disrupts adnexal structures. Additionally, application of a tattoo produces an acute, aseptic inflammatory reaction. A prior report of milia within a lichenoid tattoo reaction showed disruption of adnexal structures on histology.15
This trauma, therefore, is akin to that of secondary milia formation. Moreover, post-tattoo care regimens, such as ointment massage and occlusion, may increase accumulation of keratin debris within the needle wounds and follicular ostia. Although this may further follicular obstruction and milia formation, there are likely other factors involved, as these care regimens would likely affect normal adjacent skin.While the condition is benign and self-limited, patients often request therapy secondary to aesthetic concerns. In cases with few lesions, a needle or scalpel can be used to express individual cysts. Keratolytics, such as tretinoin, urea, and salicylic acid, have been used to reduce ostial plugging by normalizing epidermal maturation. They hasten resolution through exfoliation. Non-ablative and ablative lasers can also improve milia within tattoos, but are likely to disrupt the design clarity and pigment, making this a less favorable treatment.In summary, this case of eruptive milia in a tattoo demonstrates an exceedingly rare complication of skin-inking. It is important for clinicians to be able to distinguish this reaction from others that likely require more aggressive therapy. As tattooing is a trend on the rise, dermatologist can expect to see an increased number of tattoo-related dermatoses in their practice.14
All authors have no relevant financial interests, relationships, or affiliations to disclose.