Molluscum Contagiosum (MC) is a common viral skin infection caused by the Molluscum Contagiosum Virus (MCV), a type of Poxvirus. This infection results in distinctive small bumps on the skin’s surface. While frequently seen in children, adults can contract the virus, and it definitively affects the genital area. In adults, the infection often presents in the pubic region, groin, and external genitalia, frequently transmitted through intimate contact.
Appearance of Molluscum in the Genital Area
When Molluscum Contagiosum affects the genital area, it manifests as small, raised bumps called papules. These lesions are typically flesh-colored, pink, or pearly white and have a smooth, dome-shaped appearance. A characteristic feature is a small dimple or depression in the center of the bump, known as umbilication.
The size of these papules usually ranges between 2 to 5 millimeters in diameter. The lesions commonly appear on the external genitalia, inner thighs, lower abdomen, and pubic region. While the bumps are generally painless, they may become mildly itchy or inflamed if scratched or irritated. Their presence in the genital area often leads to misdiagnosis, as they can be mistaken for genital warts or ingrown hairs.
Primary Modes of Transmission
Molluscum Contagiosum is highly contagious and spreads through various forms of contact. The virus lives exclusively in the skin’s top layer and is transmitted when infected skin or the material inside the lesions touches another person’s skin. In adults, the primary mode of transmission for genital lesions is direct skin-to-skin contact during sexual activity.
The infection can also spread to new areas on the same person’s body through autoinoculation. This occurs when an individual scratches, rubs, or shaves existing lesions and then touches an uninfected part of their skin. The core of the lesion contains a high concentration of the virus, making any disruption a risk for spreading the infection.
Indirect contact with contaminated objects, known as fomites, can also facilitate spread. Sharing personal items like towels, clothing, or bath sponges with an infected person can transmit the virus. Although direct physical contact is the most efficient way to spread the infection, understanding all routes of transmission helps minimize risk.
Treatment Options for Genital Molluscum
Molluscum Contagiosum is a self-limiting infection that often resolves on its own. However, treatment is frequently recommended for genital lesions to prevent sexual transmission and autoinoculation. Options are divided into physical removal methods and topical therapies, depending on the infection’s extent and the patient’s preference.
Physical removal techniques include cryotherapy, which involves freezing the lesions with liquid nitrogen. Curettage is another common procedure, where a healthcare provider scrapes the lesions off the skin using a small instrument. These methods are effective for treating individual bumps but can cause temporary pain or minor scarring.
Topical treatments involve applying specific medications directly to the papules to trigger an immune response or destroy infected cells. Prescription creams such as podophyllotoxin or immunomodulators like imiquimod may be used, though imiquimod’s effectiveness is debated. Other options include caustic agents like cantharidin, a blistering agent applied by a clinician, or trichloroacetic acid. For individuals with a healthy immune system, the body will eventually clear the virus without intervention. However, this “watchful waiting” approach is less favored for genital lesions due to the higher risk of spread.
Duration and Management of Contagion
The Molluscum Contagiosum infection is self-limited, meaning it will eventually disappear without intervention, but this process can take a long time. In healthy individuals, the lesions usually resolve spontaneously within 6 to 12 months, though some cases may persist for up to four years. The infection remains contagious as long as any visible lesions are present.
Once all the bumps have cleared, the person is no longer considered contagious. Unlike viruses such as herpes, MCV does not remain dormant in the body after resolution, meaning the infection is entirely gone. However, reinfection is possible if exposed to the virus again.
To manage the risk of spreading the infection to sexual partners, it is recommended to avoid skin-to-skin contact in the affected area while lesions are visible. Covering all lesions with clothing or a watertight bandage minimizes transmission risk. Individuals should also refrain from sharing towels or other personal items that have come into contact with the bumps.