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Comportement grain milium infecté.

Infected Milia: What to do?

"Milia" are small bumps that can emerge beneath the skin's outer layer. They particularly invade the eyelid, the area around the eyes, the nose, as well as the cheeks or chin. Although they naturally disappear, some people are tempted to touch them, which can lead to infection. Discover the measures to take in this case.

Summary
Published March 25, 2024, by Kahina, Scientific Editor — 4 min read

How can a milium cyst become infected?

Milium cysts are subcutaneous bumps that are hard to the touch and contain keratin. These small bumps are not dangerous and often disappear on their own. Indeed, they do not require any special treatment. However, there are solutions if these microcysts become too bothersome aesthetically. This can include, among other things, a mechanical extraction of the milium cyst .

It's important to understand that a milium cyst is closed, unlike other blemishes such as blackheads. Indeed, it generally results from poor exfoliation of dead skin cells, which leads to the obstruction of hair follicles and thus the formation of a layer of skin above that traps them. Given that an infection occurs through the skin penetration of an infectious agent, this means that the milium cyst must first be pierced. It can particularly be opened by scratching its surface, aggressive exfoliation, or by using extraction tools such as a needle.

When one manually manipulates a milium grain or uses self-administeredmilium grain extraction tools (extractor, needle, or curette) that are not aseptic, these actions pose risks of contamination and therefore infection of the microcyst. Non-compliance with hygiene rules, such as poor hand washing or improper sterilization of tools, especially when the procedure is performed by an untrained person, creates a fertile ground for the development of bacteria, fungi, and viruses. Once the milium grain is punctured, these contaminants can enter through the wound under the skin and cause infections.

Among these, we can potentially find follicular pyodermas, characterized by a bacterial infection of the hair follicle where milia are located. They are caused, among other things, by the bacterium Staphylococcus aureus. Examples include folliculitis, boils, and anthrax, which is more serious. However, these scenarios have not been scientifically proven.

Infected Milia: What are the appropriate actions to take?

Let's remember that it is strongly advised against removing a milium grain by yourself, as this behavior exposes you to infections. If you wish to get rid of it, turn to a dermatologist who is qualified to proceed in a safe manner.

If you notice redness, a change in the appearance of the milia, pain, unusual local signs, or even fever on the affected areas, quickly consult your doctor so they can determine the appropriate treatment for your case, which will likely involve the prescription of oral antibiotics. Do not attempt to touch the infected milia, as you risk worsening the situation.

Sources

  • BERK D. R. & al. Milia: A review and classification. Journal of the American Academy of Dermatology (2008).

  • BARBAROT S. & al. Les grains de milium de l’enfant. Annales de dermatologie et de vénéréologie (2009).

  • TROUCHE F. Les infections bactériennes. Dermato-Info (2019).

  • GALLARDO AVILA P. & al. Milia. StatPearls (2023).

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