My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Overview
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Milia are tiny white bumps on the face. Most commonly seen on infants and on adult women, they are small fluid-filled lesions (cysts). They are completely harmless and cannot become cancerous, so they are a benign skin condition. There are 2 types of milia, primary and secondary:
- Primary milia are formed directly from sloughed off skin and are usually found on the faces of infants.
- Secondary milia are small cysts found within areas of skin affected by another skin condition such as a burn, injury, or blistering.
We will recommend the type of treatment that is best for the kind of milia that you have. In infants, this condition usually disappears on its own over time. For adults, there are a number of treatment options. Do not attempt to treat these cysts at home, as doing so may leave permanent scars.
Causes
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Skin constantly renews itself by sloughing off dead skin cells and forming new ones. Milia form when dead skin does not slough off normally. Instead, dead skin remains trapped in a tiny pouch on the surface of the skin.
Milia are seen in people of all ages, any race, and both sexes. They are considered normal in newborns. Secondary milia may be seen on the skin of people who have:
- Used heavy makeup that blocks the natural cycle of skin renewal
- Experienced overexposure to the sun, which thickens the skin and also interferes with the natural sloughing off of older skin cells and the growth of new ones
- Had rough clothing or bedding, especially in infants
- Undergone skin resurfacing procedures such as microdermabrasion
- Burns
- Blistering skin disorders or conditions such as poison ivy
- Used topical steroids for many years
Symptoms
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There are 2 types of milia, primary and secondary. Primary milia are seen most often in infants, when the oil gland (sebaceous gland) may not be fully developed.
Secondary milia may develop after an injury or blistering of the skin. The injury or blistering can clog the tubes (glandular ducts) that lead to the skin surface. Secondary milia can also develop on the skin of middle-aged and older people that has been damaged by the sun. Milia are most commonly seen on the face.
Diagnosis
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We usually can diagnose milia through a physical examination. Primary and secondary milia have certain characteristics:
Primary milia are:
- Close to the eyes in children and adults
- Near the nose, especially in infants
Secondary milia are:
- Wherever another skin condition exists on the body
- On the face when a person has had sun damage
Prevention
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To prevent milia from forming, avoid using heavy creams and excess makeup. It is also helpful to begin a regular program of cleansing by using mild soap and a mild astringent.
Also, you can prevent milia caused by sun damage. Use sunscreen, hats, and protective clothing and limit sun exposure. In choosing a sunscreen product, pick one with as few ingredients as possible, as substances like fragrances may irritate the skin.
Treatments
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Do not try to remove milia at home. If you do, you may cause a scar to form which could be worse than the milia.
If our diagnosis is primary milia in an infant, no treatment is necessary, as the condition will go away on its own within a few weeks. In adults, however, the milia can be long-lasting.
If we diagnose secondary milia, we will likely treat the other skin condition in that area, if necessary. Treatments for milia include:
- Prescription for a retinoid cream.
- If irritated or infected, we can remove the milia with a sterile instrument.
- Fruit acid peels or microdermabrasion procedures at one of our centers for cosmetic dermatology may be helpful.
Please note: We will usually remove a benign skin lesion only if it is painful or becomes irritated or infected. Otherwise, we will refer you to the Cosmetic Dermatology Department for evaluation. Their services are delivered on a fee-for-service basis and are not covered by your regular Kaiser Permanente coverage.
Your Care with Me
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If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might contact me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we may discuss your medical and family history and I will examine your skin. Usually, no special tests are needed, but, occasionally, we do a skin biopsy. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
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If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
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Coordinating Your Care
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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
If you come to an office visit
- At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need.
- At the end of your visit, you may receive a document called the "After Visit Summary" that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
- To help you prepare for your visit, please see additional details under Office Visit.
If I prescribe medications
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:- Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
- Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If I refer you to another specialty colleague
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
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Convenient Resources for You
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As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions.
- View your past visits and test results.
- View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
- Read about causes, symptoms, treatments and procedures.
- Find interactive health tools, videos, and podcasts to help you manage your condition.
- View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
- Locate health education classes and support groups offered at every medical center.
- Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
- View your Preventive Services to see whether you are due for a routine screening or updated immunization.
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Related Health Tools:
Videos
- Treating Common Skin Growths Treating Common Skin Growths
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.