Newborn Milia

The mother of this 8-day-old newborn was concerned about the multiple white lesions scattered over the baby's face. Most of the tiny spots were clustered on the nose.

Dr Thomas J. Zuber of Saginaw, Mich, identified these lesions as milia-discrete, minute, superficial, epidermal inclusion cysts that occur in approximately 40% of neonates.^1-3

Commonly, these white papules are seen on the forehead and cheeks⁴ but are most prominent on the nose.⁵ They are slightly elevated, rarely exceed 1 mm in diameter, and are not inflamed at the base.³ Milia represent inverted epidermis enclosing minute keratin pearls that can be extruded by gentle manipulation.⁴ Generally, no treatment is indicated, since the lesions resolve spontaneously within the first few weeks of life.^1-5 Milia need to be differentiated from miliaria crystallina, a condition that results from sweat retention and can produce clear vesicles in the newborn.^1,4

REFERENCES:1. Treadwell PA. Dermatoses in newborns. Am Fam Physician. 1997;56:443-450.
2. Cram DL, LaPerriere RJ. Skin disorders of the newborn. Am Fam Physician. 1973;7:104-113.
3. LaVoo EJ, Paller AS. common skin problems during the first year of life. Pediatr Clin North Am. 1971;18:713-756.
4. Hodgman JE, Freedman RI, Levan NE. Neonatal dermatology. Pediatr Clin North Am 1971;18:713-756.
5. Vulliamy DG. Problems of the newborn. Less urgen problems and minor abnormalities. Br Med J. 1971;4:547-551.