Milia and Whiteheads extracted on the face

This lovely woman is a patient of mine who gets non melanoma skin cancers, likely due to the cumulative sun exposure she has had through her life. She loves to garden and play golf.. both hobbies that expose you to a lot of sun!
She had three skin cancers to remove on her face.. not melanomas, but basal cell carcinomas. I noticed she had many white firm bumps on her face, and asked her if they bothered her. She said they did, but she didn’t know how to get rid of them. So we got rid of many of them for her!

A milium (single for milia) is a small superficial cyst formed in the top layer of the skin called the epidermis. They appear as tiny, pearly-white bumps just under the surface of the skin. They contain keratin (skin protein) and are harmless. They are often seen on the face, in particular on the delicate skin around the eyes. They can be prevented or minimized with exfoliating like chemical peels, microdermabrasion or topical retinoids. However, they are sometimes difficult to remove without a physician’s help, since they cannot simply be squeezed out. Often, the surface of the skin has to be pierced first with a lancet, a sharp pointed blade, or a needle, in order to successfully remove the milium. Often a comedone extractor is used to express the milium.
A whitehead is also called a closed comedo (single for comedone). It is a completely blocked pore. Keratin (skin protein) and sebum (oil) combine to block the pore. Whiteheads can be extracted using a Schaumberg-type comedone extractor as you see here, but often, a superficial nick in the skin must be placed first in the skin to allow easy extraction.

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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