Molluscum contagiosum, usually just referred to as Molluscum by your family doctor, is a viral infection of the skin. It is usually seen in school aged children and looks like pearly/skin colored bumps with small indents (known as umbilication) in their centers.
Location: They show up seemingly ‘out of the blue’ in all sorts of areas but usually they stick to places where two skin areas rub together such as elbow creases or fingers. In my practice I often see them on legs as well.
Symptoms: Generally the only symptoms will be the presence of small skin colored bumps but at times they can become itchy or painful, especially if they are located in an area that is constantly getting irritated by clothing. Secondary infection (redness, heat, pus) can also occur and needs to be treated right away by a doctor.
How is it spread? Molluscum can be shared through skin to skin contact OR through a pool/hot tub or sharing items such as towels, toys, bedding etc. that have been in contact with an infected person. In short, it is pretty hard to avoid getting it, especially for young children. Once infected the Molluscum spreads through scratching or rubbing the affected area and then scratching/rubbing an unaffected area.
Who is most likely to get it? Children with eczema are at higher risk of getting and self-spreading (auto-inoculation) Molluscum because their skin has tiny micro tears and can’t protect itself as well against the virus. It is seen in healthy and less healthy children alike, though kids with a stronger immune system usually fight it off faster.
How long does it last for? It can last for four months up to several years.
An interesting aspect of Molluscum is that once a few areas have been treated (5 or 10) all of the areas will resolve as the immune system kicks on and addresses the virus.
How to treat it? While ‘watch and wait’ is really usually all anyone needs if you are concerned about the bumps due to unsightliness, pain or itching in-office or home care can be done.
Treatment by the doctor: Molluscum is cleared by the body on its own but local irritation to the bumps can get the body to clear it more quickly. You can go in to your pediatrician to have the Molluscum treated with things such as cryotherapy (freezing it off) or curettage (burning it off) or possibly with the application of a blistering agent. Talk with your doctor about in office treatments.
For home treatment: There are no ‘tried and true’ remedies for Molluscum and none are officially recommended by the FDA. Local irritants such as apple cider vinegar, potassium hydroxide or diluted tea tree oil (be very careful with tea tree oil as it may be overly irritating, don’t use it near the eyes in particular) may help. ZymaDerm is an over the counter treatment that comes with a money back guarantee if you’ve used it for an extended period of time (I believe the limit is six months) with no resolution of the Molluscum.
Make sure to only treat the bumps and not the area surrounding them as healthy skin can get irritated by the treatments as well. Antibiotics and steroid creams will not be helpful for clearing the infection because it is viral in origin, not a bacteria and steroid creams will just reduce the health of the skin without helping to clear the infection.
As it is a viral infection I often suggest internal antiviral treatment such as Melissa officinalis (Lemon Balm) or Glycyrrhiza (Licorice) to help stimulate the antiviral part of the immune system. You should speak with your doctor about using herbal medicines, especially if your child has a complicated health history.
Why does it look inflamed after treatment? Once the body starts attacking the Molluscum you might see redness, some swelling, crusting and maybe even drainage of the area. This is the ‘beginning of the end’ sign and means the bumps are clearing. It may take anywhere from 3 weeks to 5 months to clear once this inflammation response is seen. Definitely talk with your doctor if there is any concern.
Once a person has had Molluscum they generally don’t get it again unless they are deeply immune compromised.