Recently, we came across a Malaysian beauty blogger who shared that she managed to remove her milia seeds painlessly without professional help.
In her blog post, Sue Yap, who blogs under the pseudonym of Paris B, said that a little lump just above her left eyelid had been troubling her since last September and after regular application of retinol-based skincare products, her milium has since disappeared!
Sue contended that she had discovered this milia removal method by chance. She started by sharing, “I’m not usually prone to getting milia, or oil seeds, so I never really had to figure out how to deal with it before. However, in the past year, I’ve experienced it twice, and gotten rid of them twice, with very good results.”
As you can see from the image above, Sue had a stubborn milia oil seed stuck on her left eyelid since late September of 2019. She said that while she felt it was rather irritating, she didn’t want to “dig it out” herself.
“I was using a retinol serum at the time, but taking care not to take it around my eye, as that’s what we are warned about. I also then started using an eye cream that contained retinol (Incidentally, it’s a very good one!). What I noticed after about two weeks was that the milia on my lid seemed flatter. I was quite intrigued, because I had been struggling to get rid of it for months! Here it was, appearing to go away of its own accord.
I realised then, that the only thing I’d included in my routine was this eye cream that had retinol. Because I was a little more experimental, I applied a little of my retinol serum on my face, directly on the milia spot. The retinol I was using for my face was stronger than that used in the eye cream.
In about a week, one day, I ran my finger over my eye lid, and felt a little hard ball come away from my skin. It was the milia oil seed! And it’s never come back since!”
While she had experienced really incredible results via this very slow but gentle technique that leaves no marks behind, “only lovely smooth skin”, Sue did put out a disclaimer to say that she had read up the science of it, and it supports what she experienced, but would suggest proceeding with caution nonetheless as each individual’s experience may vary.
In her most recent close-up picture on Instagram (posted 9 June 2020) seen here below, you can indeed see that the milium that previously bothered her is now no longer on her left eyelid. (Side note: how handsome is her poser beagle!?)
Quite an interesting, albeit unhurried approach, if you ask us. Which is why Daily Vanity decided to check in with trusted skin experts and ask: Can retinol-based products really remove milia?
And if you’re still a little clueless about what milia seeds are, well, you’ve come to the right place. Here’s the 411 on this common skin problem, according to the dermatologists and an aesthetic doctor.
What are milia seeds?
As Dr. Mark Tang, senior consultant dermatologist at The Skin Specialists & Laser Clinic, puts it, milia are whitish pearly bumps that appear superficially on the skin in tiny to small sizes.
It consists of a ball of keratin, which is a structural protein commonly found in our skin, hair, and nails. This keratin cyst can form spontaneously due to two main reasons: blockage of a sweat duct or hair follicle (which is common in babies or children) or after injury to the skin (such as from a healing blister, burn or wound).
Meanwhile, founder and medical director of TWL Specialist Skin & Laser Centre Dr. Teo Wan Lin shares that the location that these little cysts are most likely to be found is the eyelids, cheeks, and forehead area.
But if you think milia is exclusively found in the face, think again. Dr. Tang expounds that it can occur in any part of the body (yes, that includes your nether regions), especially if it was preceded by an injury or blister.
“In younger children, we commonly see milia classified together around the crease of the nose and in both children and adults, milia may resolve on their own or they may persist for several months or years,” explains Dr. Teo.
Sounds a lot like those pesky whiteheads, doesn’t it? Truth be told, there are many people who often mistaken milia for whiteheads because it can be difficult to distinguish between the two conditions with just the naked eye.
As Dr. Tang clarifies, “milia are firm whitish ‘seeds’ that are buried just under the surface of the skin, with no opening to the skin surface. This means that it is usually not possible to squeeze them out of the skin, without breaking the overlying roof of the skin that is covering them.”
In contrast, he explains that a whitehead, otherwise known as a closed comedone, is usually softer to the touch and doesn’t appear as ‘white’ or ‘pearly’ as a milium. Whiteheads, which is caused by a hair follicle that’s blocked with a buildup of accumulated sebum and debris, can be squeezed out and unclogged by firm pressure.
Another difference? Milia can occur at any age and in any skin type while comedones, which are part of the acne spectrum, occurs mainly in acne-prone or oily-skinned individuals, says Dr. Tang.
Milia seeds, in general, are harmless but of course, you can get rid of them if you find them cosmetically disfiguring. However, Dr. Teo remarks that there are some cases where the milia gets irritated or infected. In such cases, she says that removal is highly recommended to prevent recurrence.
According to Dr. Teo, there are other much rarer types of milia that can form in clusters with multiple milia or occur in those with underlying genetic disorders or autoimmune diseases. There are also individuals who developed milia over an area where they had applied topical steroids.
Can retinol really remove milia?
Well, here comes tricky part. According to aesthetic doctor and founder of IDS Clinic Dr. SK Tan, who has a long-running background in dermatology, it is possible for retinoids (which retinol is a type of) to reduce milia by encouraging increased cell turnover or exfoliation. Results may vary according to the degree of exfoliation, but it’s worth noting that retinoids are not the usual prescribed treatment for milia.
Dr. Coni Liu, consultant dermatologist at DS Skin & Wellness Clinic, further comments, “Retinoids are vitamin A derivatives, with a complex mode of action. One of their major uses is in their keratolytic property, which works by modifying keratinocyte metabolism, eliminating sebum in ducts and reducing inflammation, thus very effective in ‘unclogging’ blocked pores like blackheads and whiteheads.
In the case of milia seeds, there is a cyst wall surrounding the trapped keratin. This limits the efficacy of topical retinoids in the treatment of milia seeds, though we sometimes use topical retinoids to improve the appearance in extensive lesions.
In general, the effects of topical retinoids typically take about six to eight weeks to be visible. However, there may be minimal improvement in the case of milia seeds.”
Dr. Tang seems to agree as well, noting that over-the-counter retinoid creams may not be very effective in getting rid of milia. “It may work for very superficial or small milia, as the basic mechanism is that retinoid creams cause mild irritation and peeling of the skin, which leads to breaks in the skin that allow the milium to be extruded.
Prescription-only tretinoin cream, which is many times more potent than over-the-counter formulas, might work better, but may also cause more skin irritation and redness.”
Dr. Teo also weighs in, expressing that topical retinoids are considered helpful adjuncts to milia removal but “one must be very careful with the use of topical retinoids around the eye area.”
For Dr. Teo, she’d only start her patients with a very low dose of retinoid (around 0.01%) to treat milia if they choose to turn down other forms of in-clinic treatments. “Even then, we are extremely cautious and we’d apply a lot of moisturiser with it to prevent skin irritation which is a primary side effect of using a topical retinoid. I definitely do not recommend that as a first line treatment.
Furthermore, I’d like to point out that retinoids must be distinguished from retinol because retinoids are available via prescription only. In my opinion, it’s a really bad idea to use retinol products to remove milia because firstly, retinols are not potent enough to induce the kind of epidermal cell turnover that we see in individuals who use retinoids.
Secondly, it has the same skin-irritating side effects and it can really be disastrous for individuals who are applying it in sensitive areas such as the eyes,” she expounds.
Can retinol remove milia: Final thoughts
As you can probably deduce from our skin experts, retinoid creams – whether they’re by prescription or from over the counter – can’t exactly give us the results we want without sensitising our skin. Plus, the results aren’t guaranteed when it comes to removing milia with retinol.
So, if topical retinoids aren’t the solution to milia seeds, what is?
According to Dr. Tang, extraction of the milia is always the most effective, quick, and reliable method provided it is performed by a professional. He adds, “It is also predictably safe with a low risk of scarring. The main aim is to render a small, microscopic break in the skin to ‘extract’ the embedded milium cyst.
Apart from a surgical extraction, laser or electrocautery will work well too. However, it’s worth noting that milia tend to recur after some time, especially in individuals who are prone to developing them.”
Dr. Liu also agrees that extraction is a much more effective way in removing milia as this method “de-roofs” the cyst wall with a sterile needle or blade so that the small white seed can then be extracted with gentle pressure. She notes that the healing is usually fast when extracting milia through extraction and leaves minimal scarring.
She continues, “Diathermy (the use of electrically induced heat or high-frequency electromagnetic currents in surgical procedures) can also be used to destroy milia cysts, and other abrasive methods like chemical peel and dermabrasion can be explored. However, it’s worth noting that milia often clear up by themselves within a few months, and can be left alone unless they are a cause for concern.”
Dr. Tan also supports the concept of milia removal via extraction but remarks that regular use of retinoids or facial scrubs, and occasional chemical peels may be helpful.
Meanwhile, Dr. Teo recommends going for needle decompression rather than extraction. This technique differs from extraction as it removed the entire keratin cyst instead of jabbing the skin and causing skin trauma without really removing the milia itself.
Depending on the depth of decompression gauged by a trained medical professional, there will be some minimal swelling and redness for two to three days after the procedure as well as tiny scar marks left by the needle. “These marks will should completely flatten out or disappear in a week or two,” she clarifies.
Another method that Dr. Teo suggests is the CO2 laser vaporisation, which uses laser technology and is particularly useful for individuals who have larger milia seeds which may not be able to be decompressed successfully.
“If we have failed the first decompression procedure, I usually do not recommend my patients to persist in it because it will just cause inflammation and scarring. Instead, we will turn to CO2 laser to destroy the tissue and produce better cosmetic results. I also prefer using CO2 laser to treat larger milia seeds or those that occur in clusters or have persist for several years,” she contends.
With CO2 laser vaporisation, there will be a crust or a scab that forms over the area of treatment once the procedure is done, which will typically fall off within two weeks. Dr. Teo. also shares that some milia can be removed by cryotherapy and liquid nitrogen.
Having said that, it is not a crime if you’re still keen to give topical retinoids a try to remove milia seeds. However, Dr. Teo advises that it’s probably best to get your hands on prescription-only formulas as they are higher in concentration compared to retinol.
Overall, the only caveat with using retinol or retinoids as a removal method for milia is that it may not produce the desired results in the time frame that you’re looking at but will certainly cause some form of trauma to your skin, especially your delicate eye area.
Don’t just write off retinoids completely though, as our skin experts here all agree that retinoids (or retinol for that matter) work well for treating and preventing comedones (blackheads and whiteheads).
Dr. Tang adds, “it functions primarily to inhibit collagenase and stimulate collagen synthesis – this translates to the ingredient’s anti-wrinkle effects, as well as its ability to improve skin texture and the appearance of fine lines. Just keep in mind that vitamin A-based creams are best applied at night as they can get degraded by sunlight and also can cause photo-sensitivity.”