Molluscum contagiosum, commonly known as “water warts,” is a common, harmless skin infection caused by a poxvirus. These growths are typically benign and often resolve without intervention. This article provides guidance on treatment options and management strategies.
Understanding Water Warts
Molluscum contagiosum is caused by the Molluscum Contagiosum Virus (MCV), a member of the poxvirus family. The infection manifests as small, firm, dome-shaped bumps on the skin, often with a characteristic central dimple. These lesions can range in color from white or flesh-toned to pink or pearly.
The virus spreads primarily through direct skin-to-skin contact, including sexual contact in adults. Indirect transmission can also occur by sharing contaminated items such as towels, clothing, or toys. Auto-inoculation, or spreading the virus to other parts of one’s own body by scratching or shaving, is another common way the infection disseminates. While anyone can contract molluscum, it is particularly common among children aged 1 to 10 years, sexually active adults, and individuals with compromised immune systems.
Home Care and Over-the-Counter Options
Many individuals opt for “watchful waiting,” as molluscum contagiosum lesions frequently clear on their own within six months to a year, though they can persist longer. During this period, focusing on hygiene and preventing spread is important. Frequent hand washing can help reduce transmission.
Avoiding scratching or picking at the lesions is crucial, as this can spread the virus to uninfected skin areas and potentially lead to bacterial infections. Covering the lesions with clothing or waterproof bandages, especially during activities like swimming, can also help prevent further spread. Some over-the-counter (OTC) options are available, though their effectiveness can vary.
Salicylic acid, commonly found in wart treatments, may speed the resolution of molluscum contagiosum lesions, particularly in children. These products often contain adhesives to help concentrate the acid on the lesion. Apple cider vinegar is sometimes used as a home remedy, but scientific evidence supporting its efficacy is limited, and it can cause skin irritation. Topical creams containing ingredients like iodine or tea tree oil are also marketed for molluscum, but their success rates can be inconsistent, and they may cause local irritation. Consistency in application and patience are important when using home-based treatments.
Professional Medical Treatments
When home care is insufficient or if lesions are bothersome, a healthcare professional, often a dermatologist, can offer various in-office procedures. Cryotherapy involves freezing the lesions with liquid nitrogen, which destroys infected cells. This treatment can cause temporary stinging or burning and may require multiple sessions for complete clearance.
Curettage is another method where a medical device called a curette is used to gently scrape off the molluscum bumps. This procedure removes the viral core and can be effective, though it may cause brief discomfort and is typically performed on older children and adults. Laser therapy, such as pulsed dye laser (PDL), can be an option for individuals with numerous or difficult-to-treat lesions, including those who are immunocompromised. This method uses focused light to destroy the bumps, with healing usually occurring within one to four weeks.
Prescription topical medications are also available. Cantharidin, sometimes called “beetle juice,” is applied to the lesions and causes a blister to form, which helps clear the bumps as the skin heals. Imiquimod is a cream that works by stimulating the immune system to fight the virus, though it may take several weeks to months for lesions to clear. Tretinoin, a retinoid, can also be prescribed to help resolve molluscum lesions. The choice of professional treatment depends on factors such as the number and location of lesions, patient age, and tolerance for discomfort.
Preventing Spread and Recurrence
Preventing the spread of molluscum contagiosum is important. Frequent hand washing minimizes transmission. Avoid sharing personal items such as towels, washcloths, clothing, razors, and bath toys, as these can harbor the virus.
Avoid scratching or picking at lesions, as this spreads the virus to other body areas (auto-inoculation) and can lead to secondary bacterial infections. Cover all visible lesions with clothing or watertight bandages, especially during close-contact activities like sports or swimming, to prevent transmission. For children, parents might inform school or daycare staff to ensure appropriate precautions.
When to Consult a Healthcare Professional
While molluscum contagiosum often resolves on its own, consult a healthcare professional in several situations. Seek medical advice if lesions become widespread, painful, itchy, or show signs of bacterial infection like increased redness or pus. Consultation is also recommended if home treatments are ineffective or if lesions are in sensitive areas, such as the face, eyes, or genital region. Individuals with weakened immune systems should also consult a doctor, as molluscum can be more extensive and persistent. A healthcare provider can confirm the diagnosis and determine the most appropriate course of action.