Facial texture is normal, but if you’re seeing an increase of it, there could be a variety of reasons. Visiting your dermatologist may help you to better understand why, but one of the most common reasons is milia. Milia are nothing to worry about, and you're fine the way you are. But, if you're interested in treating their appearance, we have some information that could be helpful. 

 

What are milia?

Milia, also known as “milk spots” are caused by trapped, dead skin cells (keratin) beneath the skin. The trapped keratin form cysts below the surface of your skin, and these are known as milia. Your body is supposed to get rid of dead skin cells naturally by shedding them and allowing new cells to take their place. 

 

However, when your skin doesn’t shed properly, new skin can grow on top of the dead skin cells and trap them underneath. When your old skin cells don't fall off enough or quickly enough, new skin grows on top of them and traps them underneath.

 

So, unlike pimples, milia are not filled with sebum or oil. They are simply filled with keratin, a protein within the skin, hair, and hardened, dead skin cells. 

 

Why do milia happen?

Well, there are actually two types of milia, primary milia and secondary milia. Milia are thought to come from hair follicles while secondary milia derive from dead skin cells trapped within eccrine sweat ducts. Thus, milia can either come from plugs in sebaceous ducts or sweat ducts. 

 

Sebaceous ducts and the pilosebaceous unit 

 

Both hair and oil come out of the pilosebaceous unit. Sebaceous glands are located in the pilosebaceous unit, and they produce oil. 

 

In pilosebaceous units, sebaceous glands are connected to the hair follicle by a short sebaceous duct, and sebum flows through the duct, out through the follicle, and over the skin surface.

 

Furthermore, hair follicles are a type of pore, and they are known as the pilosebaceous unit’s opening. Then, there are also sweat pores.

 

But in the condition of milia, these ducts or follicles can become clogged, then skin grows over it.  

 

What causes milia?

Sometimes, heavy or oil-based skincare products can clog the pores and contribute to milia formation, especially around the eyes or the T-zone. But, because the skin around the eyes does not have oil glands, it may be difficult for them to absorb properly, and this can lead to clogging.  

 

An overexposure to UV radiation can also damage the skin. UV radiation can damage the skin barrier, and this can prevent dead skin cells from shedding properly, eventually forming bumps underneath the skin.  

 

Trauma to the skin such as UV radiation and also some medications can lead to milia. 

 

The bumps on my skin are dark or red and rough, and I can see them. Is this milia too?

 

So, milia could present differently on a variety of skin types. However, you’re most likely seeing keratosis pilaris.

 

What is keratosis pilaris?

Harvard Health states, “keratosis pilaris is so common that many dermatologists consider it a skin type instead of a medical condition. About 50% to 80% of teenagers and 40% of adults will develop these bumps at some point during their lives.”

Keratosis pilaris bumps are collections of keratin that clog your pores.As mentioned before. pores are small openings in the skin. “There are two types of pores; one type releases sweat and the other type are known as hair follicles, and they release oil.”

 

How is keratosis pilaris different from milia?

Presentation is the primary difference between them. Keratosis pilaris bumps sit on top of the skin instead of flaking off properly. They are discolored, rough, and bumpy. They are much more common in people with eczema as well. 

On the other hand, skin grows over milia trapping them beneath the skin. 

The bumps you see with keratosis pilaris are actually collections of the protein keratin sitting on top of the hair follicle and on the surface of your skin. Plus, they only plug hair follicles. They do not clog sweat ducts. 

Keratosis pilaris is largely caused by dryness whereas milia is primarily caused by a lack of exfoliation. While yes, both can result from a lack of proper exfoliation, the dead skin cells in keratosis pilaris often fail to shed because of a lack of hydration and moisture. On the other hand, the skin cells fail to shed with milia because skin has grown over the clog. Moreover, keratosis pilaris is more likely to happen on the body.

 

What are the treatments?

However, they have similar treatments. Retinoids bind to certain receptors in the skin and help it shed properly and more quickly. You can also look for AHAs, which are exfoliators that help to disintegrate dead skin cells and resurface a new layer of skin. For keratosis pilaris, you’ll want something that strips these keratin plugs away, and for milia, you’ll want something that frees up and sheds those keratin plugs. 

Both retinoids and AHAs can provide this.

However, with keratosis pilaris, you’ll also want to couple exfoliation with deep hydration to help the skin shed properly and to prevent it from recurring. 

Saturday Skin 4% GLYCOLIC ACID + PORE CARE COMPLEX - $36

This is so potent that Cassandra will use this occasionally and sparingly at night. This is one of the most potent exfoliators, and it actually causes more peeling the The Ordinary’s AHA/BHA serum, even for Cassandra. This serum provides quick results for resurfacing a new soft, smooth layer of skin. Glycolic acid is a very strong exfoliator because the molecules are so small. Their size allows them to penetrate deeply into pores and break up dead skin cells, which is great for milia. 

Once again, this will probably work faster, but it could cause some irritation on sensitive skin types or skin types with a low tolerance for potent skincare. Retinoids will also help train your skin to shed properly, but this will not. However, do not combine the two or use them within similar time frames. 

You can even use a small amount of this, mix it with your body lotion, and put it on keratosis pilaris patches. 

 

Here are a few products that might help!

MAKEP:REM UV Defense Daily Sun Fluid SPF 50+ PA++++ - $24

Since UV radiation can cause improper exfoliation and also dry skin, sunscreens are great for preventing and improving both keratosis pilaris and milia. This is also a hydrating,  physical sunscreen, meaning gives the skin moisture while also protecting it from visible light. If you’re using a potent exfoliating product, using a gentle, physical sunscreen such as this one would probably be best. This will prevent irritation or sensitization. 

 

The INKEY List PHA Exfoliating and Hydrating Body Water Cream - $14

PHAs are gentle, hydrating exfoliating models that help break up dead skin. This moisturizer also provides an extraordinary level of hydration. You can use this on the face and body. It will hydrate keratosis pilaris patches but it will not be oily enough to create or worsen milia. 

 

 

Pyunkang Yul - ATO Moisturizing Soothing Gel Lotion - $13,89 

So, this is a regular, soothing lotion with hyaluronic acid ceramides for barrier repair. It also has some soothing extracts such as lonicera japonica flower extract and artemisine. This body lotion actually has no oil at all. So, this would make a great oil-less facial or body moisturizer for milia skin but also keratosis pilaris patches since it’s so hydrating and repairing.