Molluscum Contagiosum, often called “water warts,” is a common viral skin infection caused by the Molluscum Contagiosum Virus (MCV), a member of the poxvirus family. The infection creates small, raised, pearl-like bumps on the skin, often exhibiting a small dimple in the center. The virus is most frequently observed in children between the ages of one and ten and spreads through direct skin-to-skin contact or by touching contaminated objects.
When Treatment May Not Be Necessary
Molluscum contagiosum is a self-limiting infection that resolves on its own without any intervention. The average duration for complete clearance is six to twelve months, though the process can sometimes take as long as four years. The lesions usually disappear without causing scarring unless they are scratched or aggressively removed.
Choosing to wait avoids the discomfort and potential side effects associated with active medical procedures. This approach is recommended for healthy children whose lesions are not causing significant problems. Observation is appropriate unless the lesions are causing severe cosmetic distress, are highly inflamed, or are located in sensitive areas. Active treatment is advised when the patient has co-existing conditions like severe eczema, which can worsen the spread of the virus, or if there is a high risk of transmission to others.
Over-the-Counter and Topical Home Remedies
Several accessible, non-prescription topical options can be applied at home. These treatments work by irritating the lesion to stimulate the body’s immune response. Common over-the-counter options include keratolytic agents such as salicylic acid and benzoyl peroxide.
These agents are applied directly to each lesion, aiming to induce a localized inflammatory reaction that encourages the body to clear the virus. Consistency in application is a major factor in the success of these remedies, as they require time to take effect. Some individuals also explore natural or home remedies, such as tea tree oil or the use of duct tape occlusion, though the scientific evidence supporting their effectiveness is limited or anecdotal.
In-Office Medical Procedures
Treatments administered by a healthcare professional are reserved for widespread, persistent, or cosmetically concerning cases. These in-office procedures aim to physically destroy the lesions and provide a faster rate of clearance compared to topical home remedies.
One common method is cryotherapy, which involves freezing the lesion with liquid nitrogen to cause tissue destruction. Another physical removal technique is curettage, where a curette is used to gently scrape the molluscum bumps off the skin. While curettage is effective, it may be frightening for younger children and is often reserved for older patients. A different approach uses cantharidin, a blistering agent applied to the lesion that causes a blister to form underneath, lifting the bump away from the skin within a few days.
Prescription Topical Medications
Prescription topical medications are an important part of clinical management, especially when physical removal is impractical or undesirable. These include agents like tretinoin, a retinoid that irritates the lesion to trigger an immune response, and imiquimod, a prescription cream that stimulates the local immune system. Some studies suggest imiquimod may not be more effective than a placebo in children. For patients with numerous lesions or those who are immunosuppressed, a pulsed dye laser may be used to clear many bumps in a single session.
Stopping the Spread of Infection
Preventing the spread of molluscum contagiosum is crucial for managing the condition, both to prevent autoinoculation and to limit transmission to others.
Key prevention measures include:
- Avoiding scratching, picking, or shaving over the lesions, as this can easily spread the virus to adjacent skin.
- Maintaining rigorous hygiene practices, including frequent hand washing, especially after touching the lesions.
- Covering lesions with clothing or a watertight bandage before swimming or engaging in close-contact activities.
- Avoiding sharing personal items, such as towels, clothing, or bath toys, until the infection has completely resolved.