What Is Milia And How Can You Treat It?

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If you’ve ever examined your skin up close in the bathroom mirror and spotted small white bumps, dotted under your eyes or across your cheeks, that won’t pop despite your many attempts, you may have milia. Often mistaken for whiteheads, the bumps are mostly undetectable and can cause little issue day-to-day.

But whether you have it or are unsure, or want to know the treatments that work and are available to remove them, I spoke to two skin specialists, Dr Anjali Mahto, Consultant Dermatologist at Skin55, and Pamela Marshall, Clinical Aesthetician and founder of Mortar & Milk, who share their expertise to help you in the pursuit for the healthiest skin possible.

What is milia?

Dr Mahto explains, “Milia are small white bumps or cysts that appear on the surface of the skin when dead skin cells become trapped. They are made up of keratin, a protein on the outer layer of the skin, and whilst they resemble whiteheads, they are not related to acne or infection and are simply a pocket of normal skin.”

Because milia and whiteheads differ, how they develop and therefore be effectively treated contrasts too. Marshall shares that a whitehead is a dome-shaped lesion that can turn into a larger pustule. “Milia, on the other hand, do not generally get infected and are more difficult to remove,” she says.

Milia also sticks around longer on the skin says Marshall. This is because of the build-up of keratin in a pore becomes sealed-off by epidermal cells, the outer layer of skin, and this seal is what makes the removal process more complex than simply squeezing it like you would a spot.

What causes milia?

“Milia on the face are usually formed spontaneously, and there are a number of factors that contribute,” Mahto states, who goes on to say, “Milia found around the eye area can be caused by heavy creams, where the skin around the eye is much thinner than other areas of the face. It can also occur on the nose and other areas of the body.”

Milia tends to occur as a result of skin damage – predominantly sun damage – as well as rashes and excessive use of harsh products on the skin.”

How can it be treated?

While milia can create a bumpy texture on the skin, Dr Mahto advises that it doesn’t need to be treated unless you are concerned about them, and there are products you can use at home to help minimise it. “Fewer dead cells means fewer unsightly bumps, gentle exfoliation allows the dead skin cells to be removed, resulting in much less build up,” says Mahto, recommending superficial peels containing non-abrasive AHA’s and BHA’s, including glycolic and salicylic acid as a first step. “They provide accelerated, chemical exfoliation without the need to aggressively scrub your skin and only lift off the top layer of skin.” Retinoid creams can also be used for widespread problem areas, as can chemical peels.

However, to have milia completely removed can be done in a professional setting and is not something that should be attempted at home. Marshall reveals that often people at home will use a needle to puncture the skin and then squeeze out the bumps, but as there is no guarantee that the needle is totally disinfected, so you’re at risk of infection while also squeezing out something so hard, could cause scarring.

There is also a menu of treatments to choose from in a clinic, but all should be undertaken by a qualified dermatologist or aesthetician, as they can recommend the most appropriate route to take. “The best type of treatment will also depend on the type of milia you have, as well as the number and location on the face,” Mahto says. “Before having any procedure done, especially an extraction, it is best to book a consultation with a qualified dermatologist (check their credentials on the General Medical Council Register beforehand), to see what will be best for you and your skin type.”

According to Mahto, the most common removal is via ‘de-roofing’, where a sterile needle is used to create an incision in the skin, making way for careful extraction. ‘If you have tried the usual exfoliation, chemical peels and retinol methods then electrodessication treatment is also available. This process uses electricity, and a fine metal electrode or probe to heat the skin and to destroy the milia.”

New Year’s Beauty Resolutions

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We love a New Year. A completely clean sheet of paper – even more so, with a new decade ahead of us. (Sarah never drinks, but that’s why you also won’t find Jo indulging in more than a sip of Champagne on New Year’s Eve. Why would you want to start a new year, or a new ten-year phase, feeling rubbish…? We’d rather get up and at ‘em, Hoovering under the bed and heading outdoors for lungfuls of fresh, cleansing air.)

New Year is famously a time of re-evaluation – casting off the old, embracing the new. A time of good intentions – but also, of realistic goals, because otherwise it’s just too easy to ‘break’resolutions and write off the next 363 days. Instead, we think resolutions should be like horse-riding: you fall off (which Sarah has done spectacularly on at least one occasion), and you get back on again.

Our beauty philosophy, though, hasn’t changed fundamentally from when we started writing books together back in 1996. Powered by common sense and insights into the beauty industry – and, through our Beauty Bible Awards, into what works and what doesn’t – we’ve seen fads come and go, over our years in the business. As we proudly proclaim on our own website, we’re about ‘real beauty and wellbeing for grown-ups’. So here’s what we resolve to do, at the start of a year – make it ten – so full of possibilities.

We resolve to re-evaluate our skincare regimes regularly.

Skincare needs change, over time. For instance, Jo always described herself as having ‘dry, sensitive skin’. And then one day, not long ago, she woke up and realised: actually, her skin’s not so dry and not so sensitive anymore, either. Fact: over time, our skins’ needs shift, especially at times of hormonal upheaval – but it’s incredibly easy to get into a rut.

Really think about the products you use every day, and question whether they’re delivering. Are you over 35? Time to add in an anti-ageing cream. (Though eye creams can be introduced from late 20s onwards, since signs of ageing first show up there.) Skin feel tight? Sign of dryness. Ask yourself every single time you finish a jar or bottle: is this delivering what I want? If not, make a switch and go for something new. But don’t just chop and change for the sake of it; that’s what we used to do, in the early days, and it definitely triggered years of touchy skins for both of us.

We resolve to make a date night every week. With ourselves…

When you’re having to give everyone around you plenty of TLC, nobody need feel guilty about being kind to themselves. In fact, if you don’t, you’ll soon be running on empty. Stock up on products which deliver real TLC, such as Aromatherapy Associates Deep Relax Bath & Shower Oil, or their Inner Strength. Place a soothing Space Mask over your eyes. Slather on a body oil afterwards (we love the neroli, lavender, rose and mandarin scent of Aurelia Firm & Revitalise Dry Body Oil), smooth the fantastically nourishing Ameliorate Intensive Foot Treatment into feet – and for a really kind-to-yourself feeling, slip them inside a pair of luxurious cashmere socks, warmed by a hot water bottle.

We will try a ‘beauty dare’, once a month.

Don’t let yourself become one of those people who can say ‘I’ve been using exactly the same products for years…’ Introduce one item into your regime that you don’t already use; ‘date night’ is the perfect opportunity, as you’ve already set aside the time to pamper yourself, and can ‘play’ with a different styling product, a ‘root touch-up’ product, a scrub mitt, really giving a bit of thought to what you like about the texture, the effect, perhaps (where relevant) the fragrance. Then get in the habit of using it…

We resolve to be even more sleep-obsessive.

Having recently listened to a fascinating Desert Island Discs with circadian rhythm expert Professor Russell Foster, we’re more obsessed with sleep hygiene than ever before. He actually believes that before long, we’ll regard lack of sleep as something akin to smoking, in terms of the health damage it inflicts. You might have thought that while you snuggle down beneath your crisp white sheets at night, relaxing and restoring energy was all you were doing. But scientists have now pinpointed that at around 1 am, the body is at its most resourceful – helping to repair and renew skin, as well as other body cells, while we slumber sweetly. So beauty sleep really is that – which is why it’s so vital to make sure we get your zzzzs, and slather on creams that take advantage of your natural circadian rhythms.

Our mantra is going to be ‘skin-plification’, in 2020.

We’re totally over ‘K-Beauty’, a.k.a. Korean beauty, a trend imported from South Korea, which proposes the idea that you need at least seven or eight different products each morning and evening. You don’t. You really don’t. You don’t need to spend the money, OR the time on an over-complicated regime; what you need is products that really, really work. (That’s what our Beauty Bible Awards have always been about.) We expect to see a lot more multi-tasking products like LixirSkin Universal Emulsion, which can basically be used as cleanser/moisturiser/body cream. And hallelujah for that.

We resolve to make this the year that we give your hands the TLC they deserve.

Hands work so hard for us: chopping vegetables, dancing across keyboards of all kinds – and communicating love and affection. Isn’t it time to return the favour? For silky, smooth hands, lavish care really has to become a many-times-a-day habit – rather than a quick squirt of cream in a posh restaurant loo! (Sound familiar…?) Always worth repeating, the best tip we ever heard is to keep a hand cream next to every set of taps in your life – and in our handbag. (Favourites, to be found here on VH: Lanolips Rose Gold Hand Cream Intense, and Margaret Dabbs Intensive Hand Hydrating Lotion.)

We will be completely ignoring ‘influencers’, and turning to trusted sources for info.

OK, a little New Year rant here. We’ve been in this business a l-o-n-g time, and met a huge number of experts. We’ve always believed in scratching deep beneath the surface and not taking things at face value, and that’s the foundation on which we’ve built our reputation. But today, there’s a huge buzz around ‘influencers’, who are often paid to take pretty pictures of themselves, supposedly as a result of using this product or that product. Fact: many of them don’t know their AHAs from their elbows and wouldn’t know what to say to a dermatologist, trichologist or psychologist if they met one.

As trends go, the ‘influencer’ is a bubble poised to burst, and we’re already hearing that there’s a swing back towards knowledgeable writers and experts who really know about skincare, or nutrition, or yoga, or cosmetic ‘tweaks’ – people like Alice Hart-Davis, Fighting Fifty’s Tracey McAlpine, Lucia Ferrari, Ingeborg van Lotringen (who just left Cosmo, but expect her to pop up somewhere soon…) Want real beauty advice for real life? Look to a grown-up.

We’ll always be here for you – and it only remains to say: don’t just have a gorgeous year – have a gorgeous, healthy decade…

What Does Central Heating Do To Your Skin?

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With the turn in temperature comes a dial-up of central heating in our workplaces, homes and social settings. As cosy as it feels, it’s not doing our skin any favours, with increased dehydration and dryness on the horizon.

But instead of simply enduring lacklustre skin, clinical aesthetician and co-founder of Mortar & Milk Pamela Marshall along with consultant dermatologist Dr Justine Kluk, reveal that there are preventative measures you can take, as well as the ingredients to prioritise in your routine to help ward off the effects of central heating amidst a winter chill.

What are the effects of central heating on our skin?

As Marshall explains, central heating, much like air conditioning in the summer, draws moisture from the skin which causes the outer stratum corneum to become dry and irritated. “The change from central heating to being out in the cold, going from work to home, will also affect our capillary network, causing the capillaries to become dilated.” Dry skin can then exacerbate acne, rosacea and eczema, she adds.

While increased dryness is particularly prominent across our lips and hands, keep a close eye on your cheeks as according to Marshall, the apples of our cheeks and nose tend to become more sensitised and flushed, and the skin often becomes dry and irritated too.

What preventative steps can you take to keep help avoid irritation?

While we’re all well-versed in the age-old solution to maintaining hydration levels by drinking water, you can also take extra measures to ensure skin health throughout the temperamental temperatures inside and outside.

In environments like your home, where you can control the central heating, Dr Kluk recommends using a timer so your heating comes on for a couple of hours in the evening and switches off again until morning. Not only will this help with your bills, but it won’t aggravate your skin with excessive heat. If you’re in a particularly cold place and prefer to keep your heating on overnight, turn the thermostat down and aim for a temperature around 20 degrees Celsius, says Dr Kluk to minimise its impact on the skin.

“Avoid marathon sessions in the bath or shower and keep the water lukewarm,” says Dr Kluk, who advises something as simple as trapping humidity in the bathroom while you wash by keeping the door shut. To minimise the loss of moisture from your skin, pat your face and body dry with a soft towel and apply moisturiser while it’s still a little damp.

It’s also important to steer clear of known irritants in skin care products; fragrance being one of the worst offenders. Stick to unscented shower gels, and avoid foaming agents such as sodium lauryl sulphate (SLS) in your products too. Dr Kluk recommends an emollient soap as a substitute instead.

What ingredients should you introduce to your skincare?

As for the steps to take within your skincare routine, there are a handful of ingredients that will aid recovery of damage done by central heating and increase hydration levels.

Firstly, polyhydroxy acids (PHA’s) are the best at deeply hydrating the skin beyond the stratum corneum, as well as reducing inflammation says Marshall, who makes sure her patients in her clinic use it topically all year round too.

“Look to other known humectants too, such as glycerin, urea, lactic acid and hyaluronic acid,” says Dr Kluk, which will attract water to your skin and help boost hydration. “Occlusive ingredients such as lanolin or petrolatum will also create a seal to reduce transepidermal water loss,” she adds, commonly found in lip balms and will help keep dry, chapped lips at bay.

Don’t forget to consider your diet too. According to Marshall, taking omegas and essential fatty acids are essential as our inner skin is both hydrophilic and lipophilic, and needs water hydration as much as lipid hydration. And of course, continue to keep drinking water regularly.

Is It Time We Took Skin Issues More Seriously?

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Even if you count yourself lucky and rarely have to worry red patches on your cheeks or an ever-growing sun spot above your left brow, we’ve all woken up with a corker of a blemish that captures the gaze of anyone you encounter for the next three days. Those who have waged a war against skin issues, including rosacea and acne will be only too aware of the mental impact these can have over time. 

This week, the British Skin Foundation shared a survey that revealed that nine in 10 dermatologists believe that not enough importance is placed on the psychological impact skin conditions can have on us. “This survey demonstrates that dermatologists recognise some patients experience psychological distress associated with their skin condition,” says Dr Andrew Thompson, Reader in Clinical Psychology and Practitioner Clinical Psychologist, University of Sheffield and Sheffield Health and Social Care NHS Foundation Trust.

“It also indicates that whilst dermatology is making great advances in treating the medical aspects of skin disease, perhaps not enough is being done to address the accompanying psychological effects,” says Dr Thompson. In a world where we can disguise skin concerns with make-up or add a filter to a selfie some might assume that battling with a skin concern is less of an issue than it used to be. However, in the last few months, two writers have shared their experiences with rosacea and psoriasis and how they have impacted their confidence and mental health.

While Rose Gallagher might appear to be confident on her Instagram stories, she revealed that her rosacea still affects her mental health: “It still impacts how attractive I feel in myself, especially when it flares up.” On the other hand, Sophie Cullen struggled to have her psoriasis diagnosed.

This is not uncommon as Consultant Psychologist Dr Alexandra Mizara explains, “Skin patients often experience that they are not listened to or understood by their healthcare providers. The occasions that they are listened to and understood are rare and extraordinary.”

So, how can you seek out support, or help someone you know? “If you suffer with a skin condition that has impacted adversely on your life, talk openly about it to your doctor and ask them to refer you to see a psychologist,” says Dr Mizara. If you don’t get far with this, it is also worth seeking out skin disease wellbeing services in your area or talk-based therapies to help tackle any low mood or anxiety. Dr Mizara also recommends looking up charities and support groups.

For those looking for a natural remedy to help ease their skin issues, Clear Skin Complex by Viridian contains probiotics, zinc, selenium and burdock root to help soothe a range of conditions, including acne, eczema and psoriasis. While it won’t fix these concerns overnight, it does help support your body and ease inflammatory skin conditions. Shabir has written extensively about the supplement, here.

Skip Care Is The New Self Care

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Over the past two years, the term self care has been associated with pretty much everything and if the wellness gurus are right, it’s an essential component for your mental and emotional wellbeing. From the nourishing oil you use to relieve tight, achy limbs to the journal you use to jot down your thoughts at the end of the day, the health and beauty industry is sprinkling self-care everywhere. 

Yet, there is something quite stressful about trying to find that extra half an hour in your week to tap into this wellness trend. You might even go as far as to say it’s just another thing that we’re expected to tick off the list, along with eating healthily, going to the gym, excelling at work and catching up with friends. Self care could be adding stress rather than helping reduce it.

In terms of your skincare regimen, the  relentless cleansing, massaging and layering can add an extra 10 minutes onto your evening routine – and that’s a polite estimate. If this is something you’ve struggled to get on board with you might welcome the new approach: skip care.

What is skip care?

Well, it might surprise you but it’s another Korean export. But unlike the 11 step routines that drove you, and most likely your skin, crazy, skip care is about honing in on the ingredients that really work for your skin and skipping the ones that don’t deliver the results you want. 

How can you embrace skip care?

The fundamental steps of cleanse, treat and protect still apply, but rather than piling on lots of individual products for brightening, exfoliating, hydrating et cetera, look for well formulated lotions and potions that multitask. 

For example, GoW Neurophroline Serum helps reduce the stress in your skin and hydrate. Whether you want to soothe rosacea, get a grip on acne breakouts or give dull, lacklustre complexions a boost, Neurophroline can help and pretty much everyone should be using it.

Likewise Nuori’s Supreme Moisture Mask is the perfect night cream treat for skin now that the weather is starting to turn. The lipid packed formula is surprisingly light and leaves skin feeling softer, smoother and plumper by the time you wake up.

The trick to making skip care work for you is to understand your skin and what it needs. Start with only the essential steps and embrace all the extra time you’ll now have.

Do You Need A Super Serum?

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Applying a serum has become a regular protocol in most people’s beauty routines and while stats show that many of us are eschewing multi-step routines, serums are sticking. “A need for simplicity has pushed UK women towards minimalist skincare products with more intense active ingredients, such as serums,” explains Alex Fisher, Global Skincare Analyst at Mintel. “Serums are also a well-liked format, perceived as brightening and nourishing and often include ingredients like vitamins and antioxidants that are said to illuminate skin.” Read More…