March 2004
Dear Paula,
I recently went to the Estee Lauder counter at a local department store and got some information that was completely new to me! Please let me know what you think of this.

I was returning a moisturizer that seemed to cause a reaction. I wanted to exchange the product for another, and decided on one of their other products. The salesperson was keen to sell me a special moisturizer for the eye area, but I didn't really want to spend the extra money. I have tried eye creams before, but haven't seen any results that made them seem worthwhile. Maybe I don't have the discipline to use the product in the manner prescribed.

The salesperson proceeded to tell me that using regular moisturizer in that area caused some small bumps under my eyes. She said the bumps were actually trapped "moisture" from products that were too heavy and not designed for the undereye area. She had a name for it that sounded something like "miosma." I should have asked her to spell it, but I mostly wanted to end the conversation. She said that the only way to get rid of the bumps was to go to an aesthetician, who would prick them and drain the "moisture." Of course, she was completely serious about the whole thing, and said she tried to make a point of telling people when she noticed that they had the condition.

What do you think of this? You state in your book that you see no need for special eye creams. I can't remember when I got these undereye bumps, but it was many years ago, when I was young and careless with my skin. I have assumed that they were caused by excessive sun exposure.

Sharon, via email

Dear Sharon,
Your experience of being disappointed by eye creams you have purchased in the past isn't surprising; they can't perform as promised. If they did, why would the industry keep launching new ones with new formulations every month? If the ones from last year with the same claims didn't work, why would you believe the new ones would? Lots of women blame themselves when the products they've invested in disappoint them. The advertising and sales pressure is so great that women don't blame the manufacturers' misleading claims; rather they blame their ability to get it right.

First, the skin does not trap water in permanent bubbles under the eye (they would be blisters then and a troublesome problem). Second, I have never used a special "eye cream" around my eyes. I use my regular moisturizer around my eyes and I don't have bumps around my eyes, nor do the 16 women who work in my office nor do any of the women in my life (and you can rest assured that the women in my life follow my skincare recommendations).

I suspect what the woman was trying to diagnose for you was a condition called milia. If what you have around your eyes are whitish, solid bumps that are not inflamed and haven't changed in size, then they are most likely milia, though a dermatologist or physician could tell you definitively what they are. If what you have is indeed milia, they are filled with skin cells and lipids generated in the oil gland/hair follicle. It turns out milia are very common, occurring in women and men of all ages from infants to adults, and they often show up around the eyes and cheeks. There is no research or information anywhere showing that milia is the result of not using an eye cream.
Milia can be left alone safely, but they can also be removed by a physician with a tiny incision using a cutting-edge needle and then removing the stuff inside the pore. Milia can also be effectively removed with lasers or microdermabrasion (Sources: emedicine.com/DERM/topic265.htm and Lasers in Surgery and Medicine, December 1997, pages 13-19).