Most common skin cysts are

• Epidermal cysts (sebaceous cysts),
• Pilar cysts (trichilemmal cyst)
• Vellus hair cysts and
• Milia

Epidermal Cysts

It is most common skin cysts and also called epidermoid cyst, sebaceous cyst.

They develop from hair follicle wall in skin and may follow trauma or long persisting comedone.

They can occur anywhere on body. They are skin colored dermal cystic nodules with a central punctum. Many times pressing or gentle handling of cyst may lead to extrusion of content with smell of sebum. It can be stable in size of may progress gradually varying in size from some millimeters to centimeters. Secondary infection may complicate these cysts by sudden increase in size, pain, inflammation in surrounding skin and pus discharge.

Diagnosis is usually based on clinical examination; rarely skin biopsy may be required to differentiate it from other types of cysts. Sometimes these cysts can be associated with genetic diseases which may need examination of other body organs.

Sometimes they resolve spontaneously but they tend to recur. Treatment of non- inflamed or non-infected cyst is not necessary unless desired by the patient.

Excision of cyst is required if cyst is rapidly increasing in size or causing symptoms of pain, inflammation in surrounding skin or getting secondarily infected again and again. Non-inflamed cyst can be removed without any pre surgery treatment. For inflamed cysts sometimes it is beneficial to settle inflammation with intralesional steroid injection (non-infected) or oral antibiotics (infected cyst).

Type of surgery for excision of sebaceous cyst

Punch excision and Minimal incision technique are preferred choice for excision of non-inflamed cyst. In these techniques a small incision will be given on most prominent part of cyst and then with help of instruments whole cyst with wall will be removed from this incision. Sometimes in case of large cysts, with smaller incision, content will be extracted first then wall will be removed from same small incision.

Infected fluctuant cysts may first need drainage of pus and antibiotics, then surgical excision.

Pilar (trichilemmal) cysts

These cysts look almost similar to epidermal cysts. They develop from different part of hair follicle. Most common site is scalp. They can be multiple in numbers in familial cases. There is less chance of rupturing compare to epidermal cysts. They don’t have punctum. Surgical excision is easier than epidermoid cysts.

Vellus hair cysts

These cysts develop as sudden eruption in form of small, follicular, dome shaped papule with greenish hue due to presence of hair in content of cyst. These cysts are usually asymptomatic and may regress on its own. Sometimes because of excess number and cosmetic concern patient may require treatment. Treatment of vellus hair cysts include incision and extraction, intralesional RFA or CO2 laser ablation.

Milia

OVERVIEW

Milia are tiny white bumps that are commonly develop in kids but can occur at any age. They are harmless and don’t require any treatment. Cosmetic concern or numerous lesions in-group are common indication for getting treatment. There is no effective way to prevent milia.

Causes

Milia are small keratin cysts that develop from pilosebaceous or sweat gland duct due to trapping of skin flakes just beneath the upper layer of skin. They can be of two types on basis of onset:

Primary:  Commonly develop in newborn kids, but can occur at any age.

Secondary: Sometimes injury at level of junction of upper layer (epidermis) and deeper layer (dermis) like second-degree burns, blistering diseases of skin, skin abrasion, during healing may lead to formation of milia.

Colloid melium is another type of milia and chronic sun exposure (Ultraviolet rays) and autoimmune disease are predisposing factors.

Symptoms

Milia lesions are 1-2 mm sized white colored pearl like firm smooth surfaced bump that develop commonly on face. They can present discrete or close to each other.

Milia in kids

Most commonly seen on baby’s nose, chin or cheeks. Sometimes upper trunk or limbs may also have scattered milia lesions. Milia in kids doesn’t require any treatment and most of times they resolve in weeks or months.

Milia in adults

In adults face is most common site. Cheeks, areas around eyes, nose and chin are commonly involved on face, sometimes sides of forehead may also have milia.

Colloid melium is characterized by clusters of milia having yellowish white appearance. Most commonly it presents behind the ear area.

Melasma Treatment

How dermatologist Diagnose milia?

Clinically. Dermatologist will identify milia by just examining it. Sometimes woods lamp examination can be done and rarely skin biopsy may be required specially for colloid melium.

Treatment options for Milia Removal?

Milia are harmless and don’t require any active treatment. Cosmetic concern is most common reason behind getting treatment for milia. There is no any cream or oral tablet that can clear milia. There can be little success with topical retinoid creams but irritation and dryness because of these creams make them less useful in milia. So removing milia is only method with best outcome.

Milia removal treatments

Needle Extirpation: It is most commonly performing treatment for milia removal. In this treatment a small nick will be made on roof of cyst and with help of fingers or safety pin content of cyst will be extracted out.

Radiofrequency ablation: In this treatment nick will be made with RFA machine.

CO2 laser treatment for milia– In this treatment nick will be made by CO2 laser and it is useful when lesions are numerous and present close to each other. Many times there is no need to extract the content, it fall down on its own.

Prevention of milia

There is no well defined treatment for preventing milia formation.

Regular exfoliation treatment like hydrafacial or microdermabrasion may help in reducing recurrence.

Salicylic acid facewash to control oily skin and 2-3 times in week topical retinoid creams may help to some extent.

TIPS

Watch our video on Youtube :https://youtu.be/DfpYlgr7Ahc

Keep clean your skin from pollutants and greasiness.

Periodically get exfoliation done if you have tendency of recurrent milia.

FAQs

Why should I choose Dr. KothiwalaSkinEva Clinic for Milia Removal Treatment in Jaipur?

Detailed Consultation with best dermatologist in Jaipur Dr Sunil Kothiwala,  MD (AIIMS)

All treatment options are available at clinic and best customization of treatment according to your skin concern.

Treatment is done by doctor only, not technician.

Affordable because of unique treatment offer for milia removal.

Can Milia be cured?

Yes, there are treatments by which milia can be removed without having any side effect. Although recurrences are common but cant be predicted sometimes they don’t recur too so if you are cosmetically affected due to milia get it removed.

Can I remove milia at home?

Milia are tightly packed cysts and trying any crude method at home may leave incomplete removal or scarring. So it is not advised to remove milia at home.

Is there Side effect of milia removal treatment?

In any kind of milia removal treatment there is no side effect. No post procedure spot or pit remains on skin.

For more information on Milia & skin cyst or to inquire about other services please contact us on 7726938335.