Written by Dr. Ringpfeil
Molluscum contagiosum is a benign rash that causes an eruption of small bumps on the skin. It is usually not bothersome and resolves over time. Treatment is available if the rash is irritated, spreading, or cosmetically displeasing. Our practice offers many in office treatment options for molluscum, including prescription medications, cryotherapy, laser treatment, and curettage.
Molluscum contagiosum is a rash caused by a benign pox virus. The virus causes the characteristic eruption of multiple small skin-colored or pink bumps that have a central dell. Usually the bumps are asymptomatic and resolve without treatment over 9-12 months. In some cases, irritation can cause the bumps to become red, itchy, and sore. Lesions that are red and sore tend to resolve without treatment after 10-14 days. Irritated lesions that do not resolve can be treated.
Molluscum is highly contagious and spread through skin to skin contact. It is more common in children than adults. In children, molluscum can affect any area of the body. In adults, molluscum usually occurs in the genital area. Thus, molluscum can be transmitted sexually in adults. Individuals with eczema prone skin are also more susceptible to developing molluscum. All affected individuals should avoid scratching these lesions to prevent spreading to other parts of the body.
Diagnosis of molluscum is able to be made upon examination. A biopsy is rarely needed. Treatment is indicated when molluscum bumps are irritated, actively spreading, or are cosmetically displeasing.
Many over the counter, prescription, and in office treatments are available to treat molluscum contagiosum. Our providers carefully evaluate each case of molluscum to determine which treatment option is most appropriate.
Over the counter topical treatment options include tea tree oil (ZymaDerm), green tea, and salicylic acid. These topicals typically require many applications and may cause irritation.
Prescription topical treatment options include sinecatechin (Veregen®), podophyllin, imiquimod, topical retinoids (tretinoin), and cantharadin. All but cantharadin can be used at home. They are applied directly to the molluscum lesions and typically require multiple applications. Cantharadin, also known as blister beetle juice, is applied in the office. Application of cantharadin is painless, but the blister that forms hours after application may cause some discomfort. Cantharadin is one of the most effective topical treatment options.
Cryotherapy, or treatment with liquid nitrogen, is performed in the office. Liquid nitrogen is applied to the individual molluscum lesions. This treatment aims to destroy the affected skin that harvests the virus as well as stimulate the immune system to attack the virus. Some discomfort can occur during the treatment due to the extremely cold temperature of liquid nitrogen. Cryotherapy is highly effective and the most common molluscum treatment used in our office.
Pulsed dye laser treatments are performed in the office to molluscum lesions. It causes some discomfort during the treatment, but provides good results.
Molluscum lesions can be completely removed via curettage. This involves gentle scraping of the lesions with a curette. It is not a commonly used treatment method.
If molluscum lesions are asymptomatic and treatment is not desired, it is important to prevent irritation until the lesions resolve. This includes avoidance of scratching and protection of lesions in areas that are prone to repeat friction. A band aid can be applied to these lesions daily to prevent irritation. Furthermore, eczema should be well managed to avoid development of molluscum.
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