From the Research
The recommended treatment for milia involving the eyelid is gentle extraction performed by a dermatologist or ophthalmologist, or alternatively, treatment with a CO2 fractional laser as reported in a case study 1. This approach prioritizes minimizing the risk of eye injury and promoting effective removal of the milia. The procedure involves making a tiny incision in the cyst with a sterile needle or blade, followed by careful expression of the keratin contents. Prior to extraction, the area may be cleaned with an antiseptic solution and local anesthesia might be used for comfort. For persistent or numerous milia, topical retinoids like tretinoin 0.025-0.05% cream may be prescribed for nightly application, avoiding direct contact with the eye. Some key points to consider in the treatment of milia involving the eyelid include:
- Avoiding self-extraction or picking at the milia to prevent infection, scarring, or eye damage
- Using warm compresses applied to the area for 5-10 minutes daily to help soften the milia before professional extraction
- Considering alternative treatments such as chemical peels containing salicylic acid or glycolic acid at low concentrations for use away from the eye margin, as these can increase cell turnover and prevent keratin buildup that forms milia 2. However, the most recent and highest quality study specifically addressing milia en plaque of the eyelid suggests the use of a CO2 fractional laser as a potentially effective treatment option 1.