Milia in Neonates
Milia in Neonates
Milia are common, benign, keratin-filled cysts that appear as small, white to yellow, dome-shaped papules on the skin of newborns. They affect up to 50% of newborn infants and typically resolve spontaneously within the first few weeks to months of life.
Key Points
- Prevalence: Present in approximately 40-50% of newborns
- Onset: Usually present at birth or within the first few weeks
- Resolution: Spontaneous resolution within 1-2 months
- Location: Most commonly on nose, chin, cheeks, and forehead
Clinical Presentation
- 1-2 mm white to yellow papules
- Firm and pearl-like appearance
- Non-inflammatory
- Usually multiple lesions
- Symmetrically distributed
Distribution Patterns
- Primary locations:
- Nose (most common)
- Cheeks
- Chin
- Forehead
- Less commonly on scalp, upper trunk, and limbs
Associated Findings
- Usually asymptomatic
- No surrounding erythema
- No tenderness
- Non-pruritic
Formation Mechanism
- Trapped keratin and sebum within the epidermis
- Originate from pilosebaceous follicles
- Represent retention cysts of sebaceous glands
Histological Features
- Small, superficial cysts within the epidermis
- Thin wall of stratified squamous epithelium
- Filled with laminated keratin
- No connection to the skin surface
Treatment Approach
- No treatment required - benign and self-limiting
- Parent education and reassurance is crucial
- Spontaneous resolution typically occurs within 1-2 months
Important Counseling Points
- Avoid manipulation or attempting to express the contents
- No topical treatments necessary
- Regular skin care with gentle cleansing is sufficient
- Document and monitor if unusual patterns or persistence beyond 3 months
When to Refer
- Persistent beyond 3-4 months
- Unusual distribution or appearance
- Associated with other cutaneous findings
- Parental anxiety despite reassurance
Disclaimer
The notes provided on Pediatime are generated from online resources and AI sources and have been carefully checked for accuracy. However, these notes are not intended to replace standard textbooks. They are designed to serve as a quick review and revision tool for medical students and professionals, and to aid in theory exam preparation. For comprehensive learning, please refer to recommended textbooks and guidelines.
