Molluscum contagiosum, a common skin infection caused by a poxvirus, can appear on the genital area. While generally harmless, these characteristic bumps can be a source of concern. The infection typically resolves on its own, though it can persist for several months or even years.
What Molluscum Contagiosum Looks Like
Molluscum contagiosum lesions are typically small, firm, and raised, often appearing pearly or flesh-colored. A distinguishing feature is a small dimple or indentation in the center of each bump, known as umbilication. These bumps usually range from 2 to 5 millimeters in diameter, approximately the size of a pencil eraser, and can appear individually or in clusters.
On the genital area, lesions commonly occur on the penis, vulva, inner thighs, groin, lower abdomen, and buttocks. While generally painless, the bumps can sometimes become itchy, inflamed, or sore, particularly if scratched. Scratching can also spread the infection to surrounding skin.
How Molluscum Contagiosum Spreads
The molluscum contagiosum virus primarily spreads through direct skin-to-skin contact. For adults, especially with genital lesions, sexual contact is a common mode of transmission. The virus can spread as long as lesions are present.
Transmission also occurs through indirect contact, such as sharing contaminated personal items like towels, clothing, or razors. Scratching or rubbing the bumps can lead to self-inoculation, spreading the virus to other body parts and causing new bumps.
Diagnosis and Treatment Options
A healthcare provider typically diagnoses molluscum contagiosum by visually examining the lesions’ characteristic appearance. The distinctive central dimple often allows for a clinical diagnosis without laboratory tests. In some cases, if there is uncertainty or to rule out other conditions like genital warts, a skin scraping or biopsy might be performed.
While the infection often resolves spontaneously within 6 to 18 months (or up to 2 years) without scarring, treatment may be pursued. Reasons for treatment include cosmetic concerns, preventing further spread, or if lesions are bothersome, itchy, or painful. For genital lesions, treatment is often recommended to prevent transmission to sexual partners.
Common treatment methods involve physical removal or topical applications. Physical removal options include cryotherapy, which uses liquid nitrogen to freeze and destroy the bumps, and curettage, which involves gently scraping off the lesions. Laser therapy, such as pulsed dye laser, can also be effective for multiple or difficult-to-treat lesions.
Topical medications, such as those containing retinoic acid, benzoyl peroxide, or cantharidin, can irritate the bumps and encourage their resolution. Other topical agents like podophyllotoxin or imiquimod may also be used. Some procedures can be painful, and a healthcare provider may numb the area beforehand.
Prevention Strategies
Preventing the spread of molluscum contagiosum, particularly in the genital area, involves several steps. Avoid direct skin-to-skin contact with infected lesions, especially during sexual activity. If molluscum bumps are present on or near the genitals, refrain from sexual contact until lesions are treated and gone. Condoms offer some protection but do not fully prevent transmission, as the virus may be on skin not covered by the condom.
Do not share personal items such as towels, razors, or clothing. To prevent self-spread, avoid scratching, picking, or rubbing the bumps. Shaving over affected areas should also be avoided, as it can spread the infection. Keeping bumps covered with clothing or bandages can help reduce transmission risk to others.