Milia Treatment | IC Clinic Shinjuku
Those Small White Bumps Around Your Eyes May Be Milia
Have you noticed small white bumps about 1–2 mm in size on your eyelids, outer eye corners, or cheeks? If they are painless to the touch yet won’t go away, there is a good chance they are milia (milium cysts).
Milia are benign growths formed when keratin (the protein that makes up skin cells) becomes trapped inside a pore. They pose no health risk, but because they are difficult to conceal with makeup and cannot be removed through self-care, many patients visit us with concerns about their appearance.
At IC Clinic Shinjuku, we recommend the most appropriate treatment based on the condition and number of milia present. This article is intended for anyone considering milia treatment and covers everything from how to choose a treatment method to costs and the recovery process.
Key Points for Choosing a Milia Treatment
Milia treatment generally falls into two categories: extraction and laser treatment. The right choice depends on the number of milia, their location, whether they have recurred, and your budget.
Who May Be Suited to Extraction
Extraction involves making a tiny opening in the skin with a fine needle and pressing out the accumulated keratin plug. Because it can be covered by insurance, it is well suited to those who wish to keep costs down or who are receiving milia treatment for the first time.
- Those with five or fewer milia
- Those who wish to minimise costs
- Those receiving milia treatment for the first time
- Those who want to keep downtime to a minimum
Who May Be Suited to Laser Treatment
Treatment using a CO2 laser or Er:YAG laser vaporises the milia at the root, which is associated with a lower recurrence rate. It may be a good option for those with multiple milia or those who have experienced recurrence after extraction.
- Those with six or more milia
- Those who have experienced recurrence after extraction
- Those who wish to minimise visible scarring
- Those who want to reduce the likelihood of recurrence
Milia Treatment at IC Clinic Shinjuku
CO2 Laser (Self-Pay)
The CO2 laser uses a wavelength that is readily absorbed by water in tissue, instantly vaporising the target area. Because the entire milium cyst can be removed, the recurrence rate is lower compared with extraction—one of its key advantages.
Treatment process
- Consultation to develop a treatment plan
- Local anesthesia (topical cream or injection)
- Laser vaporisation of the milia
- Hemostasis and disinfection as needed
- Application of a protective dressing
Treatment time: Approximately 10–20 minutes, even for multiple lesions
Cost: Approximately 5,000–15,000 yen per lesion (varies by clinic)
Downtime: A scab forms and typically falls off within 1–2 weeks. Redness generally resolves within 1–3 months thereafter.
Recurrence rate: Approximately 5–10%
Er:YAG Laser (Self-Pay)
The Er:YAG laser causes even less thermal damage to surrounding tissue than the CO2 laser. It is well suited to milia in delicate areas such as around the eyes, and is associated with faster healing and a reduced risk of post-inflammatory hyperpigmentation.
This option may be particularly suitable for:
- Milia on thin-skinned areas such as the eyelids
- Those concerned about post-inflammatory hyperpigmentation
- Those seeking more precise treatment
Recovery and Post-Treatment Precautions
After Laser Treatment
A scab will form after treatment and typically falls off naturally within 1–2 weeks. Some redness may remain after the scab separates, but this generally becomes less noticeable within 1–3 months.
Post-treatment precautions
- Do not forcibly remove the scab
- Keep the treated area clean
- Maintain thorough UV protection (sunscreen, hat, etc.)
- Avoid skincare products that may irritate the skin
How to Tell Whether You Have Milia
Self-diagnosis can be difficult, and we recommend a consultation with a dermatologist. As a general guide, the following characteristics are often associated with milia.
Typical Features of Milia
- Small size, approximately 1–2 mm in diameter
- White to yellowish-white in color, with a pearl-like sheen
- Dome-shaped, slightly raised above the skin surface
- Firm to the touch
- No pain or itching
- Do not become inflamed
- Most commonly found around the eyes, cheeks, and forehead
Distinguishing Milia from Similar Conditions
Difference from closed comedones (whiteheads)
Closed comedones tend to be slightly larger than milia and can become red and inflamed over time. Milia do not become inflamed.
Difference from syringoma
Syringoma are flatter and more skin-colored than milia and tend to appear in clusters under the eyes. They are benign tumors of the sweat glands and require a different treatment approach.
Difference from sebaceous hyperplasia
Sebaceous hyperplasia lesions are larger than milia and typically have a central depression. They tend to appear more distinctly yellow.
Why Milia Form
Milia form when keratin (the protein that makes up skin cells) is not properly shed and instead accumulates within a hair follicle or sweat duct. Medically known as milia, their name is said to derive from their resemblance to millet seeds.
Primary Milia
Primary milia develop spontaneously without a specific underlying cause and account for approximately 80% of all cases. Contributing factors may include disrupted skin cell turnover, constitutional predisposition, and age-related decline in skin metabolism.
Secondary Milia
Secondary milia develop following skin injury or disease—such as burns, wounds, dermatitis, or laser treatment. They occur when keratin becomes trapped within the skin during the healing process.
Factors That May Increase Susceptibility
- Dry skin
- Use of skincare products with a high oil content
- Skin conditions such as atopic dermatitis
- Frequent or prolonged UV exposure
- A family history of milia
Skincare to Help Prevent Milia Recurrence
Because constitutional factors play a role in milia development, complete prevention is difficult. However, appropriate skincare can help reduce the risk of recurrence.
Cleansing Tips
Avoid scrubbing vigorously—instead, cleanse gently using a rich lather to envelop the skin. Use lukewarm water at approximately 32–34°C and rinse thoroughly to ensure no cleanser remains on the skin. Choose a gentle, low-irritation cleanser suited to your skin type, and avoid those with excessively strong cleansing action.
Moisturizing Tips
Creams and oils with a high oil content can contribute to clogged pores. Products labeled as non-comedogenic are less likely to block pores and are generally a good choice. Look for moisturizing ingredients that absorb well into the skin, such as ceramides and hyaluronic acid.
Exfoliation Care
Gentle exfoliation once or twice a week can help prevent the build-up of dead skin cells. Products containing AHAs (such as glycolic acid or lactic acid) or BHAs (such as salicylic acid) can be used while monitoring your skin’s response. Always follow exfoliation with thorough moisturizing and UV protection.
UV Protection
UV radiation accelerates skin aging and can disrupt skin cell turnover. Use a sunscreen with SPF 30 or higher and PA+++ or above every day, and reapply every 2–3 hours. Using a hat and sunglasses in combination is also effective.
Frequently Asked Questions
Please do not attempt to remove milia yourself. Trying to extract them with a needle or fingernail carries the following risks: bacterial infection and suppuration, scarring or post-inflammatory hyperpigmentation, and damage to surrounding tissue. Please always seek care from a medical institution where treatment can be performed in a clean environment with appropriate instruments.
With laser treatment, local anesthesia is administered, so discomfort during the procedure is generally minimal.
With laser treatment, please avoid applying makeup to the treated area for 1–2 weeks until the scab has fallen off naturally. You can continue your normal routine on the rest of your face during this time.
Unfortunately, recurrence is possible. Reported recurrence rates are approximately 20–30% with extraction and approximately 5–10% with laser treatment. Some patients are constitutionally more prone to developing milia. Appropriate skincare and lifestyle improvements after treatment can help reduce the risk of recurrence.
Milia are benign growths that do not transform into cancer (malignant tumors). Leaving them untreated poses no health risk; however, they rarely disappear on their own. They may slowly increase in number or size over time. If you are concerned about their appearance, please consider seeking treatment.
Milia are seen in approximately 40–50% of newborns and are a normal occurrence. Most resolve spontaneously within about one month, so treatment is generally not required. If milia persist beyond a few months of age, please consult a dermatologist.
Laser treatment and certain topical medications such as tretinoin should be avoided during pregnancy. Please be sure to inform your physician if you are pregnant or breastfeeding.
This depends on the number and location. For five or fewer milia, treatment can often be completed in a single session. For six or more, or for milia in delicate areas such as around the eyes, treatment is often spread over several sessions. We will discuss the most appropriate treatment plan with you at your consultation.
From Consultation to Treatment: What to Expect
Step 1: Book an Appointment and Visit the Clinic
You can book by phone or online. Walk-in visits are also welcome, though you may be asked to wait.
Step 2: Consultation and Counselling
A physician will examine your skin to confirm the diagnosis of milia and differentiate them from other similar conditions. Based on the number and location of your milia and your preferences, we will recommend the most appropriate treatment and explain the expected costs and downtime.
Step 3: Treatment
The agreed treatment will be performed. Laser treatment typically takes approximately 10–20 minutes.
Step 4: Aftercare
We will provide instructions on post-treatment care. For laser treatment, a follow-up appointment may be scheduled to monitor your recovery.
For Those Considering Milia Treatment
Milia are a common skin condition experienced by many people. While they pose no health risk, concerns about their appearance can sometimes affect daily life.
If you suspect you may have milia, we recommend seeing a dermatologist for an accurate diagnosis. We will then suggest a treatment approach tailored to your individual condition and preferences.
At IC Clinic Shinjuku, we provide comprehensive support covering diagnosis, treatment, and advice on preventing recurrence. Please feel free to reach out with even the smallest concern.
References
- Berk DR, Bayliss SJ. Milia: a review and classification. J Am Acad Dermatol. 2008;59:1050-63.
- EPSTEIN W, KLIGMAN AM. The pathogenesis of milia and benign tumors of the skin. J Invest Dermatol. 1956;26:1-11.
- Connelly T. Eruptive milia and rapid response to topical tretinoin. Arch Dermatol. 2008; 144(6):816-817.
- Japan Dermatological Association: Dermatology Q&A
Disclaimer: This article is intended for general informational purposes only and is not a substitute for individual medical diagnosis or treatment. If you have any concerns about your symptoms, please consult a qualified healthcare professional at a medical institution.
