Milia are small white or yellowish bumps that commonly appear on the face, particularly under the eyes, around the eyelids, cheeks, and forehead. Although they may look similar to whiteheads, milia are not acne. Many seek treatments such as the milia co2 laser to address these concerns.
They develop when keratin becomes trapped beneath the surface of the skin, forming tiny cysts. Because milia do not have a normal opening to the skin surface, squeezing them like acne may be ineffective and can potentially cause irritation, pigmentation, or scarring. Medical professionals often recommend milia co2 laser as an effective solution for removal.
At ProDerma Clinic in Bangkok, treatment begins with a medical assessment to confirm whether the bumps are truly milia. When appropriate, milia co2 laser may be used to create a precise opening in the skin so the trapped keratin can be removed. The milia co2 laser treatment is effective in ensuring a smoother skin texture and quicker recovery.
They develop when keratin becomes trapped beneath the surface of the skin, forming tiny cysts. Because milia do not have a normal opening to the skin surface, squeezing them like acne may be ineffective and can potentially cause irritation, pigmentation, or scarring.
Milia are small keratin-filled cysts that develop just beneath the skin. Typical characteristics include:
- Small, round white or cream-colored bumps
- Usually around 1–2 mm in size
- Generally painless and non-inflammatory
- Common around the eyes, cheeks and forehead
- May occur as a single bump or multiple lesions
- Cannot usually be extracted by simply squeezing the skin
Not every small white bump is milia. Closed comedones, sebaceous hyperplasia and syringomas may sometimes have a similar appearance. This is particularly important around the eyes, where accurate diagnosis should come before treatment.
What Causes Milia?
Milia form when keratin, a natural protein found in the outer layer of the skin, becomes trapped beneath the skin surface.
: Primary milia may develop spontaneously without an obvious underlying skin condition.
: Secondary milia may occur following skin injury, inflammation, burns or certain procedures as the skin heals.
Having milia therefore does not necessarily mean that the skin is oily or inadequately cleansed.
A CO2 laser operates at a wavelength of approximately 10,600 nm and is strongly absorbed by water within the tissue. This allows the physician to precisely ablate very small areas of skin.
For milia treatment, the CO2 laser can be used to create a tiny opening over the cyst. The trapped keratin can then be carefully removed.
The objective is to treat the individual lesion while minimizing unnecessary injury to the surrounding skin.
Potential Advantages of CO2 Laser for Milia
CO2 Laser for Milia Under the Eyes
The eye area is one of the most common locations for milia, but it also requires particular care because the skin is thin and delicate.
Before performing laser treatment, it is important to determine whether the bumps are actually milia.
For example, multiple small bumps beneath the eyes may sometimes be syringomas rather than milia. Although they can look similar, these are different skin conditions and may require different treatment approaches.
When CO2 laser treatment around the eyes is appropriate, the physician selects the treatment parameters according to the location and characteristics of the lesions, with appropriate eye protection used when required.
Milia CO2 Laser Treatment: What to Expect
Treatment generally involves the following steps:
1. Medical assessment – The physician examines the lesions and confirms the diagnosis.
2. Skin preparation – The treatment area is cleansed.
3. Anesthesia – Topical or local anesthesia may be used depending on the location and number of lesions.
4. CO2 laser treatment – A small opening is created over the milia.
5. Keratin removal – The contents of the cyst are carefully extracted when appropriate.
6. Post-treatment care – Instructions are provided to support proper wound healing.
The treatment time varies depending on the number and location of milia.
What Happens After CO2 Laser for Milia?
Small areas of redness, superficial wounds or tiny crusts may develop after treatment. These are part of the normal healing process.
Patients should avoid scratching, picking or manually removing the crusts, as doing so may increase the risk of irritation, post-inflammatory pigmentation or scarring. For those considering treatment, exploring options like milia co2 laser can be beneficial.
Can Milia Come Back After CO2 Laser?
Yes. Treating existing milia does not guarantee that new milia will never develop.
CO2 laser treatment addresses the individual lesions present at the time of treatment. New keratin cysts can still form in other areas of the skin later.
If milia repeatedly develop in large numbers, a dermatologist can evaluate whether there are contributing factors or whether the lesions may represent another skin condition.
Can I Remove Milia at Home?
Trying to squeeze or puncture milia at home is generally not recommended, particularly around the eyes.
Unlike acne, milia do not have a normal pore opening. Applying excessive pressure or attempting to open them with non-sterile
equipment may lead to:
- Skin inflammation
- Infection
- Post-inflammatory hyperpigmentation
- Bleeding
- Scarring
Professional assessment is particularly useful when lesions are numerous, recurrent or located close to the eyes.
Milia CO2 Laser at ProDerma Clinic Bangkok
At ProDerma Clinic, treatment begins with an assessment of the skin lesion rather than assuming that every small white bump is milia.
The physician evaluates the type, size, depth, number and location of the lesions before recommending treatment. This is especially important for lesions around the eyes, where conditions such as syringoma can resemble milia.
When the lesions are confirmed as milia and laser treatment is appropriate, Program CO2 Laser may be considered as one treatment option.
Frequently Asked Questions About Milia and CO2 Laser
Milia are small keratin-filled cysts that form beneath the skin. They are not acne and usually do not have a pore opening, so squeezing them may cause irritation, pigmentation, or scarring.
When the bumps are confirmed as milia, a physician may use a CO2 laser to create a precise opening and carefully remove the trapped keratin. Suitability depends on the number, depth, and location of the lesions.
Topical or local anesthesia may be used depending on the treatment area and number of lesions. Sensation varies between individuals, but the procedure is designed to treat each lesion precisely.
Small areas of redness, superficial wounds, or tiny crusts may appear during healing. Avoid scratching or picking the treated area, follow the physician’s aftercare instructions, and use sun protection as advised.
Yes. CO2 laser treats the milia present at the time of treatment, but new milia may develop later. Recurrent or unusual bumps should be reassessed to confirm that they are milia and not another skin condition.
Written by Dr. Ratchayut Thanapiyachaikul
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BOARD CERTIFIED DERMATOLOGIST, AMERICAN BOARD OF DERMATOLOGY IN LASER SURGERY, FELLOWSHIP IN COSMETIC LASER UNIVERSITY OF MIAMI, FELLOW IN DERMATOSURGERY AT RAMATHIBODI HOSPITAL
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