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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

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Milia in Infant/Neonate
See also in: External and Internal Eye
Other Resources UpToDate PubMed

Milia in Infant/Neonate

See also in: External and Internal Eye
Contributors: Lowell A. Goldsmith MD, MPH, Craig N. Burkhart MD, Dean Morrell MD
Other Resources UpToDate PubMed

Synopsis

Milia (singular, milium) are minute epidermal cysts. Primary milia are extremely common on the face of newborns, in which they usually spontaneously resolve by the end of the first month of life. Secondary milia occur after injury to the skin, such as from burns or subepidermal blistering disorders (epidermolysis bullosa).

Codes

ICD10CM:
L72.8 – Other follicular cysts of the skin and subcutaneous tissue

SNOMEDCT:
254679001 – Milia

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:10/30/2018
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Patient Information for Milia in Infant/Neonate
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Contributors: Medical staff writer

Overview

Milia are tiny (1-2 mm) pearly white cysts on the surface of the skin that are common in people of all ages, but are more noticeable in infants since they are present on the face. Milia form because the oil gland in the infant is still developing, and the skin does not slough off normally but will instead remain trapped in a pocket in the skin. Milia are classified into 2 types: primary milia, which occur on normal, healthy skin; and secondary milia, which are typically found on skin affected by another skin condition. Milia that are found on the roof of the mouth in infants are called Epstein pearls and are normal in newborns.

Who’s At Risk

Milia can occur in all populations and ages. Primary milia are so common in newborns (occurring in up to 50%) that they are considered normal. Secondary milia are less common in infants but may appear if there is any injury to the skin.

Signs & Symptoms

The most common locations for primary milia in infants include:
  • Around the nose
  • Around the eye (periorbital area)
  • Cheeks
  • Chin
  • Forehead
Very rarely, infants may develop milia in the following locations:
  • Trunk
  • Limbs
  • Penis
  • Mucous membranes such as inside the mouth
A milium appears as a small (1-2 mm), white to yellow, dome-shaped bump in the superficial skin.

Self-Care Guidelines

Although milia are found in the superficial layers of skin, they are difficult to remove without the proper tools. Trying to extract them at home is not a good idea as it may lead to scarring.

Primary milia found in infants tend to resolve on their own within several weeks, though they may persist for 2 or 3 months.

When to Seek Medical Care

Any new bump on your child's skin should be evaluated by a dermatologist or by another physician.

Treatments

If the doctor diagnoses primary milia in an infant, no treatment is necessary, as the condition will resolve on its own within a few weeks.

However, persistent and stubborn milia may occasionally be treated with the following:
  • Topical retinoid cream such as tretinoin, tazarotene, or adapalene
  • Removal with a sterile lancet or scalpel followed by use of a special tool (a comedone extractor)

References


Bolognia, Jean L., ed. Dermatology, pp.1722-1723. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.601, 604, 780. New York: McGraw-Hill, 2003.
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Milia in Infant/Neonate
See also in: External and Internal Eye
A medical illustration showing key findings of Milia (Pediatric) : Cheek, Eyelids, Face, Nose, White color, Tiny papules
Clinical image of Milia - imageId=59031. Click to open in gallery.  caption: 'Few tiny, smooth, white papules near the eye.'
Few tiny, smooth, white papules near the eye.
Copyright © 2023 VisualDx®. All rights reserved.