Molluscum contagiosum is a common, generally harmless skin infection caused by a poxvirus. Many individuals seek effective ways to manage or remove the characteristic lesions. This article explores various options for addressing molluscum, from topical solutions to professional medical procedures.
Understanding Molluscum Contagiosum
Molluscum contagiosum is a viral skin infection that results in small, raised bumps on the skin. These bumps, known as papules, typically appear as flesh-colored, pearly, or dome-shaped lesions, often featuring a small dimple in the center. They generally range from 2 to 5 millimeters. The infection is common in children, but it can also affect adults, including athletes, sexually active individuals, and those with weakened immune systems.
The molluscum virus spreads easily through direct skin-to-skin contact, as well as indirectly by touching contaminated objects. Autoinoculation, where the virus spreads to other parts of one’s own body through scratching, is also a common mode of transmission. While molluscum contagiosum often resolves on its own within six to twelve months, treatment can help accelerate clearance and reduce the risk of spreading the infection to others or other body areas.
Over-the-Counter and Home-Based Topical Solutions
Many individuals explore over-the-counter (OTC) products and home remedies to manage molluscum lesions. OTC options contain salicylic acid, which aids in the resolution of the bumps. Salicylic acid is commonly found in wart treatments, and some dermatologists may suggest its use for molluscum.
Home-based approaches often involve natural substances, though their effectiveness is largely anecdotal. Apple cider vinegar (ACV) is a popular home remedy, typically applied to the lesions with a cotton ball and secured with a bandage. Dilute ACV for sensitive skin, as it can cause stinging or irritation, and remove it immediately if irritation occurs.
Tea tree oil, known for its antiseptic properties, and lemon myrtle oil have also been explored, with a small study suggesting a 10-percent lemon myrtle oil solution might reduce lesions. When using any of these methods, caution is important to avoid excessive irritation, which could lead to scarring, and maintaining good hygiene helps prevent further spread.
Prescription Topical Medications
Healthcare professionals may prescribe topical medications that are generally stronger than OTC options and require medical evaluation. Cantharidin, sometimes referred to as “beetle juice,” is a blistering agent applied by a medical professional directly to each lesion. This application causes a blister to form, which typically clears within two weeks, though multiple treatments may be necessary. The FDA approved cantharidin for molluscum contagiosum treatment in 2023.
Other prescription topical treatments include podophyllotoxin, an antimitotic agent, which patients apply at home with specific precautions. Imiquimod, an immune response modifier, works by stimulating the body’s immune system to clear the bumps and is applied typically two or three times a week. However, imiquimod may not be effective for all children, and the CDC does not recommend it for pediatric use.
Tretinoin, a retinoid, promotes skin cell turnover and is used in some cases, with results varying over several weeks to months of daily application. A more recent development is berdazimer topical gel, a nitric oxide-releasing agent, which received FDA approval in January 2024 and can be applied by patients or caregivers at home.
Professional Removal Methods
When topical treatments are not sufficient, medical professionals can perform in-office procedures to remove molluscum lesions. Cryotherapy involves freezing the lesions with liquid nitrogen, causing the infected tissue to die and fall off. This procedure can cause temporary pain, blistering, or redness, and may lead to pigmentation changes or scarring, often requiring multiple sessions.
Curettage is a procedure where a dermatologist scrapes off the lesions using a small, specialized tool called a curette. This method is quick and effective, often performed with local anesthesia, and generally results in minimal bleeding. While effective, curettage is usually reserved for older children and adults due to the potential for discomfort and the risk of scarring.
Laser therapy, specifically pulsed dye laser, uses focused light to destroy the lesions and is an option for individuals with numerous or resistant bumps. This method requires specialized equipment and can also lead to pain, blistering, or changes in skin pigmentation. Additionally, stronger chemical peels, such as those containing trichloroacetic acid or potassium hydroxide, may be applied in a clinical setting to help resolve the lesions. These professional methods are often chosen for widespread molluscum, lesions in cosmetically sensitive areas, or when other treatments have not been successful.
When to Consult a Doctor
Seeking professional medical advice for molluscum contagiosum is important in several situations. Individuals should consult a doctor if the lesions are widespread, rapidly increasing in number, or located in sensitive areas such as around the eyes or genitals. Medical attention is also advisable if the bumps become painful, itchy, inflamed, or show any signs of a secondary infection, such as pus or increased redness.
If home remedies or over-the-counter treatments prove ineffective, or if they cause adverse reactions like severe irritation or allergic responses, a doctor can provide alternative solutions. For individuals with weakened immune systems, professional evaluation is particularly important, as molluscum contagiosum can be more extensive and persistent. A doctor can confirm the diagnosis, rule out other skin conditions, and discuss the most appropriate treatment plan to address cosmetic concerns or prevent further transmission.