfriend to look at me.  I’ve tried a lot of things to try to get rid of them (or reduce them, at the very least) but nothing works.  I do not have the money to go to a dermatologist for removal of these God awful things!  I just bought a microdermabrasion cream by NEOVA after doing a bunch of research.  I just got it in the mail today and I did use it, so I guess I will wait and see if there is any improvement over the next month or two.  If not, then I just don’t know.  In addition to milia, I’ve also got painful acne that sometimes forms under the milia and it hurts so bad from the pressure.  I’m guilty of being a “picker” so that doesn’t help either and now I have these big, crusty red lesions.  Owee!  This is so crazy because I have never ever ever had my skin look this bad.  

  29. Sally Jul 26 at 11:43 pm Reply

    I know this is an old post, but I have to say, Clearasil does actually work for milia. If you put a tiny dab on a milia every night for two weeks or so, the minor irritation will cause the skin to gently kind of wear away and the milia will pop out on its own (after two weeks or so). You will be dying to pick at it the whole time but if you’re very patient it will work and you will have only minor redness and no scarring. I have done this many times. Slow but oh so cheap!!

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