Periocular milia en plaque successfully treated by erbium:YAG laser ablation.

Milia en plaque in the periocular region represent a cosmetically disturbing skin condition of unknown origin characterized by numerous tiny milia grouped around the inner canthus and the medial aspect of both eyelids. While conservative treatment and manual expression often result in local recurrence, invasive approaches harbor the risk of mechanical or thermal injury of periocular skin and lid margins. A 32-year-old female patient with refractory periocular milia was treated with the erbium:YAG laser and followed-up for 12 months. Ablative laser treatment led to nearly complete resolution of the milia and an excellent clinical result. Importantly, no scarring, dyspigmentation or ocular complications were noted. This report demonstrates the efficacy and safety of erbium:YAG laser ablation of periocular milia. The precise control of tissue ablation with minimal thermal damage makes the erbium:YAG laser an ideal tool for the treatment of the delicate periocular region where even minimal scarring can result in ocular complications.