Skin conditions are common among children, especially problems such as diaper rash, eczema, seborrheic dermatitis, warts, acne, and fifth disease, not to mention measles and chickenpox. But what about molluscum contagiosum? It’s not a term you hear often, yet it is found in 1 percent of all skin disorders, and many of those cases are in children. Kids who have another skin condition, atopic dermatitis, are more prone to develop molluscum contagiosum and to have more extensive cases than are those without it.
Molluscum contagiosum is a virus-caused infection characterized by lesions or bumps that are smooth, firm, small, raised, and usually pink, white, or flesh-colored with a tiny pit in the center. These lesions can be itchy, swollen, red, or sore and can stick around for as long as four years, although the lesions disappear in many patients within 6 to 18 months. Sizes of the lesions can range from a mere pin point to about 2 to 5 millimeters in diameter (size of the end of a pencil eraser).
Mollusca lesions can appear on the face, arms, legs, abdomen, neck, and genital region, either alone or in clusters. The condition most often affects children from ages one to 10 years, but it also can occur in adults. The virus thrives in warm, humid climates.
How is molluscum contagiosum transmitted?
The molluscum contagiosum virus is a poxvirus that is spread easily from person to person. Direct skin-to-skin contact as well as contact with the clothing, linens, towels, toys, or other items used or touched by a person with molluscum contagiosum can result in the transmission of the virus. Thus it’s easy to see how settings such as child care, nursery schools, and playgrounds can be places where the virus is shared, as well as work environments, gyms, and locker rooms.
Children and adults who have a strong immune system may present with less than two dozen bumps, while those who have a weakened system may experience many more bumps. Among adults, sexual contact is responsible for many cases of transmission.
Because the molluscum contagiosum virus doesn’t venture beyond the top layer of skin, it doesn’t enter the bloodstream or circulate throughout the body, and it never lies dormant to reappear later. Once the bumps disappear, the virus is gone and you cannot transmit it to other people.
However, it is possible to become infected again. Once someone is cured of a molluscum contagiosum infection, new exposure to the virus can cause new lesions to appear.
How to treat molluscum contagiosum
Treatment is not always necessary for molluscum contagiosum since the condition doesn’t typically spread and there are no serious symptoms. However, the lesions can be uncomfortable and unsightly, and it can be challenging to prevent children from scratching and potentially spreading the virus to other parts of the body or causing a skin infection. At the same time, some individuals with molluscum contagiosum also have atopic dermatitis, which can be a risk factor for the benign condition and may also contribute to the spread of molluscum contagiosum to other parts of the body.
Other reasons to seek treatment for molluscum contagiosum is location. Bumps in the genital area usually should be treated, especially if the patient is sexually active, to prevent transmission.
Although there are several medications that can be used to treat molluscum contagiosum (e.g., cimetidine, podophyllotoxin cream, iodine and salicylic acid, potassium hydroxide, among others), natural remedies is likely all you will need. To help soothe the skin and reduce the itching, consider the following options:
Australian lemon myrtle. Application of a 10 percent solution of Australian lemon myrtle once a day has been shown to reduce symptoms by at least 90 percent. Results typically occur after 21 days of daily treatment.
Coconut oil. The high fatty acid content of coconut oil helps fight inflammation as well as prevent skin from drying out. Apply to the bumps two to three times daily.
Colloidal oatmeal. This finely ground oatmeal should be added to warm bath water. You will know you’ve added enough oatmeal when the bath water has a milk-like texture. Soak for 10 to 15 minutes max in the bath; any longer can dry out and irritate the skin. You can also apply the colloidal oatmeal mixture on the bumps using a soft cloth.
Tea tree oil. According to a study in the Journal of Drugs in Dermatology, a combination of tea tree oil and organically-bound iodine applied twice daily for 30 days resulted in a greater than 90 percent reduction in the number of bumps in 16 of 19 children. Among children who were treated with tea tree oil alone was effective in 3 of 18 children.
In severe cases, treatment options include freezing the bumps (cryotherapy), scraping them (curettage), and laser therapy. All of these therapies require a trained professional and may involve local painkillers. Possible side effects may include skin irritation, pain, and scarring. You should never attempt to remove the lesions yourself, as it is easy to transmit the virus through the fluid inside the lesions as well as cause a bacterial infection.
A recent study published in Pediatric Dermatology evaluated treatment versus no treatment of molluscum contagiosum in 170 children. The lesions disappeared within 12 months in 45.6 percent of kids who were treated and in 48.4 percent of those not treated. After 18 months, the figures were similar: 69.5 percent and 72.6 percent, respectively. Therefore, “treatment did not shorten the time to resolution.”
Complications of molluscum contagiosum
In most cases, the lesions go away over time and there is no scarring. However, children especially are prone to scratching the bumps, and this activity as well as scraping the lesions can cause scarring.
A secondary bacterial infection is the most common complication of molluscum contagiosum, and these most often occur in immunocompromised individuals, such as those who are using immunosuppressive drugs or chemotherapy, or who have HIV/AIDS.
American Academy of Dermatology. Molluscum contagiosum.
Basdag H et al. Molluscum contagiosum: to treat or not to treat? Experience with 70 children in an outpatient clinic setting in the northeastern United States. Pediatric Dermatology 2015 May-Jun; 32(3): 353-57
Burke BE et al. Essential oil of Australian lemon myrtle (Backhousia citriodora) in the treatment of molluscum contagiosum in children. Biomedicine & Pharmacotherapy 2004 May; 58(4): 245-47
Centers for Disease Control and Prevention. Molluscum contagiosum. Risk factors.
Centers for Disease Control and Prevention. Molluscum contagiosum. Transmission
Markum E, Baillie J. Combination of essential oil of Melaleuca alternifolia and iodine in the treatment of molluscum contagiosum in children. Journal of Drugs in Dermatology 2012 Mar; (3): 349-54
Molluscum Rx. Molluscum contagiosum