Q. In the last couple of years I've noticed that the pores on my chin and some round my nose have little white plugs.  They're not whiteheads (although some do develop into them).  If I draw my fingernail along the skin, they stand slightly proud of the skin and can sometimes be removed with tweezers.  However, it would take a lifetime to get rid of them all this way.  I use Liz Earle Cleanse & Polish with a muslin cloth, a clay mask once a week and a Clarins exfoliator several times a week, even resorting to the strips I used as a teenager to get rid of blackheads.  Nothing seems to shift them and I'm becoming rather obsessed.  Have you any suggestions? A. According to consultant dermatologist Dr Stefanie Williams, whose clinic is called European Dermatology London (www.eudelo.com), ‘the lesions you describe sound like they might be milia. Sometimes called milk spots, milia appear as hard, pearly white bumps under the surface of the skin. The most common location is the face, in particular the cheeks and/or eyelids, and they may come in crops. They are tiny little cysts containing dead skin material – not pus as it might seem.’

Milia are completely harmless, but might be unsightly. Occasionally they might resolve on their own, but more often than not, they remain unless they are treated.Unfortunately even the best topical products seldom make much of a difference. But it is quite straightforward to remove them.

The easiest way is to see a medical aesthetician for manual extractions. Dr Williams’s European Dermatology London Clinic (www.eudelo.com) specialises in these, removing them as part of a Fit Skin Forever Facial, £150 with milia extraction. (Wherever you go, do make sure that the practitioner is qualified and experienced in milia manual extraction.) She explain that the therapist scratches the surface of the skin above the milia with a fine, sterile needle and then gently squeezes out the content using a special technique.

An alternative method of removal is a procedure called advanced electrolysis or ACP, which is also available via a medical aesthetician trained in Sterex electrolysis. To find a local salon, visit www.sterex.com and click on 'Find a Salon'.