Why do I get tiny red bumps on my cheeks? (photo)

Hi,

Thank you for your question and pictures. From the photos and in the absence of any history provided, these tiny bumps appear to look like closed comedones (commonly known as "whiteheads").

Some could also be milia, and less likely, syringoma. A doctor will need to ask you more questions such as whether these bumps are itchy/painful, whether you are on any oral or topical medications, your current skincare regime etc to be able to diagnose and manage this most appropriately.

Comedonal acne and milia respond well to non-invasive treatment such as medical-grade vitamin A derivative creams.

Stubborn ones may be extracted, treated with chemical peels and/or lasers too. Do speak to your doctor to find out more regarding these procedures. Your doctor may also suggest you make some changes to your skincare regime to prevent new ones from forming.

Best regards,

Dr. Joanna Chan

Hi

It looks like you have a cluster of milia over your face. Milia are due to an accumulation of sebum and dead skin cells in the outer layers of the skin. They can become hard due to a layer of keratin that covers it. Once that happens it can be quite difficult to remove it at home.

Products that contain an exfoliating agent such as lactic acid, salicylic acid, and glycolic acid are useful in softening it so that they can be extracted.

Extraction is best performed under aseptic conditions in the hands of a trained therapist. In fact the procedure is almost like an excision and must be done with a sterile needle to break the keratin encapsulation. The trapped sebum and dead skin cells can then be extracted either manually or with the aid of a sonic cleansing blade.

Once the extraction has been performed it is advisable to apply some antibiotic cream to reduce the risk of infection and to have sun protection and avoid strong sunlight to minimise the risk of PIH occurring.

Hope this helps.

These are multiple tiny 'pin-head' papules or bumps on both cheeks with background reddness on the cheeks. These 'pin-head' papules are whitish in color.

The chronic history and appearance described above suggest that the diagnosis is milia. These are tiny keratin cysts on in the epidermal (top) layer of the skin.

The cause is usually unknown, but can be due to injury to the skin, chronic sun exposure or even aging.

As milia is benign, it can be managed conservatively or treated with a course of oral isotretinoin, due to the extent of involvement. This will increase the turnover of the epidermal layers of the skin and result in exfoliation of these tiny cysts.

If they occur singly, I normally use a sterile needle to lance out the tiny keratin pearl.