At a Glance - Sebaceous gland hyperplasia vs milia

Dr Jean Watkins discusses the differences between sebaceous gland hyperplasia and milia in the newborn

Sebaceous gland hyperplasia
Aetiology

  • Occurs in more than 50 per cent of newborn babies.
  • Occurs less commonly in premature babies.
  • Related to hormonal influences of maternal androgens on the pilosebaceous follicles leading to an increase of sebaceous cell numbers and volume.
  • Regression of the lesions follows withdrawal of maternal hormones after delivery.

Presentation

  • Multiple white or yellow papules in areas where there are many sebaceous glands.
  • Most commonly presents on the cheeks, upper lips and forehead.

Management

  • No treatment required.
  • The lesions will resolve spontaneously within the first few months of life.

Milia 

Milia presents as white globules on the chin, cheeks and forehead

Aetiology

  • Occurs in 40 per cent of newborn babies.
  • Small inclusion cysts containing keratin.

Presentation

  • May appear at birth or in infancy.
  • Small, white pearly globules. May be 1-2mm in size.
  • Usually present on the cheeks, chin, forehead or scalp.
  • Larger single milia may occur in the region of the foreskin, scrotum or labia majora.

Management

  • Normally no treatment required.
  • Lesions usually resolve spontaneously within a few weeks.
  • The pricking out of the contents with a sterile needle or cryotherapy, which is sometimes done in older patients with the condition, seems unwarranted in babies.

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