Molluscum contagiosum, commonly known as water warts, is a widespread viral skin infection caused by a member of the poxvirus family. Although the lesions are typically benign and self-limiting, they can cause cosmetic distress or be highly persistent in some individuals. While the body’s immune system will eventually clear the virus, many people seek removal options to shorten the infection or reduce the risk of spreading it. The approach depends heavily on the patient’s age, the location and number of lesions, and whether active intervention is desired.
Identifying the Cause and Appearance
Water warts result from an infection by the Molluscum Contagiosum virus (MCV), a type of poxvirus. The virus invades the epidermal layer of the skin, leading to characteristic growths, but it does not circulate throughout the body. The lesions are distinctive, appearing as small, firm, dome-shaped papules, usually measuring between one and six millimeters in diameter.
These bumps are often flesh-colored, white, or pink. A defining feature is a small indentation or pit at the center, known as an umbilication. They can appear almost anywhere on the body, though they rarely occur on the palms or soles of the feet. The lesions are usually painless, but they may become red, swollen, or itchy as the immune system begins to fight the virus.
Self-Care and Non-Invasive Management
For many healthy individuals, particularly children, the initial strategy is often “watchful waiting,” allowing the infection to resolve naturally. The immune system will recognize and eliminate the lesions, a process that typically takes between six and eighteen months. This non-interventional approach avoids the discomfort or potential scarring associated with active treatments.
Preventing the lesions from spreading to other areas of the body is a primary goal of self-care. Avoid scratching, picking, or shaving over the bumps, as this can transfer the virus to adjacent skin and create new lesions. Maintaining good skin hygiene and keeping the affected areas moisturized can reduce the itchiness that often leads to scratching.
Covering the individual lesions with clothing or a small, waterproof bandage helps to contain the virus and prevent spread to others or to uninfected areas of the skin. This simple barrier method is often sufficient to manage the infection while waiting for clearance. If any inflammation or secondary infection occurs, consult a healthcare provider for assessment and management.
Professional Treatment Options
When the lesions are numerous, persistent, located in sensitive areas, or causing significant cosmetic concern, a healthcare provider may recommend active treatment to speed up clearance. These clinical methods are primarily destructive, aiming to eliminate the infected skin cells and trigger an immune response. The choice of procedure often depends on the patient’s age and tolerance for discomfort.
Physical Removal Methods
Cryotherapy involves applying an extremely cold substance, typically liquid nitrogen, directly to each bump, freezing and destroying the infected tissue. The procedure can be painful and may cause temporary blistering, but it is highly effective and usually requires several sessions. Another physical removal method is curettage, where a provider uses a small, sharp instrument to scrape the lesions off the skin.
Topical Treatments
Topical prescription treatments offer a less invasive alternative, often leveraging chemical agents to destroy the lesions or stimulate an immune reaction. Cantharidin is a chemical vesicant applied in the clinic that causes the skin to blister beneath the lesion, lifting it off the surface. Newer topical prescription options, such as Berdazimer gel, work by releasing nitric oxide to target the virus and are approved for use in young children.
Prescription retinoids, such as tretinoin, can also be applied to the lesions to irritate the skin, encouraging the body’s immune system to clear the virus. For extensive or recalcitrant cases, especially in individuals with compromised immunity, other immune-modulating creams or oral medications may be considered. All active treatments carry a small risk of temporary skin discoloration or minor scarring, which must be weighed against the benefit of faster clearance.
Stopping the Spread and Preventing Re-Infection
The Molluscum Contagiosum virus spreads easily through direct skin-to-skin contact and through contact with contaminated objects. Preventing this transmission is a major reason for seeking treatment, especially in households or in settings like schools and athletic facilities. The virus resides only in the skin lesions, meaning that once the bumps are gone, the person is no longer contagious.
To minimize transmission, avoid sharing personal items that come into contact with the skin:
- Towels
- Washcloths
- Clothing
- Sports equipment
Lesions should be consistently covered with clothing or a watertight bandage, particularly when participating in activities like swimming or contact sports. Children with covered lesions generally do not need to be excluded from school or pool activities.
Consistent hand hygiene is important, particularly after touching or bandaging any lesions. In adults, if the lesions are located in the genital area, the virus can be sexually transmitted through skin contact, and sexual activity should be avoided until the bumps have cleared. Taking these preventative steps reduces the risk of spreading the infection to others.