Molluscum Contagiosum

What is molluscum contagiosum?

Caused by a virus, molluscum contagiosum causes small bumps on the skin that tend to clear with time.  While molluscum contagiosum may sound like a dreaded spell from a Harry Potter story, it’s actually a skin condition that’s relatively harmless.

You can get molluscum at any age, but it’s most common in children who are 1 to 10 years old. Children who have atopic dermatitis (often called eczema) tend to get it more easily.

Causes

As the name suggests, molluscum is contagious. You can catch it by:

  • Having skin-to-skin contact with someone who has molluscum bumps on their skin.
  • Touching something that someone who has molluscum bumps used, such as an unwashed towel, wrestling mat, or kickboard.
  • Sharing unwashed clothes or sports equipment with someone who has molluscum.

Often, the only sign of this skin infection is small bumps on the skin. These bumps tend to be painless, but they can itch.  Avoid scratching, rubbing, and picking at the bumps.  Scratching, rubbing, or picking at the bumps can spread the virus to other parts of your body. The bumps can develop anywhere on your skin, in the moist tissue lining your eyelids, and in the genital area.  Scratching and picking at the bumps may also cause another problem. The germs on your hands and nails can infect the bumps with bacteria. If this happens, the bumps can feel painful. You may develop a fever.

That’s why it’s so important to:

  • Avoid scratching or picking at the bumps
  • Keep the skin with bumps clean
  • Wash your hands often

When to see a board-certified dermatologist

It’s important to make sure that the bumps are due to molluscum. If you’re unsure, seeing a board-certified dermatologist can help. These doctors have expertise in diagnosing more than 3,000 diseases that affect the skin. A dermatologist can often diagnose molluscum by looking at the bumps.

If you have molluscum and a healthy immune system, your dermatologist may recommend letting the bumps clear on their own. They will go away without leaving a trace, but this takes time. On average, the bumps clear in 6 to 18 months without treatment. Sometimes, this takes longer.

Treatment may be recommended if the bumps are painful, itchy, or infected with bacteria. Treatment can also be helpful when a child is likely to spread molluscum to other children or has eczema.

How long is molluscum contagiosum contagious?

 It’s contagious until all the bumps go away.  As the bumps start to clear, you may notice that they look red and swollen. This change can be worrisome for parents, but it’s a good sign. It means the body’s immune system is fighting off the virus.

Symptoms

Molluscum contagiosum is generally a harmless skin infection. You’ll often see small, firm bumps on the skin.

These bumps can appear anywhere on the skin; however, children usually get them on their:

  • Torso
  • Armpits
  • Knees (especially the backs of)
  • Arms (especially in the crooks)
  • Groin area

Mollusca (the bumps) rarely appear on the palms or the soles, but you can get them in the moist tissue that lines the inside of your eyelids.

What does molluscum contagiosum look like?

The following pictures show you what molluscum contagiosum tends to look like. This lineup begins by showing you what the bumps look like when they first appear and ends with what you may see right before the skin clears.

First sign

The bumps appear on the skin between 2 and 8 weeks after you get the virus that causes this skin infection.  When the bumps first appear, you usually see ones that are small, firm, pink, flesh-colored, or white. These bumps will likely get bigger.

 

Dome-shaped bumps

As the bumps grow, they become dome-shaped and develop an indent in the center, which can look like someone pushed a pin into the middle.

Molluscum on eyelid

When a bump develops on an eyelid, it often looks like a water blister, as shown here.

Having molluscum on an eyelid can cause frequent pink eye. When the molluscum contagiosum clears, the pink eye also tends to disappear.

Spreading bumps

Scratching or picking at one or more bumps and then touching skin without the molluscum contagiosum can spread the virus to other areas of your skin.  In time, new bumps appear. Some people have widespread bumps, as shown here.

Large bumps

Having a weakened immune system, due to an organ transplant, cancer treatment, or an HIV infection, can cause large bumps.  Clusters of large bumps, such as shown here on this man’s forehead, can appear.

Bumps about to clear

When the bumps become red and look like pimples, it means your body is fighting off the virus.  This change is a good sign. It means the bumps will soon clear.

Does molluscum contagiosum cause pain?

This skin infection is usually only painful when scratching or rubbing infects the bumps with bacteria.  Sometimes, the bumps feel itchy.

How long does it take for the bumps to go away?

The body can clear the bumps on its own, but this can take time. You may see new bumps for several months. As some bumps clear, new ones can appear. This cycle usually lasts about 6 to 18 months before the skin clears completely.

Sometimes, clearing takes longer. New bumps can continue to appear for 3 or 4 years, and there have been reports of molluscum contagiosum lasting 5 years.  There’s no way to know how long it will take for your bumps to clear.

Source: American Academy of Dermatology

Several treatment options are available. It’s important to know that there is no one best treatment for molluscum.  Dermatologists choose treatment based on many considerations, such as a patient’s overall health, number of molluscum bumps, and where the bumps appear. For children, age is also an important consideration.

Your dermatologist may recommend treatment that you:

  • Receive in your dermatologist’s office
  • Apply at home
  • Take for a prescribed amount of time

No matter which treatment is used, treatment takes time. The following explains the different treatments and what each involves.

Treatment you receive in a dermatologist’s office: The goal of this treatment is to destroy the bumps without harming the skin. To do this your dermatologist may use:

  1. Cantharidin (beetle juice):Made from blister beetles, dermatologists have used this to treat warts and molluscum since the 1950s. When treating molluscum bumps, your dermatologist applies the beetle juice to each bump. Your dermatologist will apply it to each bump in such a way that a water blister forms.

You should see a blister on each treated bump within 24 to 48 hours. As the skin heals, the bumps clear. This usually occurs within 2 weeks.  To be effective, most patients need 2 in-office treatments.

When applied by a dermatologist, this is a safe and effective treatment for molluscum. It’s often a treatment for young children because it is painless when applied.

Warning!

Cantharidin should only be applied in a doctor’s office. When you buy this treatment online and apply it at home, you risk serious side effects, such as deep chemical burns, intense pain, and scarring.

  1. Cryotherapy: Your dermatologist applies an extremely cold substance to each molluscum bump. This extreme cold can effectively destroy the bumps. Because new molluscum can form, you will need to return for treatment every 2 to 3 weeks until the bumps clear.

Cryotherapy can be painful, so it’s not recommended for young children. Due to the pain, it’s seldom used to treat patients who have many molluscum bumps.  Cryotherapy may be a treatment option for a teen or adult wrestler who needs to get back to the sport.

  1. Curettage: During this treatment, your dermatologist uses a medical device called a curette to remove the molluscum bumps from the skin. In skilled hands, this is a simple and effective treatment that causes little or no bleeding.

Because your dermatologist cuts into the skin, this treatment can be frightening for young children. As such, curettage is usually only performed on older children, teens, and adults.

  1. Pulsed dye laser (PDL): This may be a treatment option for someone who has many molluscum bumps. It’s also recommended for patients with difficult-to-treat molluscum, such as people with AIDS.

Studies show that PDL can effectively treat dozens of bumps in less than 2 minutes. During one such study, 43 patients who had many molluscum bumps were treated with the PDL. In 42 of these patients, all the bumps cleared within one month of PDL treatment.  The treated skin tends to heal completely between 1 and 2 weeks on the face. When treating other areas of the body, the skin tends to heal completely between 2 and 4 weeks.

If you are considering PDL, it’s important to know the following:

  • Insurance rarely covers the cost of this treatment, which tends to be expensive.
  • PDL has been safely and effectively used on children as young as 8 years old, but it may be difficult to treat younger children with PDL.
  • People who have skin of color can develop temporary (lasting 6 weeks to 6 months) lighter or darker spots on the skin treated with the PDL.
  • Not every dermatology office offers PDL, so you may be referred to another dermatologist for treatment.
  1. Use forceps or a scalpel to remove the core:During this procedure, your dermatologist squeezes each molluscum bump to remove the cheesy substance inside, which contains the virus. This can be painful, so medication is applied to numb the skin first.

You should not try this at home. Without proper technique, you can cause a serious infection and spread the virus to other parts of your body.

Other treatments that your dermatologist may use: Other treatments that should be applied in a dermatologist’s office, include:

  • Bichloracetic acid
  • Glycolic acid
  • Lactic acid
  • Trichloroacetic acid peel

Placing any of the above on the bumps helps to destroy them. You may need several visits for this to be effective. These treatments tend to burn when applied. Afterward, you may have some redness, pain, or swelling. Some patients develop mild scars.

Treatment you apply at home

Sometimes, molluscum is best treated with a medication that you apply at home. While you will find many treatments sold online, these are the ones that a dermatologist may recommend.

Warning!

Some molluscum treatments that you can buy online without a prescription may not work and could be harmful, according to the Centers for Disease Control and Prevention (CDC).

  1. Imiquimod cream: This medication helps stimulate the body’s immune system so that it will clear the bumps. You apply the cream as directed to the bumps, usually 2 or 3 times a week. After the cream sits on the bumps for a prescribed amount of time, you must wash it off.

You must continue to apply imiquimod until the bumps clear, which is usually about 16 weeks.

It’s important to know that no one treatment works for everyone. Signs that imiquimod is working include swelling and irritated skin.  The CDC does not recommend imiquimod for young children.

Prescription required: Yes

  1. Podophyllotoxin cream: This cream can be an effective treatment for some sexually active patients. You apply the cream to each molluscum bump, usually twice a day for 3 weeks.

This is not an option for pregnant women. Applying it to the genital area can harm the baby.

Prescription required: Yes

  1. Salicylic acid: Often used to treat warts, this can be effective for molluscum as well. Your dermatologist can tell you how often to apply it. The goal is to continue using it until you get a reaction.

Prescription required: No

  1. Sinecatechin (green tea): This botanical, which is made from green tea, has been approved by the FDA to treat genital and anal warts. It’s reported that this may also effectively treat molluscum bumps in the genital and anal areas.

Prescription required: Yes

  1. Tretinoin: To get results, you must apply this correctly. Your dermatologist can show you how to apply it by using a toothpick to get the reaction you need. The goal is to irritate the surface of the skin, which can help the body’s immune system clear the virus.

Prescription needed: Yes

Medication you take at home

Cimetidine: This medication is used to treat ulcers and conditions that cause the stomach to produce too much acid, such as heartburn.  It may also be a treatment option for a patient who has severe eczema (atopic dermatitis) and molluscum that covers most of the body. Dermatologists recommend it only when other treatment fails to work.

Prescription needed: No

What is the outcome for someone who has molluscum?

For most people the skin will clear without treatment, usually within 18 months. A few people continue to have bumps for longer.  Treating molluscum may clear the skin more quickly; however, the bumps can return after treatment. It’s also possible to pick up the virus again, which can cause new bumps.

Source: American Academy of Dermatology

Our Locations