Why won't Milia resolve on their own?

by Dr Wan Chee Kwang
October 23, 2023

Milia are small white bumps that appear on the skin and many patiently wait for them to disappear on their own. While milia can go away with time, some may persist for months, causing patients frustration.

This blog post will shed light on what milia are, why they form, and why they don’t resolve naturally. We will also explore milia removal and introduce you to safe and effective treatments for addressing this skin concern at 1Aesthetics.

Milia: why they form

Before we dive into why milia can be so persistent, it's essential to understand what they are and what causes them. 

Milia are small, dome-shaped cysts filled with keratin, a protein typically found in our skin, hair, and nails. Unlike acne, which is caused by clogged hair follicles and sebum, milia form when dead skin cells accumulate and block sweat ducts beneath the skin. 

They typically appear on the skin's surface, are firm to the touch and have a smooth, pearly texture. Milia can grow anywhere on the body but are usually found on the face. It is common for milia to fade away with time but some may persist without removal treatment.

Deeply embedded

One of the primary reasons why milia don't resolve on their own is that they are deeply embedded in the skin. 

Although milia is seen on the surface, they actually reside deep within the sweat ducts. This deep-seated location and their being firmly lodged beneath the skin's surface makes it nearly impossible for them to be washed away or resolved by the body’s natural processes.

No opening

Unlike whiteheads or blackheads that have openings on the skin's surface, allowing them to be squeezed out or naturally exfoliated, milia have no such exit route. Without an opening, the trapped dead skin cells can’t be cleared through the skin's usual exfoliation process.

Confusion with other types of skin growths

Another crucial factor preventing 'milia' from resolving independently is the possibility of them being different skin growths like syringoma, sebaceous hyperplasia, or warts, which can be mistaken for milia. Therefore, it is essential to seek the guidance of a qualified and experienced medical professional for accurate advice. 

Resorting to 'burning' off procedures at beauty salons may not only prove ineffective but also carry the risk of causing potential scarring.

Milia removal treatments

Although milia don't pose any health risks, many individuals prefer smooth skin that is free of them. If you dislike the appearance of milia and are looking into milia removal, let's discuss the available professional treatments in 1Aesthetics. 

Depending on the severity and location of your milia, we may recommend one of the following options.

Manual extraction or surgery

A doctor can manually extract milia using specialised tools. A trained professional should only perform this procedure to avoid complications, including infection or scarring. While effective, manual extraction can be uncomfortable and messy due its lack of precision compared to energy-based treatments.

Ultrapulse CO2 laser

The Ultrapulse CO2 laser can be used to vaporise the milia. This method uses highly focused and intense laser beams to precisely target milia with minimal scarring. Its settings can be controlled according to the depth of the milia, making it ideal for both deep and superficial milia.

RF ablation

Radiofrequency (RF) ablation is a minimally invasive treatment that uses high-frequency radiofrequency energy to break down the cyst walls and help the milia disintegrate. This method is suitable for various sizes of milia and can treat even sensitive areas like the eyelids. 

A study found that RF ablation was highly successful in treating benign cutaneous lesions, including milia, with excellent or good clinical results in 93.5% of cases. This method is generally well-tolerated and has a low risk of scarring.

Effective milia removal in Singapore

Milia can be a persistent skin concern, but they don't have to be a lifelong annoyance. 

While you can consider several milia removal treatment options in Singapore, it's essential to choose a trusted skincare professional to determine the best approach for you. 

The treatment methods mentioned earlier can all remove milia. However, based on 1Aesthetics’ experience, RF ablation and Ultrapulse CO2 laser methods have been more effective at complete milia removal, with minimal scarring and a lower chance of recurrence.

1Aesthetics provides milia removal treatment that prioritises your safety and comfort. We also specialise in other skin growth treatments, such as lipoma removal and skin tag removal

Contact 1Aesthetics today to schedule a consultation and take the first step towards smoother skin.


  1. Dong Hyun Kim, Dong Ju Hyun. (2016). 27.12 MHz Radiofrequency Ablation for Benign Cutaneous Lesions. Biomed Research International.

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