Miliums
Milium cysts consist of small papules in the form of tiny, whitish, brightly colored ‘pellets’ that usually appear around the eyes, eyelids, and cheeks. They are nothing but the accumulation of keratin, the cutaneous protein that is usually naturally desquamated, which remains enclosed within a capsule. They do not imply any alteration of health nor are they contagious.
We do not know the cause that causes the appearance of milium cysts, of which there are different types. The most common are those of adults, which may be secondary to a chronic sun exposure or some skin disorders, although most often are idiopathic (of unknown cause). In general they are asymptomatic and the only annoyance they cause is aesthetics, since they usually appear in especially visible areas.
For the removal of milium cysts you can choose to open and drain (with minimal puncture and extrusion) or the evaporation with CO2 laser. The difference between these two procedures lies in the purpose: the drainage of the cyst solves only temporarily its presence, because we do not remove the capsule. In contrast, the CO2 laser eliminates the cyst immediately and definitively as it delicately evaporates the capsule. Another difference between the therapeutic options is that the puncture and extrusion of the contents of the milium cyst is difficult in noble areas such as the eyelids, because to extrude its keratin requires a firm support on the tissue and can be a painful technique to Injuries near or over the eyes. The CO2 laser, on the other hand, does not require any pressure on the cyst, simply evaporates it. For this reason it is the best method to eliminate milium cysts in especially sensitive areas such as the eyelids.