The Truth About Milia: Don't Try to Pop These White Bumps

Ellie Rashid (0:00)

People often will try to squeeze them. Don't try to squeeze it out because you can't. The reason why it doesn't come out is because there's no exit route.

Emma Craythorne (0:08)

So what are they? What are they? What are Milia?

Ellie Rashid (0:13)

Hello and welcome to the After Hours Skin Clinic. I'm Dr. Ellie Rashid, a consultant dermatologist with a PhD in regenerative dermatology.

Emma Craythorne (0:20)

And I'm Dr. Emma Craythorne, a consultant dermatologist and fellowship trained in skin cancer and laser surgery.

Ellie Rashid (0:27)

We work at St. John's Institute of Dermatology and at One Wellbeck right here in Central London.

Emma Craythorne (0:32)

But this is our favorite clinic where we unpack the evidence, challenge the trends and answer the questions you don't have time in your dermatology appointment.

Ellie Rashid (0:42)

This is the other side of dermatology, the questions that you want to ask your dermatologist, but don't have time to. And if you don't have a dermatologist, you do now.

Emma Craythorne (0:53)

Okay, Ellie, do you want to tell everybody what we're talking about and why we're talking about this subject?

Ellie Rashid (1:00)

The reason I'm giggling is because I was going to try to pretend that it's about something patient-related. I get Milia.

Emma Craythorne (1:09)

It's always back up to Ellie.

Ellie Rashid (1:12)

I get Milia. And I thought it would be great if we did a really deep dive into Milia. And also whenever I post anything about my Milia, there are always lots of people that ask me what I do about them. And so I thought it could help the wider public. So if you get Milia, listen to this episode, or someone you know gets Milia, then you know what to recommend. Well, I'll just recommend they listen to this episode. But yeah, that is my motivation for doing it.

Emma Craythorne (1:36)

It's a good subject because I would say almost in every clinic I do, somebody will, they'll never come in with the Milia and say, you know, this is the reason I'm here to see you, doctor. But they will have it pop up halfway through. They'll say, oh, and could you just tell me what this is? And what do I do about this? So I think this is a great episode title.

Ellie Rashid (1:55)

I normally notice on people when I'm doing a full skin check. And obviously, because I love doing it, I always extract them for them for free.

Emma Craythorne (2:05)

Do you extract your own?

Ellie Rashid (2:06)

I do, but I get them, I get them around my eyes. And sometimes because it can be quite fiddly to do, I find it quite difficult to do myself. So sometimes I'll ask a colleague to do it for me.

Emma Craythorne (2:20)

And I think particularly if you're doing it around the eyes, that is an area to be kind of careful with, you know.

Ellie Rashid (2:26)

Completely. I mean, periorbital cellulitis.

Emma Craythorne (2:30)

I've seen a patient in hospital with that from trying to remove, it was actually a spot and not a Milia, but the patient was in intensive care.

Ellie Rashid (2:38)

What?

Emma Craythorne (2:38)

Yes, sepsis.

Ellie Rashid (2:40)

Oh my gosh. I mean, yeah, you should probably have it professionally done. But that's the thing, there are so many clinics that offer like Milia extraction and you might not know how they're doing it and if they're using like sterile products, if you're going to do it, do it properly.

Emma Craythorne (2:56)

So what are they? What are Milia?

Ellie Rashid (2:58)

So Milia are essentially these tiny little cysts. So they're these little balls of keratin, but they're very superficial, that top layer of our skin. And one of the reasons why, so it might look like a little pussy spot or a little white head or something. And so people often will try to squeeze them.

And the reason why it doesn't come out is because there's no exit route, because it's got this little coverage over it. So the way that you can pop them out is by using a sterile needle to create a little exit route for it and then be able to extrude the keratin content. So what our skin cells are made up of. So that keratin is essentially what collects in it. And this little ball pops out. It's one of the most satisfying things to do.

Emma Craythorne (3:43)

And do you know why they're called Milia?

Ellie Rashid (3:45)

Yes, I do, but tell us.

Emma Craythorne (3:47)

They come out like a little white seed. That's what it looks like, it's hard. And I actually love taking it out and showing it to the patient.