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Dermatologist Dr. Jessica Krant says true milia are embedded, complete small cysts in the skin that cannot be removed by an exfoliating cleanser. Although some work themselves out of your skin after a couple of months or a few years, others won’t budge unless removed with a tiny excision. Estheticians sometimes try to extract them like blackheads, causing damage to the skin. When a combination of gentle cleansing and steam facials do not remove milia, see a dermatologist for treatment, either with a small procedure or prescription creams to aid in softening them.
Dr. Joshua Zeichner, a New York dermatologist, has found the Clarisonic system effective for his patients to exfoliate dead skin and help open milia. The brand has three facial skin cleansers formulated by skin type, and an exfoliating cleanser for the body. He says you can use any brand of cleanser with the Clarisonic tool, including a hand-held battery operated “buffer” with a rotating circular brush head. There are several models available that allow you to adjust the rotation speed, allowing you to customize your clean for your face and body. For a more affordable alternative, he suggests the Olay Pro-X Advanced Cleansing System.
Corrective skin specialist and professional makeup artist Marcella Cardinal of Orlando, Fla., says that while some people are more predisposed to forming milia, too-rich skin products may also be a culprit. Juice Beauty's Exfoliating Cleanser is gentle enough for daily use and it's appropriate for all skin types, except users with active rosacea. The formula has jojoba exfoliating beads that are gentle enough that they won't cause micro scratches in your skin. The key is to use gentle pressure for a longer period of time. Other ingredients include pineapple enzyme, an effective but gentle exfoliant, and aloe to create balance as it calms and hydrates your skin.
Another pick by Zeichner is the Naturally Clear Blemish & Blackhead Control Apricot Scrub by St. Ives. The creamy formula is made with a blend of 2 percent salicylic acid, with ground apricot pits, corn kernels and walnut shells that will slough off dead skin on the surface of your face to aid in the release of milia.
Zeichner says washing your skin with a cleanser with glycolic acid listed as a principal active ingredient is another effective way to exfoliate your skin to help loosen up milia. These include DERMADoctor Litmus Test Glycolic Acid Cleansing Gel or the Glycolic Cleanser by Serious Skin Care. In lieu of a cleanser, Cardinal says you can achieve similar benefits by using a light glycolic exfoliating mask as a weekly exfoliating treatment, such as Pevonia Clarifyl Purifying Mask, paired with a lighter moisturize to keep milia at bay.