Molluscum Contagiosum (MC) is a common viral skin infection caused by the Molluscum Contagiosum Virus (MCV), a member of the poxvirus family. Although generally benign and often clearing without intervention, its transmission methods frequently raise questions about its classification. While not exclusively a sexually transmitted disease (STD), MC can be transmitted through sexual contact, particularly in adults. This article clarifies the virus’s nature, modes of spread, and management.
Defining Molluscum Contagiosum
The Molluscum Contagiosum Virus specifically targets the skin, leading to characteristic growths called mollusca or papules. These lesions are typically small, firm, and dome-shaped, measuring between two and five millimeters in diameter. They are usually flesh-colored, white, or pink and feature a distinctive central dimple known as an umbilication. While generally not painful, the lesions may become inflamed, red, or itchy if scratched or irritated.
Transmission Routes Beyond Sexual Contact
MC is most frequently spread through close, non-sexual skin-to-skin contact, making it common in young children. Direct physical contact activities, such as wrestling or sharing a bath, can easily transfer the virus. The virus can also be acquired indirectly by touching contaminated objects (fomites) that have come into contact with the lesions. Shared towels, clothing, gym mats, and pool equipment are common examples of items that facilitate this transmission.
A person with the infection can inadvertently spread it to other parts of their body through autoinoculation. This self-transfer occurs when a person scratches, rubs, or shaves over an existing lesion and then touches an unaffected area of skin. Covering the lesions, especially during contact sports or swimming, helps reduce the risk of spreading the infection to others and the risk of autoinoculation.
Sexual Transmission and Adult Presentation
MC is frequently classified as an STI when it appears in sexually active adults. Transmission occurs through direct skin-to-skin contact during sexual activity, even if the partner has no visible lesions. Sexually transmitted mollusca commonly appear on the genital area, inner thighs, lower abdomen, and buttocks. Lesions in these areas warrant consultation with a healthcare provider for accurate diagnosis and consideration of testing for other STIs.
Individuals with a compromised immune system may experience a more widespread or persistent infection. For example, people living with Human Immunodeficiency Virus (HIV) may develop numerous, larger, and atypical lesions resistant to standard treatments. In contrast, lesions in otherwise healthy adults are often fewer in number and remain confined to the area of sexual contact.
Treatment and Resolution
In healthy individuals, Molluscum Contagiosum is typically self-limiting, meaning the lesions will eventually clear on their own. This spontaneous resolution usually occurs within six to eighteen months, though some cases may persist longer. Treatment is not always necessary but is often pursued for cosmetic reasons, to prevent spread, or to manage persistent or widespread cases.
Medical treatment options include physical removal methods such as cryotherapy (freezing the lesions) or curettage (a scraping procedure). Topical agents are also used, including blistering solutions like cantharidin or prescription creams containing retinoids or podophyllotoxin. Consulting a healthcare provider is important for diagnosis and to determine the most suitable treatment plan, as some treatments carry a risk of scarring.