Every few weeks I receive a text message from a friend concerned about little bumps that recently appeared on her child. The bumps are often round and flesh-colored and have an indentation in the center. Most of the time, the bumps seem to bother the parent more than the child but can occasionally become red and swollen or feel sore and itch. The diagnosis? Molluscum Contagiosum.
Molluscum, much like warts, are caused by a virus that spreads from person to person. It is a very common condition and children are more likely to get molluscum than adults (although, we do see adults with molluscum too). The virus can be transmitted by direct skin-to-skin contact or touching an object (like a towel, mat, toy or clothing) that previously touched a lesion on someone’s skin. There are also reports of people getting molluscum from a gym or swimming pool. Molluscum can spread to other parts of the body if a lesion is rubbed or scratched so it is important to avoid picking at the bumps.
Although molluscum is a virus, it dwells so superficially in the skin that the body’s immune system often doesn’t recognize it is there. Although it may clear on its own, it may take months to years. For this reason many dermatologists recommend treatment. In addition, molluscum can multiply quickly, spread to other areas of the body and to other people, and can be difficult to treat if it spreads. Treatments usually include some type of irritation to the skin in attempt to call the immune system to action in order to clear the virus. Treatment varies from patient to patient but may include liquid nitrogen (freezing the lesions), topical acids or blistering solutions (like Cantharadin, aka “Beetlejuice”), or electrocautery (burning the lesion). We often prescribe or recommend at-home treatments as well. Skin discoloration resulting from infection and treatment is generally temporary and will fade with time.
Besides children, other people at higher risk for molluscum include: those who participate in close contact sports or activities, those living in hot and humid areas, individuals having a disease that weakens the immune system (such as HIV), and those with eczema. Molluscum can spread quickly on eczematous skin and is generally more stubborn to treat due to barrier compromise.
A few caveats: Be really careful about purchasing at-home treatments online. Sometimes they can do more harm than good. Seeing a dermatologist will help you make an informed decision regarding treatment and like most medical conditions, it is always better to seek evaluation and treatment early. Finally, it is important to note that not all cases need treatment. Sometimes it just makes sense to allow the molluscum to resolve on their own. We can help you decide!
By: Theresa Helsel, MS, MPAS, PA-C
Reference: America Academy of Dermatology