Molluscum
contagiosum consists of small, harmless growths caused by a skin
virus. They resemble pimples with a waxy, pinkish look and a small
central pit. Molluscum are contagious and are spread by direct
physical contact. Molluscum occur most often in children. When found
in adults the direct contact was usually sexual contact. In normal people the molluscum go away
eventually once the body becomes immune to them.
Each molluscum usually spreads
onto skin that comes in contact with it. They spread much
more extensively in skin that already has eczema or in individuals
with weakened immune systems. In healthy individuals each
molluscum lesion may last 6-8 weeks. With continuous spreading,
however, new lesions appear over time, such that the mean
duration is about 8 months, with some infections
lasting up to five years. Scarring may occur, particularly
if the lesions become infected.
There is no single perfect treatment for molluscum contagiosum,
since we are unable to kill the virus. A blistering agent (cantharone
or TCA acid) or liquid nitrogen, will destroy individual molluscum
lesions. Scraping off the bumps using a tool called a curette can is a
common way to surgically remove them, but an injection of "Novocaine"
will be needed for numbing.
New lesions may still form even while the existing ones are being
destroyed. New growths should be treated when they become large enough
to be seen. A tiny scar may remain when they heal. Candidates for
removal include children with lesions on their face (quite common),
older kids who are embarrassed by them and won't change for gym class or
sports, etc, and younger kids where the molluscum is making control of
their eczema difficult. Removal is usually curative but even if some
do return, those can be dealt with the same way or left in peace
without causing problems in most cases.
Irritating drugs applied just to the little bumps speeds
resolution. These drugs include salicylic acid, Retin-A, Aldara cream
and Condylox solution. Occasionally the oral drug Griseofulvin seems
to clear up molluscum for reasons that are not known. Sometimes a rash
appears around the growths when the body starts to reject the virus,
and the molluscum lesions become red, itchy or sore. This molluscum
will clear without treatment.
At this itching reaction may get out of hand, and the child may appear to
develop eczema in months before development of complete immunity to
the molluscum. For extensive molluscum it is essential to treat the
itching and skin dryness. This often requires oral and topical steroid
prescriptions and antihistamine medications, and frequent applications
of a good moisturizer. Molluscum are contagious, so physical activity
should be restricted to avoid transmitting it to others. You can
always consider the option of no treatment, as molluscum do eventually
clear on their own.