Has your child or another child you know been diagnosed with molluscum contagiosum? If so, you are definitely not alone. Molluscum is a skin condition caused by a poxvirus known as molluscum. It most commonly affects kids under 10 and it is very contagious. In fact, some reports suggest that 20% of kids will be affected at some point during their childhood. If your child has been diagnosed with molluscum, there are some things to look for. But worry not, this disorder is usually self-limited and will resolve on its own without intervention.
What does it look like?
Parents often describe molluscum as “skin tags.” They are small, usually several millimeters, and often show up in clusters. Molluscum lesions are round and raised. They tend to be pink or flesh-colored and almost pearl-like and shiny. If you look closely, the center has a tiny indentation. The gunk inside is white and firm, not pus. Molluscum bumps can live anywhere on the body, but particularly like insides of elbows, armpits, and behind knees.
Incidence
Because up to 20% of kids are affected at some point in their childhood, you can be assured that your child will be exposed at some point. (Joy!!) Children with eczema and sensitive skin are often more likely to get it and have more bumps than those who do not. Molluscum happens more in gyms where kids share mats and equipment. Young wrestlers spread the virus easily.
Diagnosis
In most cases, no special tests are needed to diagnose molluscum contagiosum. And although you may never have heard of it, the chances are good that your pediatrician has already seen several today and will recognize it near immediately on sight. For cases that are not clear, we will consult dermatology.
Treatment
Most of the time, time and patience are all that we recommend for treatment. And although this is frustrating for parents (believe me, I know, our kids get molluscum too!!), it is often the safest method and the least harmful. Many treatments for molluscum have downsides.
Do Nothing
This is the most recommended treatment for molluscum contagiosum. Most cases of molluscum resolve on their own (without intervention) within 6-18 months. They disappear nearly as quickly as they come, and generally leave no scarring or other indication that they’ve even existed.
Pros: Cheap, easy, painless
Cons: Does not stop spread, patience is a virtue most of us (myself included) don’t have in spades.
Freezing
If there are many lesions, or the lesions are causing a lot of distress due to location, freezing can be an option. Think of freezing, or cryotherapy, like localized frostbite. Your doctor will use liquid nitrogen for 30-50 seconds on each little bump. As many children have upwards of 20-30 bumps, this can be quite an undertaking and will often need to be split over several sessions.
Pros: Decreases spread of the molluscum and encourages the body to resolve the infection sooner than it would have on its own.
Cons: It HURTS! Even after the initial procedure, it will continue to hurt. Afterwards the skin blisters. Cryotherapy increases the risk of infection and scarring.
Topical creams
Several creams can treat molluscum contagiosum. Most pediatricians who start creams use acne creams such as tretinoin to treat molluscum. When using tretinoin cream, apply only to the very tops of the molluscum avoiding the skin at the base. Over the counter wart medicines are safe to use. Dermatologists may also apply a medicine such as cantharidin in the office which kills the top few layers of skin.
Pros: Can decrease spread of the molluscum and encourage the body to resolve the infection sooner than it would have on its own.
Cons: Often causes blistering and pain to the surrounding skin. In children with eczema, it can cause a flare-up of the chronic skin issues. As with any disruption in the skin barrier, can increase risk of infection and scarring.
Curettage (cutting off)
This is something usually done by the dermatologist. The dermatologist uses a special curved instrument to scrape off the affected bumps.
Pros: Instant gratification
Cons: Painful, may lead to scarring
Oral medicines
For children with widespread molluscum lesions, your pediatrician may recommend treatment with an oral medicine such at cimetidine. Cimetidine is a medicine generally used for acid reflux. But in some children, it can encourage the body to take care of the viral warts.
Pros: easy and painless
Cons: requires taking medicine twice daily for 3 months
Prevention of Spread
You can minimize the spread. Follow a few simple rules.
Wash Hands
Do not share towels
keep sores covered if possible
Try not to scratch
Restrictions
Molluscum is a NORMAL childhood ailment. DO NOT restrict their activity. They MAY attend school. They MAY attend sports. If you are getting pushback from anyone questioning this, let your pediatrician know so they can help.
Outcome
Luckily for all of us, this is just a little blip in your child’s health and wellness. Molluscum contagiosum WILL resolve. With or without our help. So hang in there. This too shall pass!!
Other Resources for Molluscum Contagiosum
American Academy of Dermatology Overview of Molluscum