Incision of Milia Cysts, Abscesses and Furuncles

What is milia cyst? 

Milia are very small benign whitish lesions that often appear on the surface of the skin and structurally they are classified as keratin cysts. This means they are filled with keratin, a protein produced by the skin, which becomes trapped between the outer and inner layers of the skin. They resemble tiny papules, are firm and round in shape, usually white or skin-colored, painless and not accompanied by itching.

Although they are benign and asymptomatic, therefore do not require treatment, many people choose to have them removed for aesthetic reasons especially since they are most commonly found on facial skin (eyelids, forehead, cheeks, nose, chin) and are easily visible (a cosmetic concern).

How are milia diagnosed and treated?

Milia are usually diagnosed during a dermatological examination and can be treated or removed in various ways. Some of the removal methods include microdermabrasion, chemical peels, electrocautery and incision. A simple approach to removing a small number of milia cysts involves making a tiny incision in the skin lesions, during which the surgeon uses tangential pressure with a scalpel or curette to extract the contents of the milia.

What are abscesses and furuncles?

An abscess is a localized collection of pus in the skin that can affect any part of the skin and is usually caused by a bacterial infection. The most common signs of an abscess are swelling and pain.

A furuncle (boil) is a skin abscess that involves hair follicles and the surrounding tissue, caused by Staphylococcus. It often appears on the face, neck and gluteal region so it is uncomfortable and painful and looks like a nodule that oozes bloody purulent discharge.

How are abscesses/furuncles diagnosed and treated? 

The diagnosis of an abscess/furuncle is made through a physical examination and it is treated by incision and drainage to allow the pus to be released and to promote healing of the tissue/skin.

A surgical incision is performed with the injection of a local anesthetic to minimize pain during the procedure. A careful vertical cut is made in the skin over the abscess/furuncle to access its interior. The pus is then removed from the abscess and once it is drained the incision is surgically closed with sutures and covered with a sterile dressing.