Overview

Molluscum contagiosum is a common skin infection caused by a virus that results in small, raised, pearl-like bumps on the skin. It's caused by a type of poxvirus and spreads through direct skin-to-skin contact or by touching objects contaminated with the virus, like towels or toys. While it can affect anyone, it's most frequently seen in children, sexually active adults, and people with weakened immune systems. The good news is that molluscum contagiosum is generally not a serious health threat, but it can be bothersome and sometimes affect self-esteem due to the appearance of the bumps.

Symptoms

You might notice several characteristic signs if you or your child has molluscum contagiosum:

• Small, firm, raised bumps: These are often the first sign. They are typically dome-shaped and may have a waxy or pearly appearance.
• Central dimple or "pit": Many bumps have a tiny indentation or dot in the center.
• Size: Bumps usually start small (1 to 5 millimeters, about the size of a pinhead to a pencil eraser) but can sometimes grow larger.
• Location: They can appear anywhere on the body, but are common on the face, neck, armpits, arms, hands, abdomen, and inner thighs. In adults, they may appear on the genitals, lower abdomen, or inner thighs.
• Itching: The bumps can sometimes be itchy, especially if the skin around them becomes dry or irritated.
• Redness and Swelling: Sometimes, the skin around the bumps can become red, inflamed, or even develop an eczema-like rash. This is often a sign that your body's immune system is starting to fight off the virus.
• Clustering: Bumps often appear in small clusters or groups.
• Painless (usually): The bumps themselves are typically painless, though they can become sore if they get infected from scratching or irritation.

Diagnosis

Diagnosing molluscum contagiosum is usually straightforward for a healthcare professional.

• Visual Examination: In most cases, a doctor can diagnose molluscum simply by looking at the characteristic appearance of the bumps.
• Skin Scraping or Biopsy (Rare): Occasionally, if the diagnosis is uncertain, your doctor might take a small scraping from one of the bumps to examine under a microscope or, very rarely, perform a skin biopsy. This is not usually necessary.

Management & Treatment

Dealing with any skin condition can be a source of stress, but the positive news is that molluscum contagiosum is temporary and usually goes away on its own without leaving a scar. For many families, the best approach is patient observation.

The body's immune system typically recognizes the virus and clears the infection over time. This process can take anywhere from 6 to 12 months, and in some cases, up to 2 years.

However, treatment might be a good option if the bumps are:

• Located in a sensitive area
• Causing discomfort, itching, or social-consciousness
• Spreading rapidly or becoming infected with bacteria from scratching

Professional Treatment Options

If you and your doctor decide treatment is the right path, several effective methods are available:

• Topical Medications: Your dermatologist can prescribe or apply specific creams or solutions. Some of these work by gently irritating the bumps to trigger the immune system to fight the virus. One common in-office treatment uses cantharidin, which causes a small, painless blister to form, lifting the bump off the skin.
• Cryotherapy: This involves freezing each bump with liquid nitrogen. It's quick and effective but can cause some temporary discomfort.
• Curettage: In this procedure, the doctor uses a small, spoon-shaped tool to gently scrape the bumps off the skin.
• Laser Treatment: A pulsed dye laser can be used to target and destroy the bumps, which can be a good option for people with many bumps or weakened immune systems.

Home Care and Self-Management

While waiting for the bumps to clear, good home care is essential to prevent spreading the virus to others or to other parts of your body.

• Avoid scratching: This is the most important rule! Scratching can lead to scarring, infection, and spreading the virus.
• Keep the bumps covered: When around others, especially during contact sports or swimming, cover the bumps with clothing or a waterproof bandage.
• Practice good hygiene: Avoid sharing towels, clothing, or razors. Everyone in the house should use their own personal items.
• Be gentle with your skin: If you have eczema, keeping it well-controlled can help prevent the molluscum from spreading.

Important Safety ConsiderationPlease do not attempt to squeeze, scrape, or remove the bumps at home. This can cause pain, spread the infection, and lead to permanent scarring. Always talk to a healthcare professional about the safest and most effective treatment plan for you or your child.

Duration & Outlook

Molluscum contagiosum is a self-limiting condition, meaning it typically goes away on its own without treatment.

• Typical Timeline: For most healthy individuals, the bumps will clear up within 6 to 12 months, although it can sometimes take longer, even up to 2 years or more, for all bumps to disappear. New bumps can appear as old ones are resolving.
• Chronic or Acute: It's generally considered acute, but the duration can feel chronic for those experiencing it for many months.
• Outcomes to Expect: The bumps usually heal without scarring. However, if bumps are aggressively scratched, picked at, or become infected, there's a small risk of scarring or slight skin discoloration.
• Warning Signs for Complications: Be aware of signs of a bacterial skin infection, such as increased redness, warmth, swelling, pain around the bumps, or pus. Also, if bumps appear very large, spread rapidly, or occur extensively in someone with a weakened immune system, it’s important to see a doctor.

Prevention

Preventing the spread of molluscum contagiosum is key, especially in households with children or in close-contact environments.

• Avoid Direct Contact: Try to avoid touching, scratching, or picking at the bumps.
• Handwashing: Wash your hands thoroughly with soap and water after touching the bumps or areas where they are present.
• Don't Share Personal Items: Avoid sharing towels, clothing, razors, sponges, and bath toys.
• Cover the Bumps: Keeping the bumps covered with clothing or a watertight bandage can help prevent spreading the virus to other parts of your body or to other people, especially during contact sports or swimming. Change bandages daily.
• Avoid Shaving: Avoid shaving or using electrolysis on areas with bumps, as this can spread the virus.

Causes & Triggers

Understanding the cause can help in managing and preventing molluscum contagiosum.

• What causes it? Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), a type of poxvirus.
• Common Triggers and How to Avoid Them:
  • Direct skin-to-skin contact: This is the most common way it spreads. Avoid close physical contact with the bumps of an infected person.
  • Contaminated objects (fomites): The virus can live on surfaces. Avoid sharing personal items like towels, clothing, toys, and sports equipment.
  • Autoinoculation (self-spread): Scratching or picking at a bump can spread the virus to other parts of your own body. Try to keep hands off the bumps.
  • Warm, moist environments: The virus may thrive in these conditions, such as swimming pools or shared baths, though direct contact is still the primary mode of transmission.
• Who is most likely to develop it?
  • Children, especially those between 1 and 10 years old, due to frequent close contact.
  • People living in warm, humid climates or crowded conditions.
  • Individuals with atopic dermatitis (eczema), as their skin barrier may be compromised.
  • Sexually active adults (can be transmitted through sexual contact).
  • People with weakened immune systems (e.g., due to HIV/AIDS, organ transplant, or immunosuppressive medications).
• Risk Factors: Having eczema, a weakened immune system, and participating in contact sports are notable risk factors.

When to see a doctor

While molluscum often resolves on its own, it's a good idea to consult a healthcare professional in certain situations. We're here to help you understand when that might be necessary.

• Uncertainty about the diagnosis: If you're not sure if the bumps are molluscum, it's best to get a professional opinion.
• Bumps in sensitive areas: If bumps appear on the eyelids, near the eyes, or in the genital area.
• Signs of infection: Look for increased redness, swelling, pain, warmth, or pus draining from the bumps.
• Rapid spread or large number of bumps: If the bumps are spreading quickly or there are very many of them.
• Underlying skin conditions: If you or your child has eczema, as molluscum can sometimes worsen it.
• Weakened immune system: Individuals with compromised immunity should always see a doctor for molluscum.
• Significant bother: If the bumps are causing significant itching, discomfort, or emotional distress (like self-consciousness or bullying).
• If you simply want to discuss options: Even if it's not urgent, talking to a dermatologist can provide peace of mind and information.

A gentle reminder: This information is for educational purposes. If you have any concerns about a skin condition, please consult with a healthcare professional or a dermatologist for an accurate diagnosis and personalized advice.

Frequently Asked Questions (FAQs):

• Is molluscum contagiosum dangerous? No, for most healthy people, molluscum contagiosum is a harmless, though sometimes annoying, skin infection. It doesn't typically cause long-term health problems.
• Can my child go to school or daycare with molluscum? Generally, yes. Most schools and daycares do not require children with molluscum to stay home, as the condition is common and spreads through direct contact. It's advisable to keep the bumps covered with clothing or bandages to minimize the risk of spread. Check with your specific school or daycare for their policy.
• If the bumps go away, can they come back? Once all the molluscum bumps have cleared, you are generally considered no longer contagious and immune to that specific strain of the virus. However, it's possible (though less common) to get infected again with a different strain of the molluscum virus in the future.
• Why are the bumps sometimes red and inflamed? Sometimes, the skin around molluscum bumps can become red, itchy, and inflamed. This is often a sign that your body's immune system is recognizing and starting to fight off the virus. This "molluscum dermatitis" or "BOTE" (Beginning of the End) reaction can be a positive sign that the bumps will soon resolve, but it can also be quite itchy.
• Does scratching make molluscum worse? Yes, scratching or picking at the bumps can spread the virus to other parts of your skin (autoinoculation) and can also introduce bacteria, leading to a secondary skin infection. It can also increase the risk of scarring.

References

• American Academy of Dermatology Association. (n.d.). Molluscum contagiosum: Diagnosis and treatment. Retrieved from https://www.aad.org/public/diseases/a-z/molluscum-contagiosum-treatment
• Centers for Disease Control and Prevention. (2021, May 28). Molluscum Contagiosum. Retrieved from https://www.cdc.gov/poxvirus/molluscum-contagiosum/index.html
• Mayo Clinic. (2022, March 1). Molluscum contagiosum. Retrieved from https://www.mayoclinic.org/diseases-conditions/molluscum-contagiosum/symptoms-causes/syc-20375226