Molluscum contagiosum is a common viral skin infection caused by a poxvirus, resulting in small, raised, pearly lesions on the skin. Because it is often mistaken for a common wart, many people wonder if over-the-counter (OTC) wart removers will work. Non-prescription wart removal products are generally not recommended for molluscum contagiosum and are often ineffective. The structural difference between the two lesions explains why the same treatment approach is unsuitable and can even be harmful.
Understanding Warts Versus Molluscum Contagiosum
Warts and molluscum contagiosum are both caused by viruses, but they affect the skin differently, which dictates treatment success. Warts are caused by the Human Papillomavirus (HPV) and result in a significant overgrowth of keratin, the hard protein making up the outermost layer of skin. This keratin buildup creates the rough, hard, external structure characteristic of a wart.
Molluscum contagiosum is caused by the Molluscum Contagiosum Poxvirus (MCV) and produces lesions with a soft, waxy central core. This core, known as the molluscum body, contains the virus particles deep within the center. Unlike the superficial, hardened structure of a wart, the lesion’s viral material is contained internally. This structural disparity means treatments designed for warts fail to effectively address molluscum.
Why OTC Wart Removers Are Ineffective for Molluscum
Over-the-counter wart removers use mechanisms designed to destroy the thick, keratinized tissue of a wart. The most common type is a keratolytic agent, such as salicylic acid, which chemically dissolves excess keratin. Since molluscum lesions lack extensive keratin buildup, applying strong salicylic acid primarily damages the surrounding healthy skin. It fails to penetrate the core where the virus is concentrated.
Another common OTC method involves cryotherapy kits, which attempt to freeze and destroy the tissue. These home-use kits use a less potent freezing agent than the liquid nitrogen used in a medical office, targeting the external, hardened layers of a wart. When used on molluscum, these agents may cause irritation, blistering, and potential scarring. They often fail to reach or destroy the deep, waxy molluscum core. This mismatch often results in skin damage and irritation, sometimes leading to secondary bacterial infection, without eliminating the viral infection.
Recommended Management and Treatment for Molluscum
Molluscum contagiosum is often a self-limiting condition, meaning the lesions typically resolve on their own without intervention, usually within 6 to 18 months in people with healthy immune systems. Treatment is often sought to prevent the spread of the virus to other parts of the body or to other people.
For management, it is recommended to cover the lesions with a bandage or clothing to prevent scratching, which can spread the virus (autoinoculation). Good hygiene, such as avoiding the sharing of towels or bath water, also helps limit transmission.
When treatment is necessary, a healthcare provider, often a dermatologist, chooses options designed to destroy the lesion or stimulate the immune response. Office-based treatments include physical removal methods like curettage (scraping off the lesion) and professional cryotherapy using liquid nitrogen. Prescription topical medications may also be used, such as cantharidin, which causes a blister to form beneath the lesion, lifting it off the skin. Topical retinoids (like tretinoin) or immune-modulating creams are sometimes prescribed for at-home application to stimulate clearing. The FDA advises against using unapproved non-prescription products for molluscum due to the risk of irritation, scarring, and delayed diagnosis of other skin conditions.