molluscum contagiosum

health

Jul 18

As parents, it’s natural to feel concerned when you notice unusual bumps or rashes on your child’s skin. One common condition that often worries parents is molluscum contagiosum, a viral skin infection that affects many young children. Here’s what you need to know about it, how it’s diagnosed, and the steps you can take to help your child—and protect others in your family.

what to know

Molluscum contagiosum is a skin infection caused by a virus from the poxvirus family. It causes small, painless, flesh-colored bumps on the skin. These bumps can range in size from tiny pinheads to larger, pea-sized spots. They are often smooth and dome-shaped, sometimes with a small dimple in the center. While the bumps are harmless, they can be quite persistent and may last from several weeks to even a few months. You might see bumps that are:

small (2-6 mm)
round (dome-shaped) with a central depression in the middle
smooth
firm
sometimes alone, sometimes in clusters

Clinical pearl: We call the round raised lesions “papules”, and they do have a characteristic appearance - that central umbilication, or divet, in the middle of the lesion.

Though you can see it anywhere on the body, it’s common on the trunk (chest and abdomen), arms, and sometimes the face. Molluscum is spread by direct skin-to-skin contact, sharing objects (sharing towels, toys, clothing, wrestling mats, etc.), and autoinoculation (when a child scratches and touches other parts of their body).

This virus is common in children, as it spreads easily through direct contact with the skin or through shared items like towels, clothing, or toys. The condition can be more frequent in warm, humid environments, so swimming and close play in areas like daycare settings may contribute to its spread.

We do see it more commonly in children who have underlying eczema or sensitive skin, swimmers (it can exist in warm water), and those who are immunocompromised. Though its specific incubation period isn’t known, it may be anywhere from 2-6 weeks.

We can usually identify it clinically (you can do a biopsy to confirm, but it is mostly a clinical diagnosis).

One of the most important things to know about molluscum is that it’s generally benign and it can last for a while (from a few months to a few years) before it goes away. It does, for the most part, go away on its own.

what to do

If you notice these types of bumps on your child’s skin, especially if they have recently been in close contact with other children or shared personal items, it’s a good idea to reach out to your child’s pediatrician. They can help confirm whether these bumps are molluscum contagiosum or something else, like warts or a common skin irritation.

Diagnosing molluscum contagiosum is usually straightforward. Your pediatrician can typically identify it just by examining your child’s skin. In most cases, there is no need for a biopsy or lab tests. The distinctive appearance of the bumps—especially if they have the central dimple—is often enough for a clear diagnosis.

Most molluscum in otherwise healthy kids eventually heals on its own without scarring. This is why we don’t always recommend treatment (and some of the treatment options can themselves be irritating, cause scarring, or be painful). There are treatment options available: if it’s very distressing to your child, if they have eczema or other skin conditions that are exacerbating molluscum symptoms, if it’s causing a lot of scratching or irritation, if it’s spreading or causing pain, etc. However, treatment is often more about managing discomfort or reducing the chance of spreading rather than a medical necessity. Here are a few options:

Berdazimer gel: this is a topical nitric oxide-releasing agent approved for children 1 years old and older. You apply it daily to each lesion for up to 12 weeks at home.
Cantharidin: this is an extract from a blister beetle. It’s an effective and common way of treating molluscum for children 2 years old and older. It’s a solution that forms a thin film. It’s an in-office treatment — your provider (often dermatologist, some pediatricians do it in their offices) will apple a thin film to non-inflamed lesions. You’ll leave them uncovered after the visit, wash off the film ~1 day after they apply it, and then recheck in a month. It can sometimes blister up as a part of healing. This is not for facial lesions or lesions in the GU area. You can also see changes in skin pigment after treatment (hypo or hyperpigmentation), so make sure to talk with your care team if you’re considering this.
Topical tretinoin: low-dose t-retinoin may be trialed for facial lesions. the data is a little more mixed on efficacy (it has been variable), but you can chat with your care team for questions.
Liquid nitrogen (cryotherapy) or manual extraction: These treatments are often effective but are also painful and not well tolerated by many kids, so they’re not typically first-line. Cryotherapy can also cause changes in pigment, especially in kids with darker skin tones, so please remember to talk with your care team about this as well.

home remedies: do they work?

Many parents are curious about home remedies for molluscum contagiosum, especially treatments like apple cider vinegar. Some believe that apple cider vinegar works by its natural acidity, which may have mild antiviral properties. When applied to molluscum bumps, the acidity is thought to potentially irritate the viral lesion and stimulate the body’s immune response to help it heal faster. However, scientific data on the effectiveness of apple cider vinegar for molluscum is limited, and there’s a risk that the acidity could irritate your child’s sensitive skin, potentially causing redness or discomfort. Other natural options sometimes mentioned include tea tree oil or coconut oil, which are thought to soothe skin irritation, though these also lack strong clinical backing specifically for molluscum. If you’re considering any of these remedies, it’s best to talk to your pediatrician first. They can help assess whether home treatments are appropriate for your child’s age and skin type and ensure they’re used safely.

tips for preventing spread

Since molluscum contagiosum is highly contagious, it’s important to take steps to prevent spreading it to siblings or other children. Here are some easy precautions you can take:

Avoid Sharing Personal Items: Keep towels, washcloths, clothing, and other personal items separate to prevent the virus from spreading. Washing these items regularly can also help.
Limit Skin-to-Skin Contact: If possible, avoid direct skin contact with the bumps. Encourage your child to refrain from scratching or picking at them, as this can spread the virus to other parts of their body or to others.
Cover the Bumps: Covering the affected area with clothing or a light bandage may reduce the risk of spreading, especially if the bumps are on the hands, arms, or legs.
Practice Good Hygiene: Encourage handwashing, especially after touching the bumps or changing bandages. This is a simple but effective way to reduce the chance of spreading the virus.

when to seek help

In general, if your child’s molluscum contagiosum isn’t causing any discomfort or other issues, it’s okay to simply wait for it to resolve on its own. However, you should see a healthcare provider if:

The bumps are red, swollen, or painful, which could be a sign of a secondary infection.
Your child has a weakened immune system, which may make the infection more persistent.
You’re concerned about spreading the virus to others or want guidance on managing symptoms.

Though molluscum contagiosum can be unsightly, it’s important to reassure your child that it’s not dangerous and will get better on its own over time. With some simple precautions, you can help protect others and support your child while they recover. If you have any questions or concerns, don’t hesitate to reach out to your pediatrician—they’re here to help guide you through each step!

Sending you a big hug,

Anjuli

Sources:

Pera Calvi I, R Marques I, Cruz SA, et al. Safety and efficacy of topical nitric oxide-releasing berdazimer gel for molluscum contagiosum clearance: A systematic review and meta-analysis of randomized controlled trials. Pediatr Dermatol. 2023 Sep 18;. PubMed ID: 37721050

Hebert AA, Bhatia N, Del Rosso JQ. Molluscum contagiosum: epidemiology, considerations, treatment options, and therapeutic gaps. J Clin Aesthet Dermatol. 2023 Aug;16(8 Suppl 1):S4-S11. PubMed ID: 37636018