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Milium grain extractor: how does it work?

A superficial and benign microcyst, the milium grain can, however, become bothersome due to its appearance. Several techniques are conceivable to make it disappear, using an extractor for example. Discover how this equipment works and what are its advantages and disadvantages.

Summary
Published March 25, 2024, by Kahina, Scientific Editor — 4 min read

How is a milia extractor used?

Although milium cysts are benign, aesthetic reasons may prompt us to want to remove them. Firstly, it is important to consult a dermatologist who will examine the appearance of the microcysts and make a diagnosis. Following this analysis, they will determine the appropriate treatment, tailored to the nature, location and number of milium cysts. The common solution is extraction using a milium cyst extractor. This procedure is carried out by a healthcare professional, to ensure the complete safety of the process.

Initially, the skin will be disinfected with an antiseptic such as alcohol. Following this, the doctor utilises a sterile hypodermic needle with a sharp tip, the gauge of which depends on the size of the lesions. It's typically between 0.4 and 0.5 mm in thickness for the larger milia, and between 0.2 and 0.3 mm in thickness for the smaller milia. Using this needle, they will be able to incise the epidermal surface of the milium in order to trigger the release of the keratin cluster from the skin breach.

Once the milium is "pierced", the doctor will apply pressure on the sides of the breach in order to facilitate the expulsion of the keratinous ball. To do this, they may use a comedone extractor or a curette.

  • A comedone extractor is a tool equipped with an extraction orifice shaped like a keyhole, often used to remove acne spots. By positioning the milium at the centre of the orifice and applying pressure, the content will then be extracted.

  • A curette is a medical tool used in minor skin surgical procedures. It is said to facilitate "curettage". It features a sharp-edged ring that is used to remove blemishes and dead cells.

Once the contents of the milium grain have been removed, the procedure is complete. Depending on the extent of the area to be treated, it will last approximately 30 to 60 minutes. Following the procedure, some patients may experience small red marks or tingling in the extraction area. In this situation, they are advised to follow appropriate care in the days following the procedure to allow for optimal healing.

What are the positive and negative aspects of this intervention?

  • Benefits : The results are practically instantaneous and can last for several years with a minimal risk of recurrence. The technique is easy and quick to perform, and is less expensive than other procedures such aslaser ablation in particular. It does not require anaesthesia.

  • Drawbacks : As previously mentioned, there is a risk of observing small redness in the area affected by the extraction, although they generally disappear quickly with the appropriate care. Finally, there is always a risk, albeit smaller, that milia may return.

Let us remind you that using a milia extractor by yourself is strongly discouraged, and can lead to infections and scarring.

image extracteur grain milium
The extractor is surrounded in pink.

Sources

  • SHALITA A. R. Comedo extraction. Archives of Dermatology (1972).

  • KANWAR A. J. & al. Enucleation of milia with a disposable hypodermic needle. Journal of the American Academy of Dermatology (2002).

  • HSU S. & al. Evacuation of milia with a paper clip. Surgical Pearls Editor (2006).

  • WINE LEE L. & al. Successful treatment of facial milia in an infant with orofaciodigital syndrome type 1. Pediatric Dermatology (2017).

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