Have you ever had milia appear on your eyelids?

 

Milia do not cause symptoms such as pain or itching, so removal is not always necessary.

However, when they appear on visible areas such as the eyelids, many people may find them bothersome.

 

In this article, we will explain what milia are, how they can be removed with lasers, and also introduce simple removal methods you can try at home.

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What are milia?

 

Milia are often thought to be a type of acne, and many people mistakenly believe they are sebum.

However, the white material inside milia is not sebum, but rather dead skin cells and keratin, and they often appear around the eyes and on the eyelids.

 

The cause of milia is that dead skin cells, which should normally be expelled, become trapped within the epidermis due to factors such as ultraviolet exposure, physical trauma, or genetic predisposition.

 

On the other hand, whiteheads (sebum) are formed when sebum from the sebaceous glands mixes with skin cells and is discharged, so they mainly occur in pores and are less likely to develop on the eyelids.

Conditions similar to milia include folliculitis with white contents, acne (whiteheads), as well as lesions that resemble milia such as syringomas, skin tags, and warts.

 

When multiple types of lesions are present together, even specialists may have difficulty distinguishing them, but if observed carefully, clear differences can be seen.

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How to Remove Milia

 

Milia on the eyelids can be sufficiently removed at home without necessarily visiting a dermatology clinic.

 

Since the cause is dead cells trapped within the epidermis, you can either create an opening in the epidermis that covers the contents, or accelerate skin turnover to expel them.

 

1. Ointments or keratolytic agents that promote turnover

 

The first simple method you can try at home is applying exfoliant gels or tretinoin ointments that contain ingredients capable of dissolving keratin.

 

Since these medications can cause corneal damage if they get into the eyes, it is better to avoid using them on the eyelids.

However, if milia appear on other areas, consistent application of these ointments alone can be effective.

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2. Physically creating an opening to release the contents

For milia on the eyelids, this method is the most appropriate.

It is a method of directly removing milia at home by purchasing a lancet needle and alcohol swabs at a pharmacy.

1. Disinfect the skin thoroughly with alcohol.

2. Use the needle to make an opening in the milia.
   (If it is large, it may be necessary to puncture multiple times to make the hole wider.)

3. Gently press it out with a cotton swab.
   (Never press too hard, and if it does not come out, do not force it.)
   (It is also inappropriate to use an extractor on the eyelids.)

 

With this method, removal is possible in most cases,
and dermatologists also use essentially the same method, only with different needles.

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Removal by Laser

 

For the treatment of milia, CO2 lasers or Er:YAG (ablative) lasers are used.

 

In the end, since the removal method is making an opening with a laser,
it is essentially the same as using a needle.

 

CO2 and ablative lasers do not penetrate the skin of the eyelids,
so the possibility of damage to the eyeball is very low.

However, if the laser beam is accidentally directed toward the eyeball, there is a risk of corneal damage.

 

Therefore, to prevent such accidents, metal or silicone protective contact lenses are inserted when performing laser removal of milia.

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Aftercare Following Removal

 

In dermatology clinics, it is common to apply Duoderm after removing moles, syringomas, warts, milia, or skin tags,
but in fact, this is not very appropriate.

Duoderm and acne patches are used to suppress exudate and are not intended to help wound healing.
(They are used for the purpose of protecting from external irritation.)

 

Since milia removal only creates a small wound,
it is better to apply an antibiotic eye ointment rather than using an acne patch afterward.

 

Antibiotic ointments such as Madecassol or Fucidin may get into the eyes,
so their use on the eyelids or around the eyes is not recommended.

※ However, since eye ointments are prescription drugs and cannot be purchased over the counter, if you don’t have them at home, it is fine to simply leave the area as is.

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Conclusion

 

In this article, the reason I focused on milia rather than moles, warts, or pigmented lesions on the eyelids is because the removal methods are different.

 

Milia can be easily removed with a needle, but other lesions can only be treated with lasers.

 

However, many dermatology clinics do not have corneal protective shield lenses,
and even if they do, some clinics are reluctant to use CO2 or ablative lasers, which are less profitable, and therefore may not provide treatment.

 

Treatment of the eyelids itself is simple, only taking some time.

 

I hope that more doctors will put themselves in the patient’s shoes and treat kindly, prioritizing patient care over profit.

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3-Point Summary

1. Milia are clusters of dead cells trapped under the skin, resembling acne in appearance, and can also occur on the eyelids.

2. With alcohol swabs and a lancet needle from a pharmacy, milia can easily be removed at home without visiting a dermatology clinic.

3. For aftercare, applying an eye ointment is ideal, but since the wound is small, leaving it untreated is also fine.

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I hope this article is helpful to many people.

 

If you have any questions, please leave a like or a comment, and I will kindly respond directly.

 

Thank you very much.

 

📍 Primi Clinic
3F, 52 Seongsuil-ro, Seongdong-gu, Seoul

 

📍 Primi Clinic
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