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Brooke’s Blog: Dermatology Questions and Answers

Dear Brooke, I have a few whiteheads on my cheeks that have been there forever. I have tried to squeeze them, but nothing comes out, and they feel kind of hard. What are they and how can I finally get rid of them? Thank you for your advice! – Natasha, 24 years-old, from Short Hills, New Jersey. Dear Natasha, It sounds like you have what is called milia on your cheeks. Milia are little cysts filled with keratin (a protein found in skin) that are benign in nature and are very common. Milia can often occur after sunburns, dermabrasion, or after trauma to the superficial layers of the skin. People can also get milia following a rash on their face after coming in contact with a substance or chemical. Additionally, there is a genetic component associated with milia, meaning that if members of your family have them, there is an increased probability that you will too. Milia typically occur on the face with the most common location being around the eyes and upper cheeks. Milia are often confused with acne, specifically whiteheads; the difference being that whiteheads are usually softer and filled with sebum while milia are firmer in texture and filled with keratin. Due to their benign nature, milia do not require treatment and can be left alone safely without any risk to the patient. Milia can be removed very easily by your health care practitioner with a small incision and then manual expression of the contents of the cyst. It is recommended to have a medical professional remove the milia in order to prevent scarring or infection if not removed properly. Many patients find that using a topical retinoid, such as tretinoin, can help decrease the frequency and occurrence of milia. Typically, once milia have been removed, they do not recur in the area treated. Best Regards, Brooke Studley, RPA-C
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Schweiger Dermatology

110 East 55th Street
New York, NY 10022

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