Pediatric Milia Clinical Presentation

Updated: Apr 05, 2018
  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
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The clinical history varies somewhat between subtypes. Milia are usually asymptomatic.

Congenital milia are typically present at birth, although their onset may be delayed in premature neonates. Lesions usually resolve spontaneously.

Acquired milia have a tendency to persist without treatment. When acquired, a history of preceding trauma or associated bullous skin disease may be noted.


Physical Examination

The typical lesion is a 1-3 mm white to yellow, dome shaped and smooth papule. Lesions may be associated with a faint blue hue in darkly pigmented skin. [12]  

Lesions may be solitary or multiple.

Congenital milia predominate on the face, and the nose is commonly affected.

Benign acquired milia of children and adults favor the forehead, cheeks, eyelids, and genitalia.

Milia may be grouped.

Milia en plaque presents as an erythematous plaque studded with multiple milia. Lesions may be several centimeters in size.

Multiple eruptive milia favor the face, upper trunk, proximal extremities, and groin.

See the image below.

Milia in a week old infant. Milia in a week old infant.