NOT ALL BUMPS ARE MILIA: UNDERSTANDING THE DIFFERENCE BETWEEN MILIA, SYRINGOMAS, AND SEBACEOUS HYPERPLASIA
As a skin therapist, I often see clients coming into my skincare studio concerned about tiny bumps on their face, especially around the eyes and cheeks. Many assume they’re dealing with milia—those small, hard, white cysts that seem to come out of nowhere. While milia are quite common, they aren’t the only possible cause of these skin bumps. Conditions like syringomas and sebaceous hyperplasia can look quite similar, and it’s important to know the differences. Today, I’m here to help you understand what you might be dealing with and what your treatment options are.
WHAT ARE MILIA?
Milia are small, white cysts caused by keratin trapped under the skin. They are most commonly found around the eyes, cheeks, and forehead. Unlike acne, milia don’t come from clogged pores but rather from skin that fails to exfoliate properly.
Milia are harmless but can be stubborn to get rid of on your own. While they often go away naturally, professional extraction is a safe and effective way to remove them if they’re bothersome.
Treatment for Milia:
Manual Extraction: This is the most common treatment, where a skin therapist uses a sterile needle to gently release the trapped keratin.
Gentle Exfoliation: Regular use of exfoliants like alpha-hydroxy acids (AHAs) or retinoids can help prevent milia formation by promoting cell turnover.
WHAT ARE SYRINGOMAS?
Syringomas are benign, small, flesh-colored bumps that develop from overgrowth of the sweat ducts. They often appear in clusters under the eyes or on the upper cheeks and can be mistaken for milia due to their size and color. Unlike milia, syringomas tend to be softer and more deeply rooted.
While syringomas are harmless, many people seek treatment for cosmetic reasons, as they can be persistent and don’t resolve on their own.
Treatment for Syringomas:
Laser Therapy: This method uses concentrated light to vaporize the bumps with minimal damage to surrounding skin.
Electrosurgery: A small electrical current is used to remove the growths.
Topical Retinoids: These can sometimes reduce the appearance of syringomas by promoting cell turnover, although results are often gradual.
WHAT IS SEBACEOUS HYPERPLASIA?
Sebaceous hyperplasia is a skin condition where the oil glands become enlarged, creating yellowish, soft bumps that often have a central depression or "dimple." These typically appear on the forehead, cheeks, or nose—or the body and are more common as we age.
Sebaceous hyperplasia can look like milia or syringomas, but the key difference is the yellow color and central indentation. While not harmful, sebaceous hyperplasia can be cosmetically bothersome.
Treatment for Sebaceous Hyperplasia:
Laser Therapy or Electrosurgery: These treatments can help shrink or remove the enlarged oil glands.
Topical Retinoids: Regular use of prescription-strength retinoids can help reduce the size of the oil glands over time.
Cryotherapy: This involves freezing the bumps with liquid nitrogen to shrink them.
WHY DO CLIENTS CONFUSE THESE CONDITIONS?
Many of my clients come in convinced they have milia, especially when the bumps are small and white. It’s easy to see why—milia are common, and the differences between these conditions can be subtle. However, it’s important to get the right diagnosis before attempting treatment, as the solutions for one condition may not work (or may worsen) another.
As your skin therapist, I can help differentiate between these conditions through a careful consultation and skin analysis. This is why I always emphasize the importance of a professional evaluation—self-diagnosis can often lead to frustration or even skin damage if treated incorrectly.
HOW TO PREVENT AND MANAGE THESE CONDITIONS
While syringomas and sebaceous hyperplasia are often genetic and harder to prevent, there are ways to maintain healthy skin and reduce the likelihood of bumps forming:
Exfoliate Regularly: Regular, gentle exfoliation helps prevent milia by keeping skin turnover at a healthy rate.
Sun Protection: Sunscreen can help prevent the worsening of sebaceous hyperplasia, which can be exacerbated by sun damage.
Avoid Harsh Products: Over-drying or irritating products can sometimes trigger oil glands to enlarge, so a balanced skincare routine is key.
CONCLUSION: LOVE THE SKIN YOU’RE IN
If you’ve noticed small bumps on your skin and aren’t sure what they are, don’t worry—you’re not alone! Whether it’s milia, syringomas, or sebaceous hyperplasia, there’s always a treatment option that can work for you.
Cultivate a Purposeful Routine. Your skin deserves lifelong dedication. Treating it well parallels caring for your body—it's a lifestyle choice.
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