Molluscum

Dr. Mouhammad Aouthmany, MD, FAAD

Board Certified Dermatologist

 Molluscum
  • Molluscum is a common skin infection caused by a pox virus.

  • It is acquired via direct contact with an infected individual or by contact with an object that an infected individual has touched (towels, etc.); it is contagious.

  • Molluscum is very common in children. Adults acquire molluscum less frequently than children – in adults, it is often sexually acquired.

  • Does not usually cause permanent skin problems (scarring) and does not cause internal disease. 

  • Scratching or picking at molluscum lesions increases the likelihood of spread. 

  • If you notice that the lesions are becoming red and irritated, that is a good sign. That often means those lesions are resolving. 

Treatment:

Treatment of molluscum in children is generally more difficult than in adults, simply because children often do not tolerate treatments used in adults (liquid nitrogen).

  • Do nothing: Even without treatment, molluscum is what is referred to as self-limited; in other words, it will resolve on its own, but how long this takes is quite variable. The lesions could go away in weeks, or it could take months or even years without treatment.

  • Liquid nitrogen: In adults and some children, molluscum is successfully treated by freezing with liquid nitrogen. Generally, several treatment sessions every 2–4 weeks are necessary. 

  • Cantharidin: This medication is a liquid that is applied to individual lesions. It does not hurt when applied, but it causes blistering several hours later, which can be painful. This is generally used for children.

  • Aldara: A prescription cream that is applied to the lesions nightly for 1–3 months. This treatment is generally well tolerated, but it is expensive if insurance doesn’t pay for it ($170) and many times it simply doesn’t work. If excessive irritation (some irritation is good) develops, then the application time is reduced to every other night.

  • Retin-A cream: Commonly used for acne, this cream is also sometimes used for molluscum. It is usually well tolerated, but it generally needs to be used for months and it often doesn’t work.

  • Occlusion therapy: Sometimes effective for molluscum. This involves covering the lesions with duct tape at night (not on the face or genitalia) and removing it in the morning. This is a simple, low–cost treatment that is a reasonable choice if only a reasonably small area is involved.

Note on eczema: If your child also has eczema, don’t forget to treat the eczema; molluscum spreads more easily in skin affected by eczema.