Molluscum Contagiosum

What is Molluscum Contagiosum?

Molluscum contagiosum is a relatively common skin condition.

 

Molluscum contagiosum typically presents as small, firm, papules that can be pink, flesh colored, or white and that have a central dimple. The lesions, called mollusca, are usually painless, but can sometimes be painful or itchy. They can occur anywhere on the body.

 

As its name implies, molluscum contagiosum is highly contagious and is usually spread from person to person, but can be spread from contact with an inanimate object that an infected person touched. The infection usually self resolves and typically lasts between 4 to 6 months, but can last up to 4 years.

Who is at risk?

A previous history of molluscum contagiosum infection does not lead to resistance, so people with a previous infection are still at risk. Groups of people who are at increased risk of infection with molluscum contagiosum include the following.

 

  • Children between the ages of 1 and 10
  • People who live in warmer, tropical areas
  • People with weakened immune systems, such as those with HIV infection or some cancers, and those who have undergone organ transplant
  • People who have eczema, or atopic dermatitis
  • People who participate in contact sports where bare skin-to- skin contact is common

 

The infection itself usually resolves without scarring. However, picking, scratching, or cutting off lesions at home can lead to scarring and should be avoided.

What are the Treatment Options?

The condition usually self resolves, so treatment is often unnecessary. When needed, however, the following options are available.

Physical removal

Physical removal of lesions may involve cryotherapy or curettage. Cryotherapy freezes the lesions with liquid nitrogen, while curettage involves piercing the core and scraping out the internal contents. These in-office treatments may be painful, requiring local anesthesia, but usually yield rapid results.

 

Do not try to remove lesions at home. It’s important to see a licensed health care provider to prevent scarring and the unintentional spread of the virus to other areas of the body or to others.

Oral therapy

Studies have shown that oral therapies can lead to gradual removal of lesions. This treatment method is often desirable for children because it’s not painful and may be administered at home by parents or other caregivers. This method uses oral zinc sulphate and oral cimetidine and decreases the chances of scarring. Unfortunately, facial mollusca do not respond as well as to oral therapy.

Topical therapy

Some topical medications are applied in the physician’s office, while others may be applied at home. Cantharidin (a naturally derived medication from the blister beetle) is applied in the office. This medication causes local blistering, but heals without scarring. Due to its strong blistering nature, it’s important to wash off this medication with copious amounts of water within 4 to 6 hours of application.

Prescription topical creams that can be used at home include podophyllotoxin cream (0.5%), salicylic acid, Tazorac, and imiquimod. Pregnant women should avoid podophyllotoxin because of presumed toxicity to the fetus.

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