Q. Can I get milia removed without scar?

Answered by
Dr. Gaurang Gupta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 11, 2017 and last reviewed on: Jun 28, 2019

Hi doctor,

I have a noticeable milia spot on my cheek. My dermatologist said that she would extract, but it could leave a dented scar. I have read that it does not scar. I am very nervous and unhappy with this milia, which looks like a big whitehead.

Will it be safe to get it extracted? I have panic and anxiety disorder. So, I am so anxious right now. My current medications are Xanax and Simvastatin. I never had milia before and all my laboratory work is good. Please share your opinion.

#

Hello,

Welcome to icliniq.com.

Milia are a white material containing papule type lesions that mainly presents over the face. Milia are due to sun exposure. Long term sunlight exposure cause sweating and mild sunlight reaction and in turn form milia. If you notice the area, then you will come to know it is always present over sun exposed part only like face, hand, neck and forehead.

For further prevention, use proper sunscreen with 50 SPF (sun protection factor). Sunscreen should be applied in daylight before going outside twice or thrice in a day.

I want to make you sure that after removal of milia no marks will be left. I do it on a daily basis and almost every day. It should be extracted by small needle and it is not a time taking, painful or complicated procedure. Milia is very superficial lesion so even if it is removed manually by needle or extractor they do not leave any scar or marks.

So, you can go for it without any anxiety or anxiousness. It is completely a very superficial procedure. To make you more comfortable, I would like to tell you that scar always comes when something happening deep to the skin like any injury or severe acne. But, milia are so superficial.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I had the milia extraction done three days ago. She lanced it and with her fingers, she squeezed it out. It hurts a little. Now, I have some scab, which is turning brownish and my skin is pulling slightly tight near the scab. I am not putting anything on it except a gentle cleanser to wash my face.

How long will this scab last? Is this normal?

#

Hello,

Welcome back to icliniq.com.

Yes, this is the normal process of healing and the scab will go off in a week without leaving any scar or marks. If your doctor have not prescribed any cream, then do not apply anything. But, I do give antibacterial cream. Although it is very subjective, a few doctors give.

Do not try to remove it on your own or while washing the face. Try to avoid the area where you have a scab while washing. I think, when everything has been done properly and no scar or marks would come.

For further doubts consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

My little scab fell off in a week. I thought everything went well, but my milia are still there and it is like I never had it removed. I am very upset. What can I do now since the extraction did not work? Did the milia just come back? I do not understand how this happened? Will this go away?

#

Hello,

Welcome back to icliniq.com.

There are two things to look now:

  • Are you sure that it is milia?
  • Was extraction done properly?

Milia is simply a very small papule or pimple type, which contain whitish material and always present over the face, around the eye, photos exposed part. It usually never comes back after extraction. Now, if extraction is not done properly and the material remained in milia, then it will reappear. So, I think the full material was not extracted.

But, another possibility also there called as molluscum. Yes, molluscum also looks like milia. It also contains whitish material. It will come on face and cannot get removed very easily. It is highly recurrent. Consult your dermatologist and confirm whether it is milia or molluscum. Also, you can send me photos. It should be clear and focusing your milia part.

Revert back with the photos to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I do not believe it as molluscum. Both my dermatologist and esthetician said it as milia. It is not as big as it was, but it is still there. My esthetician did the procedure, but I will go to my dermatologist now. I did not get any scar or pigmentation.

#

Hi,

Welcome back to icliniq.com.

Do not worry. You have to follow the procedure again as there may be a little material remained in. Just get it removed by the same procedure. I think you should go to the same doctor and get removed completely. Because, the procedure is the same and there is always a little chance of error.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Hi doctor,

I went to another dermatologist. She said that it is not milia because if it was, then it would have come out very easily. She said it is a cyst. But, I do not remember the name of the cyst. She said she could cut it out, but could scar and so suggested to leave alone or try microdermabrasion. I am going to see my esthetician today. Should I try some kind of peel or dermasweep procedure or leave it alone?

#

Hi,

Welcome back to icliniq.com.

Well, I was concerned about that previously also that whether you really have milia or something else. It would be very helpful if you can send the photos of that. Your dermatologist told that it is not milia, but some cyst. I think that may be sebaceous cyst.

The problem is cyst and milia are totally different things and looks very different. Sebaceous cyst does not have a mouth or whitish material as I hope your doctor said sebaceous cyst only. If it is sebaceous cyst, then you have to wait for three to five month and watch its size.

If the size is not reducing or increasing, then you can get it removed by a surgeon and not a dermatologist. Because, dermatologist can remove it, but will not be able do it esthetically. But, a trained surgeon will minimize the scar and stitch marks in a better way.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

Your opinion is I should leave it alone. Is it?

#

Hi,

Welcome back to icliniq.com.

Yes, if it is sebaceous cyst, then just leave it for six months and watch its growth. There are three treatment options for cyst:

  1. Wide excision: Complete removal, but can leave scar.
  2. Minimal excision: No scarring, but cyst will return.
  3. Laser with punch biopsy excision.

My suggestion is to just wait and watch for six months and observe it's size. Sometimes, it reduces itself too. If the size increases, then get it removed.

For further information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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