Molluscum Contagiosum: A Complete Guide

April 13, 2024

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Molluscum contagiosum is a common viral skin infection that causes small, painless bumps on the skin called mollusca. The infection is caused by the molluscum contagiosum virus (MCV) and spreads through direct skin-to-skin contact, as well as through contaminated objects and surfaces. While molluscum contagiosum often resolves on its own, treatment may be desired to speed healing, prevent spreading, and reduce symptoms.

What Is Molluscum Contagiosum?

Molluscum contagiosum is a contagious viral infection of the skin that results in round, firm bumps ranging from 2-5 mm in diameter. These flesh-colored growths typically have a dimple or pit in the center and are called mollusca.

While usually painless, molluscum contagiosum spreads easily through skin contact and can be irritating. Scratching or picking the bumps may lead to further spreading and potential secondary bacterial infections.

There are four types of the molluscum contagiosum virus, named MCV-1 through MCV-4. Types 1 and 2 cause most cases of the disease in humans.

What Causes Molluscum Contagiosum?

Molluscum contagiosum is caused by infection with the molluscum contagiosum virus (MCV). This poxvirus is part of the larger family of poxviruses, which also includes the viruses that cause smallpox and chickenpox.

The MCV virus spreads through direct skin-to-skin contact with an infected person. Activities like sexual contact, wrestling, and close-contact sports facilitate transmission. It can also spread through contact with contaminated objects like towels, toys, and pool surfaces.

Once contracted, the virus incubates for 2-7 weeks before mollusca lesions appear on the skin.

Molluscum Contagiosum Symptoms

The signature symptom of molluscum contagiosum is the appearance of round, dome-shaped bumps on the skin called mollusca. These small, fleshy growths have a pit or dimple in the center, giving them an umbilicated appearance.

Other symptoms of molluscum contagiosum include:

  • Small, pink or white bumps – Typically 2-5 mm in size
  • Smooth, firm, and waxy bumps
  • Dimpled center – The umbilicated appearance
  • Little to no pain – Mollusca are usually painless
  • Itching – Bumps may become irritated
  • Mostly affects children – Very common in kids 2-12 years old

Who Gets Molluscum Contagiosum?

Molluscum contagiosum most often occurs in children between the ages of 2 and 12. It is also frequently seen in sexually active adults.

Others at increased risk include:

  • People with eczema or atopic dermatitis
  • Those with compromised immune systems, including people with HIV/AIDS
  • Athletes participating in contact sports like wrestling
  • Users of public pools and showers

Where Does Molluscum Contagiosum Appear on the Body?

Molluscum contagiosum can appear anywhere on the body, but most often develops in areas liable to skin trauma, as well as warm, moist areas like the armpits and groin.

Common sites include:

  • Face
  • Neck
  • Armpits
  • Hands
  • Arms
  • Genitals
  • Lower abdomen
  • Inner thighs

In adults, molluscum contagiosum frequently occurs on the genitals. In children, the bumps often develop on the face, torso, armpits, and arms.

Molluscum Contagiosum Stages

Molluscum contagiosum tends to follow a progression of stages:

Stage 1: The virus enters the skin through micro-abrasions and infects the epidermal layer.

Stage 2: Small, pink papules form with the characteristic central dimpling. This is the onset of visible mollusca.

Stage 3: More bumps appear, often in clustered groups, as the infection spreads across the skin surface. The mollusca grow larger.

Stage 4: The body’s immune system activates to fight the virus and the bumps slowly get smaller and develop a white, waxy appearance.

Stage 5: The mollusca resolve fully as the infection clears, typically leaving no scarring. Lesions may persist for 6-12 months without treatment.

Is Molluscum Contagiosum Dangerous?

Molluscum contagiosum is generally harmless and does not have serious health consequences. However, it can contribute to emotional distress or social stigma, especially with genital lesions.

While molluscum bumps often resolve without treatment in 6-12 months, the infection can linger for up to 4 years. Spreading is also a concern. For these reasons, medical treatment may be preferred.

Rare complications include:

  • Bacterial skin infections from scratching lesions
  • Conjunctivitis if bumps spread near eyes
  • Immune disorders like Guillain-Barre syndrome

When to See a Doctor About Molluscum Contagiosum

See your doctor if you notice any unusual growths on your skin that may be molluscum contagiosum. Signs warranting medical evaluation include:

  • Multiple small, round, firm, flesh-colored bumps
  • Lesions with an umbilicated or dimpled appearance
  • Bumps that persist for longer than 2 months
  • Spreading to large areas of skin
  • Genital lesions
  • Bumps near eyes
  • Signs of skin infection like redness, warmth, pus

Testing is not available for molluscum contagiosum. Your doctor will make the diagnosis by examining the appearance of the lesions. Medical treatment can then be discussed if desired.

Molluscum Contagiosum vs Chicken Pox

Chicken pox and molluscum contagiosum are often confused, as they both cause blister-like eruptions on the skin. However, there are distinct differences:

Molluscum ContagiosumChicken Pox
Flesh-colored/pink bumpsFluid-filled blisters
Dimpled centerNo dimpling
2-5 mm sizeVarious sizes
Minimal painItchy and painful
Localized clustersWidespread rash
Rare on palms/solesCommonly on palms/soles

While chicken pox causes an extensive body rash, molluscum leads to smaller localized outbreaks. And unlike the painful blisters of chicken pox, molluscum bumps are relatively painless.

Molluscum Contagiosum Diagnosis

There is no lab test to diagnose molluscum contagiosum. Doctors identify the infection simply by examining the appearance of the skin lesions. The small, round, umbilicated bumps are quite characteristic.

However, molluscum can occasionally be confused with other conditions like:

  • Warts
  • Keratosis pilaris
  • Basal cell carcinoma
  • Chicken pox

If there is uncertainty, your doctor may perform a skin biopsy or dermatoscopy for confirmation. But in most cases, visual inspection is sufficient for diagnosing molluscum contagiosum.

Molluscum Contagiosum Treatment

Several treatment options exist for molluscum contagiosum, including:

At-home treatments

  • Over-the-counter creams – Containing ingredients like salicylic acid
  • Duct tape or bandages – To occlude lesions
  • Hot baths – To expose lesions to heat

In-office procedures

  • Curettage – Scraping off lesions
  • Cryotherapy – Freezing lesions with liquid nitrogen
  • Laser therapy – Destroying bumps with a laser
  • Medicated creams – Applied by doctor

Oral medications

  • Cimetidine – Boosts immune response against virus
  • Isotretinoin – Antiviral and anti-inflammatory

Treatment also focuses on preventing spread by covering lesions, avoiding skin contact sports, and not sharing personal items like towels and razors.

Many cases of molluscum contagiosum resolve without treatment in 6-12 months as the immune system defeats the infection. But medical treatment can quicken healing.

Molluscum Contagiosum Prevention

To help prevent molluscum contagiosum:

  • Avoid direct skin-to-skin contact with infected persons
  • Refrain from picking or scratching lesions
  • Cover bumps with clothing or bandages
  • Disinfect toys, bath tubs, and shared surfaces
  • Shower immediately after sports or exercise
  • Do not share towels, razors, or other personal items
  • Strengthen immune defenses with rest and nutrition

Since molluscum spreads through surface contact, good hygiene and skin protection are key for preventing transmission.

If bumps do develop, prompt medical treatment can hasten healing and limit spreading.

Frequently Asked Questions

How do you treat molluscum contagiosum on the eyelid?

For molluscum bumps on the delicate eye area, ophthalmologists often prescribe topical antiviral eye drops or careful surgical removal to avoid spreading or scarring. Cryotherapy is not used on the eyelids due to inflammation risks.

Can molluscum contagiosum reappear?

Yes, it is possible for molluscum contagiosum to recur after treatment. Some virus may remain dormant in the skin and reactivate later, especially in immunocompromised people. Using preventive measures can help avoid reinfection as well.

Is molluscum contagiosum itchy?

Molluscum lesions are typically painless, but can become itchy if irritated. Scratching the bumps can worsen itching while also increasing risks of spreading the virus further across the skin or developing secondary skin infections.

Should molluscum lesions be covered while swimming?

It is generally recommended to cover visible molluscum lesions with watertight bandages when swimming. This helps prevent spreading the virus through contaminated pool water. Shared public surfaces like locker rooms can also facilitate transmission.

Can molluscum contagiosum bumps disappear and come back?

Yes, the characteristic molluscum bumps can resolve as the body fights the virus, only to have new bumps reappear later if some latent virus remains in the skin tissue. This cycle of dormancy and recurrence is more likely in those with weakened immune defenses.

Key Takeaways

  • Molluscum contagiosum causes round bumps on the skin called mollusca
  • It spreads through skin contact and shared surfaces
  • The umbilicated lesions usually affect kids but can develop anywhere
  • Treatment is not required but helps avoid complications
  • Preventing spread is key to containing infection
  • Proper diagnosis involves visual inspection of lesions

By understanding the symptoms, transmission routes, and treatment options for molluscum contagiosum, this common viral rash can be effectively managed. Seeking prompt medical care is important for confirming diagnosis and discussing whether intervention is desired to hasten healing.

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