Acne Vulgaris - Dr Colin Hong

Have you heard of milia? It’s a common skin condition that affects people of all ages. Milia is characterized by small, white bumps on the skin that can appear anywhere – usually on your face and hands. It’s caused when dead skin cells become trapped in the pores or follicles, forming small cysts filled with protein keratin. While milia may not be serious, it can be uncomfortable and embarrassing for those affected by it. Fortunately, there are treatments available to help manage the condition and reduce its appearance. 

History and Definition

Milia is a skin condition characterized by small, white, raised bumps that appear on the skin. It is a common skin condition that affects people of all ages, but it is most commonly seen in newborns and infants. Milia is often referred to as “milk spots” because it is commonly seen in newborns, but it can also affect adults.

The first recorded description of milia is believed to have been made by the ancient Greek physician Aulus Cornelius Celsus, who wrote about a skin condition that caused small white bumps on the skin. However, it was not until the late 19th century that milia was formally recognized as a distinct skin condition.


The following are common symptoms of milia:

  • Small, white bumps: Milia are usually 1-2 millimeters in size and have a raised, white appearance. They may occur in clusters or singularly.


  • Smooth surface: A milium’s surface is smooth and has no surrounding redness or inflammation.


  • Multiple areas of the face: Milia commonly occur on the face, particularly around the eyes, cheeks, nose, and forehead.


  • Infants and newborns: Milia are common in infants and newborns and typically resolve on their own within a few weeks to a few months.


  • Adults: Milia can also occur in adults, particularly in those with a history of sun damage, skin conditions, or the use of certain cosmetic products.

It is important to note that other skin conditions can mimic the appearance of milia, such as sebaceous hyperplasia or basal cell carcinoma. If you have any concerns about a skin bump or growth, it is important to see a dermatologist for an accurate diagnosis.


The exact cause of milia is not well understood, but several factors have been associated with their development, including:

  • Sun damage: Sun damage can cause skin cells to become trapped, leading to the formation of milia.


  • Skin conditions: Certain skin conditions, such as eczema or psoriasis, can increase the risk of developing milia.


  • Genetics: There may be a genetic component to the development of milia, as they tend to run in families.


  • Aging: As people age, their skin can become thin and fragile, increasing the risk of developing milia.


  • Use of certain skin care products: Some skin care products, such as heavy creams or ointments, can clog pores and lead to the formation of milia.


  • Trauma: Trauma or injury to the skin, such as a burn or a cut, can trigger the formation of milia.

In most cases, milia are harmless and do not require treatment. However, if you have any concerns about milia or any other skin condition, it is recommended that you consult a dermatologist for a proper evaluation and diagnosis.


The diagnosis of milia is typically made based on a visual examination of the affected area. Milia are small, white, raised bumps that are easily visible on the skin, and they can often be diagnosed based on their appearance alone.

In some cases, a dermatologist may perform a biopsy to confirm the diagnosis of milia and to rule out other skin conditions that may have similar symptoms. During a biopsy, a small sample of the affected tissue is removed and examined under a microscope to determine the exact type of growth.

In addition to a visual examination and biopsy, the dermatologist may ask about your medical history, including any skin conditions you have had in the past and any medications you are taking. This information can help the dermatologist or plastic surgeon determine the underlying cause of the milia and to develop an appropriate treatment plan.


Treatment for milia typically involves removing the affected cysts. There are both non-surgical and surgical options for removing milia.


  • Topical creams: There are some topical creams that may help to soften the affected cysts, making them easier to remove.


  • Manual extraction: A dermatologist can use a sterilized needle or scalpel to carefully extract the cyst.


  • Electrodesiccation and curettage (ED&C): In this procedure, an electric current is used to destroy the affected tissue, which is then scraped away with a curette.


  • Cryotherapy: This procedure involves freezing the affected tissue using liquid nitrogen.

Regardless of the treatment option chosen, local anesthesia is typically used to numb the affected area and minimize discomfort during the procedure.

After the treatment, the affected area may be sore and swollen for a few days. The doctor may prescribe pain medication to help manage any discomfort. The area may also be covered with a bandage to protect it from injury.

It is important to keep the affected area clean and dry and to follow any aftercare instructions provided by the doctor to minimize the risk of infection and promote healing. In some cases, there may be some scarring after the procedure, but this is typically minimal and may be hidden by the surrounding skin.

Risk Factors

The following are some of the risk factors for developing milia:

  • Age: Milia are more common in newborns, but can also occur in people of all ages.


  • Sun damage: Excessive exposure to the sun can cause damage to the skin and increase the risk of developing milia.


  • Skin conditions: People with certain skin conditions, such as eczema or dermatitis, may be more prone to developing milia.


  • Genetic predisposition: Milia can be inherited, and some families may have a genetic predisposition to develop the condition.


  • Certain medications: Some medications, such as corticosteroids or topical retinoids, can increase the risk of developing milia.


  • Skin trauma: Trauma to the skin, such as from injury or surgery, can increase the risk of developing milia.


  • Cosmetics: Using heavy, occlusive cosmetics can clog the pores and increase the risk of developing milia.

It’s important to keep in mind that these are just some of the risk factors associated with milia, and having one or more of these factors does not guarantee that a person will develop the condition.


While milia are generally not a cause for concern, they can sometimes cause complications. Some of the most common complications of milia include:

  • Inflammation and irritation: Milia can become inflamed or irritated, especially if they are frequently scratched or traumatized. This can cause redness, swelling, and pain.


  • Infection: Milia can become infected, especially if they are frequently scratched or traumatized. This can cause redness, swelling, and pain, and may require antibiotics or other treatments.


  • Recurrence: Milia can recur after they have been removed, especially if the underlying cause has not been addressed.


  • Cosmetic concerns: Milia can be unsightly and can cause cosmetic concerns, especially if they are located in visible areas of the body.


  • Pain: Milia can be painful, mainly if they are located in an area that is frequently used or if they are large and put pressure on nearby structures.

It’s essential to note that the severity and likelihood of these complications can vary greatly depending on the location, size, and underlying cause of the milia, as well as the patient’s overall health and the effectiveness of their treatment. If you have milia, it’s important to seek prompt medical attention to minimize the risk of complications and ensure proper treatment.

When to See a Doctor

Milia are small, white bumps that can appear on the skin and are usually harmless. However, if you have concerns about the appearance or number of milia on your skin, it may be a good idea to see a doctor.

Here are some reasons why you might want to see a doctor for milia:

  • Persistent or spreading milia: If milia persist for a long period of time or continues to spread, it may be a sign of an underlying skin condition that requires medical attention.


  • Changes in appearance: If the milia change in appearance, and become red, swollen, or painful, it is important to see a doctor to rule out any underlying skin conditions.


  • Presence of other symptoms: If you have other symptoms, such as itching or burning, in addition to the milia, it is a good idea to see a doctor to rule out any underlying skin conditions.


  • Concerns about appearance: If you are concerned about the appearance of your milia, a doctor may be able to provide treatments to remove the milia and improve the appearance of your skin.

In general, a dermatologist, skin specialist, or plastic surgeon is best equipped to diagnose and treat milia. They can evaluate your skin, rule out any underlying skin conditions, and recommend appropriate treatments.

Step-by-Step Guide to Carpal Tunnel Syndrome Treatment

Here’s a step-by-step guide to the treatment of milia:


During your first appointment, your doctor or plastic surgeon will perform a thorough evaluation of your skin and medical history. They will also examine the milia to determine the size, depth, and location of the lesion.

Treatment Options

Based on the examination, your doctor will discuss the various treatment options available for milia removal. These may include manual extraction, microdermabrasion, chemical peels, or laser therapy.

Your doctor or plastic surgeon will help you choose the best treatment option based on factors such as the size and location of the milia, your age, skin type, medical history, and personal preferences.


If you have decided to go ahead with a procedure, your doctor or esthetician will give you pre-operative instructions, including information on avoiding certain activities, avoiding sun exposure, and avoiding certain skincare products.


The procedure for milia removal will vary based on the treatment option selected. For example, manual extraction involves using a sterile instrument to gently extract the milia, while laser therapy uses high-energy light to destroy it. Microdermabrasion involves removing the top layer of dead skin cells, and chemical peels involve applying a chemical solution to the skin.

Post-Operative Care

After the procedure, your doctor will provide you with post-operative instructions, including information on wound care, avoiding sun exposure, and avoiding certain activities that could disrupt the healing process.

You will typically need to schedule a follow-up appointment with your doctor to assess the results of the treatment and to determine if any further treatment is necessary.

The exact process may vary depending on the individual case and the doctor’s or esthetician’s specific recommendations. It’s important to follow their instructions and to attend all scheduled appointments to ensure the best possible outcome.


In conclusion, milia is a relatively common skin condition that affects both adults and children alike. Although it can look alarming, it is rarely causing for concern and can be treated with exfoliation or professional extraction. While milia may not always be the most attractive of skin blemishes, the good news is that they are typically harmless and can usually be easily managed with proper treatment.

By staying on top of your skincare routine, you can prevent further milia from developing and reduce the appearance of existing lesions. If left untreated, however, they may persist or increase in numbers over time. For this reason, if you have any concerns regarding milia or other skin conditions it is important to speak to your doctor, dermatologist, or plastic surgeon. With the right care, milia can be managed and treated effectively.


Do you want to make a change to your appearance? Dr. Colin Hong has the expertise and experience you need for Cosmetic, Plastic, and Reconstructive surgery in Toronto, North York, and Markham. With over 35 years of professional practice, he is one of the top plastic surgeons in the city – all at an affordable cost! 

For more information or to book a consultation with Dr. Hong, please call (416) 222-6986 or email us at with your full name, email address, and phone number. Please also obtain a referral from your family doctor before making an appointment for milia removal. 

Frequently Asked Questions

Related Services:

Check out our videos:

Why Do I Need a Hair Restoration?

Can I Smash a Ganglion Cyst?

What Will a Chemical Peel Do?

Our Testimonials

Elizabeth Ezpinosa

Amazing experience, Doctor Hong is very confident and good at what he does. Every time I go to him I always get good results that I love and feel safe. Very friendly and helpful staff!

Pat Kia

He has very good skills and also a very professional team.

C Wong

Dr. Hong and his staff are very efficient. Dr. Hong managed to diagnose my genetic disease that's been going on for years, and proposed a reasonable price given my situation. Thank you Dr. Hong. I greatly appreciated your help and will recommend your service to my friends and family