For the milia en plaque I prefer radiosurgery using a tiny tip electrode. In the past I also used Erb-Yag Laser.

Thanks Dear Uwe.

radiosurgery with tiny electrode tip, making sure there is no excess burning. use preferably lower current with shortest contact time.

Thanks Dear Satyaprasad Venkata.

  The best and simplest method is to take a tiny needle or scalpel blade and nick the milia and then use a comdone extractor to remove the contents.  It should heal beautifully and not leave any scarring. IT SHOULD BE DONE CAREFULLY

Thanks.

What about dermabrasion?

I agree with Dr. Josefh Anyetal Sowah

Dear Joseph, nick and comedone extraction gives the best result. The same nick can also be given by the RF machine but must be delicate. advantage of the comedone extractor is that you can go to the depth of the milia.

Dr Joseph, yes you are right. The same nick can also be given by RF machine

dermabrsion does not work for millia

Thanks.

Either radiosurgery or a small monopolar diathermy unit (eg Birchter Hyfrecator at about 0.8-3 watts via a sharp tip very successfully treats these.  They may take a while to resolve after treatment and there is a very small theoretical risk of leaving a small punctum like scar, but I have yet to see that after 20 years of experience.

Yes Dr. Jonathan sharp tip also can be used. Comodone extractor needs more of controlled pressure.

Milia do not need to be treated unless they are a cause for concern for the patient. They often clear up by themselves within a few months. Where possible, further trauma should be minimised to reduce development of new lesions.

• The lesion may be de-roofed using a sterile needle or blade and the contents squeezed or pricked out.

• They may be destroyed using diathermy and curettage, or cryotherapy.

• For widespread lesions topical retinoids may be helpful.

• Chemical peels, dermabrasion and laser ablation have been reported to be effective when used for very extensive milia.

• Milia en plaque may improve with minocycline.