Why and how to use Milian’s solution?

What is Milian’s solution?

Milian’s solution is a mixture of two dyes: methyl green and gentian violet (or crystallized violet), with the addition of water or alcohol at 60° to facilitate application. The dyes used have drying, weakly antiseptic properties increased by the presence of alcohol and antifungal properties on the Candida albicans fungus.

Has it been banned in France?

Currently Milian’s solution is not no longer marketed in the form of pods, however, it is still available in magistral preparation in pharmacies. Despite numerous stock-outs, it has never been banned in France. It should not be confused with methylene blue which is no longer on sale in pharmacies but only intended for hospital use.

What are the indications for Milian’s solution?

Milian’s solution is used to dry oozing skin lesions (cuts, scratches) at risk of infection in the following cases:

• I’nappy rash (red buttocks) of the infant
• impetigo : bacterial skin infection which is characterized by yellowish crusts
• the intertrigo : bacterial or fungal infection in the folds of the skin favored by maceration
• THE other bullous or vesicular diseases of the skin such as hand-foot-mouth syndrome or chickenpox

In infants, the aqueous solution (based on water) is preferable to avoid the passage of alcohol in the blood.

The solution is directly sprayed on lesions or dabbed on using a compress, once or twice a day. Milian’s blue should not be used concomitantly with physiological serum at the risk of forming particles in suspension. It is recommended store the product in a stoppered bottle away from heat, humidity and light. Note that this solution is messy since it colors the skin, textiles and surfaces for a long time. To effectively clean objects, it is recommended to use alcohol modified at 70° and not water.

What are the alternatives to Milian’s solution?

The equivalents of Milian’s solution are the other drying dyes such as eosin, fluorescein. However, their use is no longer recommended as first-line treatment because they can mask the signs of an infection. Thus, the following non-colored drying lotions are good alternatives: Avène Cicalfate®, A-Derma Cytelium®, Gilbert Sensimyl®, Noreva Exfoliac®.

What are the dangers of Milian’s solution?

By its coloration, Milian’s solution can hide the signs of a bacterial infection or yeast infection, which can make it difficult to monitor lesions and thus delay the initiation of appropriate treatment. This solution should not be used as a disinfectant since it presents relatively weak antiseptic properties. Failure to use a local disinfectant beforehand can lead to the occurrence of infection or even superinfection of the lesions. Furthermore, the use of Milian’s blue must be limited to a maximum of 7 days to limit the appearance of irritations. In addition, long-term drying of the skin can block the healing process which is preferably carried out in a humid environment. Similarly, the skin slathered with product should not be exposed to the sun due to the risk of burns. Once applied, the solution should not never be covered with a bandage, which would promote the passage of chemical components in the blood. Milian’s solution can be toxic if swallowed or brought into contact with eyes. Indeed, it induces laryngitis, facial edema and irritation even ulcerations, especially in young children. In this case, rinsing with clear water must be carried out without delay. Note that a poor conservation of the product can contaminate it and induce lesion infection upon application.