How to Get Rid of Milia
I love your column and enjoy reading all the wisdom you share with your loyal readers! I have a question for you, not sure if you are the right person to ask, but I consider you a skincare guru so maybe you can help me. I get some bumps around my eyes called milia. Well, a few years ago I went to see a dermatologist and he was able to remove them quickly and painlessly in a matter of minutes. Now I have a new insurance provider and I went to see my general practitioner yesterday and she told me that these bumps are considered a cosmetic issue and a referral to a dermatologist would not be covered. I could, of course, see a dermatologist but pay out of pocket for the procedure. So I asked if she was aware of any home remedies to remove and prevent them. She said “No” and that was that. So I have been searching online and not finding much. Any thoughts? I keep thinking that surely there must be a magic cream or potion out there than can help me!
Your doctor was mostly right about at-home milia removal procedures — your dermatologist likely extracted them with a heated, sterile lance, which is the only SURE-FIRE way to quickly remove existing bumps. And something you should never, ever do yourself at home, because of the high risk of injury and scarring. Some estheticians will do blackhead extractions as part of spa facials, and some MIGHT tackle milia on certain parts of the face (chin, cheeks, etc.) but most won’t go near the delicate eye area and will suggest a microdermabrasion or chemical peel procedure instead. (Something you can also get at a dermatologist’s office.) Drilling down the cost well, you can buy over-the-counter (not-as-stong) microdermabrasion peels at Sephora or department stores, and this is a common suggestion for treating milia at home.
The problem is that the peels and OTC microdermabrasion treatments just don’t always seem to work, at least not in the way people WANT them to work, which is: use it once or twice and TA-DAAAA! Problem solved! You usually are left with a red, irritated skin (think every sitcom ever where the Vain Lady Character decided to get a laser peel right before some Big Important Fancy Event)…and little or no change to the deep-rooted, stubborn-as-hell milia, unless you keep doing the treatment on a regular basis. And at that point (and at those prices), some milia sufferers find that you might as well save up for the in-office treatment to wipe the slate clean, and focus on preventing the bumps from returning.
(Many dermatologists who have a significant “cosmetic” part of their business [think Botox] will often let you come in for a free consultation, so you could at least get a second, more helpful opinion and work out just how much money we’re talking here. You could also go back to your general doctor as ask for the referral for covered reasons, like mole/freckle checks [which everybody should do!] or any skin rashes/allergies/irritations you might notice.)
So. As far as eradication goes, the tier looks like 1) in-office extraction by a doctor, 2) in-office microdermabrasion by a doctor, 3) non-prescription strength peels and dermabrasion masks at the spa or Sephora. That’s…really about it, unfortunately.
As far as prevention, though, I have more ideas for you. And if you stumble upon the REASON you get the bumps, they WILL disappear on their own — albeit very, very slowly. But that’s still probably better than shelling out a ton of money on treatments only to have the milia return every. single. time. The top culprits/causes:
1) Sun damage. Milia is very common in honest-to-God burn victims, or any time after the skin has suffered a trauma. The stubborn, persistent stuff on your face could be from a stubborn, slow-burn injury from the sun — a consequence of every sunburn you’ve ever had. So from this day forward, I hereby decree: WEAR SUNSCREEN. Go with something formulated for faces and oil free. It doesn’t have to be ultra-high SPF, but you need to wear something.
2) Harsh facial scrubs. Somewhere along the line we all heard “exfoliate” and lost our damn minds. All these “pore-clearing” scrubs out there are the equivalent to washing your face with sandpaper. If you are using anything on your face that contains fruit pits (apricot, peach, etc.), walnut shell, tree bark or anything called “microbeads” or “dermabrasion crystals” or ANYTHING LIKE THIS, stop. Stop! The whole microdermabrasion concept is something you do OCCASIONALLY. RARELY. Because it’s tough as hell on your skin. These scrubs can honestly poke/tear little holes in your skin — especially the skin around your eyes — and allow MORE dirt/oil/dead skin cells to clog up under the surface. Switch to a smooth, oil-free wash for everyday use, and use cleansers and masks labeled “exfoliating” no more than one to three times a week (and again, you can exfoliate without pointy jabby doohickies in the product). I cannot possibly yell at people enough about this.
3) Makeup. Yeah, this one sucks, because when you already HAVE the blemishes, what else can you do except slather more makeup on to cover them up? But you should take a close look at what you’re using. Liquid foundation and heavy under-eye concealers are the usual suspects — try switching to an oil-free tinted moisturizer. Powdered foundation is another option. Some swear it’s a godsend to oily, troubled skin, while some (ME) have the exact opposite experience. It just depends. If you do use blemish concealer on the bumps, make sure it’s oil-free. I like ones that actually treat the zit at the same time, like Murad or Clinique.
Fellow milia sufferers, any advice for M? Any products or treatment regimens you’ve had success with? Any tips on getting insurance companies to bend to your cosmetic-procedure will?