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Traumatic Milia

Last updated Jan. 6, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Traumatic Milia occurs secondary to an injury to the skin that is caused by burns, certain health conditions affecting the skin, or even after a surgical or radiation procedure.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Traumatic Milium
  • Traumatic Milium Cyst

What is Traumatic Milia? (Definition/Background Information)

  • Milium is a benign condition that presents as a small cyst under the skin surface, commonly on the face. They are usually multiple in numbers, and hence, called Milia (plural of Milium)
  • Traumatic Milia occurs secondary to an injury to the skin that is caused by burns, certain health conditions affecting the skin, or even after a surgical or radiation procedure. It can occur in individuals of any age group and gender
  • The cause of Traumatic Milia is any trauma sustained by the skin. Hence, any situation that causes an injury to the skin may be a potential risk factor
  • There are no significant signs and symptoms associated with Traumatic Milia, although they may not be cosmetically appealing, particularly if they occur on the face or other prominent areas
  • The condition may also not require any treatment in most cases. Also, in a majority of individuals, Traumatic Milia may disappear spontaneously on its own
  • However, if treatment is necessary, the options may include topical creams, cryotherapy, laser therapy, and dermabrasion. The prognosis of Traumatic Milia is generally excellent

Who gets Traumatic Milia? (Age and Sex Distribution)

  • Traumatic Milium can be observed in a wide age range of individuals, including newborns, children, and adults
  • Both males and females are affected
  • There is no known racial, ethnic, or geographical preference

What are the Risk Factors for Traumatic Milia? (Predisposing Factors)

The risk factors for the development of Traumatic Milium include any factor that causes skin trauma, such as:

  • Burns or sunburns (from sun overexposure)
  • Skin disorders causing blister formation such as pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa, and lichen planus
  • Porphyria cutanea tarda, a type of blood disorder that can affect the skin
  • Contact dermatitis, an allergic reaction of skin to certain substances
  • Surgical procedure such as dermabrasion
  • Radiation therapy causing damage to the skin
  • Cutaneous leishmaniasis treatment
  • Heel stick procedure: It is a minimally-invasive procedure to collect blood sample from young babies. Occasionally, this procedure can cause Traumatic Milium at the site of the skin prick
  • Exposure to poison ivy (plant)
  • Tattoos

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Traumatic Milia? (Etiology)

  • The exact cause of development of Traumatic Milia is unknown
  • However, the onset of Milium is secondary to skin trauma, resulting in sweat duct disruption
  • The skin trauma may occur due to factors such as burns, exposure to sunlight, skin disorders, and certain procedures

What are the Signs and Symptoms of Traumatic Milia?

In majority of the cases, Traumatic Milia is asymptomatic and presents no significant signs or symptoms.

  • Multiple cysts may be observed at the site of trauma, which can be sited anywhere in the body
  • In individuals with porphyria cutanea tarda, Milia usually occurs on the hands and fingers
  • These cysts are small and occur just below the skin; the surface appears as pearly white bumps
  • Each cyst may be between 1-2 mm in size
  • Solitary cysts are not commonly observed
  • There may be itching sensation in the affected region

How is Traumatic Milia Diagnosed?

  • Traumatic Milia may be diagnosed based on their presentation, a clinical examination, and comprehensive medical history (including a history of recent trauma affecting the skin, the presence of any skin disorders, etc.)
  • The examination of the skin by a dermatologist using a special magnified lens (dermoscopy) may be undertaken
  • Mostly, there is no necessity for a skin biopsy to diagnose the condition
  • Specific tests may be undertaken based on the presence of any underlying disorder

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Traumatic Milia?

Traumatic Milia does not generally present any significant complications. However, the following may be observed:

  • Some individuals may have cosmetic concerns due to the appearance of multiple cysts, in which case an appropriate treatment may be recommended
  • Complications may arise from the underlying skin disorder, burns, or cancer therapy

How is Traumatic Milia Treated?

The treatment measures for Traumatic Milia may include the following:

  • Topical retinoids
  • Laser ablation therapy
  • Cryotherapy
  • Chemical peels
  • Dermabrasion
  • Administration of antibiotics (such as tetracycline) in some cases
  • Treatment of the condition which caused Traumatic Milia

In many individuals, the condition is self-limiting and the cysts may regress and disappear within a few weeks. Also, no treatment may be necessary in a majority of individuals, since Milia is a benign condition with no serious signs and symptoms.

How can Traumatic Milia be Prevented?

Current medical research has not established a way of preventing Traumatic Milia. However, the following may be observed:

  • If it is caused by certain underlying disorders, then treating the underlying condition may help in the treatment and early cure of Milium
  • Avoid or minimize sun exposure
  • Prompt treatment of any skin trauma may help control the onset of Milia

What is the Prognosis of Traumatic Milia? (Outcomes/Resolutions)

  • In a majority of cases, Traumatic Milia is asymptomatic or mild that subsides on its own without the requirement for any treatment, within a few weeks or months. However, the healthcare provider may undertake to regularly monitor the condition
  • The prognosis is generally excellent with suitable treatment
  • However, the overall prognosis may depend upon the factor or disorder causing Traumatic Milia

Additional and Relevant Useful Information for Traumatic Milia:

  • Cleaning the skin too hard with strong chemicals or soaps may aggravate the condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
  • Scratching the affected areas or picking the cysts must be completely avoided

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Nov. 17, 2015
Last updated: Jan. 6, 2019