Should a dermatologist remove the milia on my face?

September 17, 2021 9:56 AM

I recently had a facial, and the esthetician said that the white dots on my face (on my forehead and below my eye) are milia. She was not able to remove them and said that I should have them removed by my dermatologist.

I did some reading online and found a couple of different sources that said that milia usually go away on their own. Should I spend the money to get them removed by dermatologist or just leave them alone?

There are 4 new ones that I have had for about a month. I also have a couple that are much older and look a little different, so maybe those are something different, not milia.

posted by allison00 to Clothing, Beauty, & Fashion (12 answers total)

Are they bothering you? My understanding is that milia are harmless, so the only reason to remove would be if you don’t like having them on your face. You could also try using an AHA (like glycolic acid) or a retinol - they help exfoliate the outer layers of skin, which can help milia go away, though it doesn’t work for everyone.
posted by insectosaurus at 10:34 AM on September 17, 2021 [9 favorites]

Estheticians love to point out every single flaw you have on your face and pathologize it. Others might refer to this as "being an adult human with skin."

It's good practice to go to a dermatologist regularly anyway to get checked for cancers and other skin diseases. I'm only 35 and am good about sunscreen and I've had a number of things removed for looking sus over the years. ("Wow, I usually only see these on seniors!" ok thx can you please just carve it out of my leg and cell check the margins...) Ask the dermatologist about your face stuff while you're there, in case it's not all milia.

But no, don't just run off for removal procedures because of something your esthetician told you. That's like taking a supplement because the trainer at LA Fitness told you it would help you get sick gainz.
posted by phunniemee at 10:56 AM on September 17, 2021 [8 favorites]

You don't need to get them removed if you don't want to. They're not harmful to you. But if you do want to, you should have a derm do it. In my experience, whether they'll go away on their own is impossible to predict.
posted by praemunire at 11:05 AM on September 17, 2021 [2 favorites]

They are harmless, and they are supposed to go away on their own although mine do that very slowly if at all. It's not particularly difficult to remove them, but they are under the skin slightly so you have to make a tiny incision to get them out which will bleed a little (which is probably why your esthetician can't/won't as there is a higher risk of infection etc).

If you do have them removed, there is a tiny hard piece of keratin, resembling a grain of rice underneath/inside, it's not like a cyst or spot. I have removed larger ones myself when they annoyed me but leave smaller ones alone. They don't, in my experience get 'worse' and I don't find them very unslightly, but I am freckled and don't really go in for the airbrushed aesthetic anyway.
posted by plonkee at 11:28 AM on September 17, 2021

Mine have always gone away on their own, though it takes a long time. I would not deal with the expense or tsuris of having them removed. I would consider changing up your face and eye cream or makeup if you're getting a lot of them, especially if you made a change in products shortly before they started appearing. Not sure about the forehead, but for stuff that specifically goes in the eye area, Sephora reviews are usually pretty good at flagging which ones tend to cause milia and which ones are safer.
posted by babelfish at 11:28 AM on September 17, 2021 [1 favorite]

One woman did that to my face a decade ago, without telling me she was going to do it. I ended up with hundreds of red dots (blood) all over my face. I looked like I had measles. If it never bothered you until she mentioned it, there's no point. People from every profession will take a magnifying glass to you and point out what is wrong. I'm sure a plastic surgeon would have a field day with me but that doesn't mean I should invest in their opinion.

I would try insectosaurus' suggestion first before anything else.
posted by ihaveyourfoot at 11:28 AM on September 17, 2021

Based on your report of the conversation, I interpret the esthetician as explaining that removing the milia was beyond her abilities and explaining how you could get them removed. I didn't gather from your report of the exchange that she was proscribing what you should do.
posted by ASlackerPestersMums at 12:07 PM on September 17, 2021 [1 favorite]

I had milia that stuck around for years and years, despite using chemical exfoliants. I would absent-mindedly pick at mine, causing them to bleed and leaving slowly-fading marks around the milia. I finally got a facial and the esthetician physically removed them. It hurt, but they stayed away and didn't leave any scars. So if you want them gone, and the esthetician couldn't get rid of them, then I guess it just depends on how long you are willing to wait for them to go away and how much the dermatologist costs. I am glad I had mine removed.
posted by pizzazz at 5:23 PM on September 17, 2021

Although I only have a few here & there, mine seem to get bigger. I had one on my eyelid that was ugly so I had the derm remove it. She said it could come back but hasn’t yet.

My sister otoh, had many, many on her face. (IANAD) The derm removed them & prescribed Retin-A topical cream/gel to keep them from coming back & to prevent new ones from forming. Retin-A is a very strong anti-acne med but it’s a panacea for types of issues like blackheads, milia, pimples, large pores, etc. With consistent & continuous use it can also erase fine lines & some deeper wrinkles.

It wrecks one’s face in the beginning but with continued use the flaking & redness heals revealing a smooth complexion.
posted by 2CatsInTheYard at 9:48 PM on September 17, 2021

Every place has different laws around what estheticians can do. And every person has different policies of what they will do.

As mentioned, milia are not a typical pimple. They are a hard pearl-like ball under the skin. To remove them you generally need to make a very very tiny knick, almost a pinhole, in the skin to pop it out. Which usually all heals fine with no issues.

But again, everywhere has different rules. In some places estheticians can’t legally puncture the skin.

And their job is to cleanse and treat your skin, which they can’t (or won’t) fully complete. So no, you don’t need to do it. But it seems they explained what it was, and how to treat it. They also likely wanted to protect themselves from a customer complaint about something they can’t treat themselves.

Most of mine have gone away on their own over time. I use AHA or BHA products for skincare.
posted by Crystalinne at 9:09 AM on September 18, 2021

I've had a few over the years, and some of them have taken years to go away on their own. I exfoliate several times a week, so if exfoliating works to get rid of milia, well it didn't for me

I found that using any oils that are solid at room temp (coconut, babassu, cocoa butter) clog up my pores and cause milia, especially around the eyes. If you're using anything like that, or any rich, thick creams, eliminating them from your routine may help the problem
posted by Zaire at 3:08 AM on September 21, 2021

Here's a dermatologist on youtube showing you how to do this yourself.
posted by apparently at 11:57 AM on September 21, 2021