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Molluscum contagiosum is a viral skin infection that causes raised spots or bumps on the skin. There’s usually no need to worry since symptoms of the infection go away on their own within 6 months to a year. Molluscum contagiosum is, however, very contagious, so it pays to visit a doctor, get a diagnosis, and take positive measures to make sure no-one else gets infected.
What is molluscum contagiosum?
Molluscum contagiosum, or water warts, is a common but harmless viral skin infection. Infected skin tissues typically erupt in a cluster of one to three dozen small bumps or pimples (papules) called “Mollusca” that may become itchy, red, dry, or sore. The infection usually clears on its own without scarring in six to 12 months but may persist for up to four years. The molluscum contagiosum virus does not lie dormant within the body; therefore, symptoms that return indicate a new infection. Complications are not common but may include bacterial infections or worsening of eczema around the area affected by molluscum contagiosum.
The molluscum contagiosum virus (MCV) responsible for the infection belongs to the poxvirus family. The virus infects the upper skin layer, called the epidermis, which is constantly being shed and replaced with new skin cells. It does not spread through the blood or bodily fluids.
The virus is primarily spread through direct skin-to-skin contact, including sexual contact. People can reinfect themselves on other parts of their body by touching, rubbing, scratching, or squeezing the lesions. A molluscum infection can also be spread indirectly through contaminated objects, such as towels, bedclothes, toys, razors, and similar objects. Once caught, the infection has an incubation period of two to seven weeks before bumps start to appear.
Molluscum is a common infection, especially in warm, humid, or crowded areas. Both adults and children can become infected with molluscum contagiosum. Up to 5% of children in the United States get molluscum infections and as many as one in three adults have been exposed to the virus. Some people are more at risk than others, especially those with atopic dermatitis or compromised immune systems.
Molluscum contagiosum infections are usually acquired by young children between the ages of two and five. In children, the lesions often appear on the face, trunk, shoulders, or limbs. Among teens and adults, molluscum is usually spread through sexual contact or contact sports. Sexually-transmitted molluscum infections typically appear on the genital area, anus, inner thighs, and lower abdomen. People with compromised immune systems may have lesions spread extensively around the body.
How is molluscum contagiosum diagnosed?
Molluscum contagiosum is diagnosed by a general practitioner or dermatologist primarily by examining the bumps.
The symptoms of molluscum contagiosum are limited to the appearance of the skin lesions, which usually appear in a cluster of a dozen or more bumps that are:
- Pearly, pink, or purple-colored
- Dome-shaped
- About one-tenth to less than one-half an inch in diameter
- Firm, with a dimple in the center
The healthcare provider may need to examine the lesions with a dermatoscope, a small, handheld magnifier with light. If there’s any doubt, the doctor can confirm the infection using a specialized microscope or a skin biopsy.
Molluscum contagiosum treatment options
Molluscum warts typically disappear on their own without scarring within a few months. Dermatologists may treat the condition if the infection is extensive, located on the genitals, or cosmetically disruptive. When determining treatment options, a specialist may also consider whether the patient has a weakened immune system or other risk factors.
Physical removal
A dermatologist can physically remove the molluscum warts using a variety of outpatient procedures:
- Cryotherapy. Using liquid nitrogen, a dermatologist will freeze the molluscum lesions to remove them. The procedure has a high success rate at clearing lesions and can be performed without anesthesia.
- Curettage. The dermatologist will apply a topical anesthetic and remove the infected lesions with a curette, or a type of pick. Povidone iodine may be applied to the area afterward to prevent infection. Curettage can be highly successful, but there is a risk of scarring.
- Laser therapy. Using a pulsed dye laser, a concentrated beam of light is focused on the molluscum lesion, removing it with heat.
Chemical removal
Certain chemical treatments involving glycolic acid or lactic acid can be used to help get rid of molluscum bumps. However, these chemicals can irritate the skin and cause redness or swelling. Chemical treatments should be administered by a dermatologist and may require several visits to completely treat the lesions.
Medications
Immune-modulating drugs can be successful at ramping up the immune system’s fight against the virus. These medications can be taken orally or applied topically to the infected area. For severe infections or patients with a weakened immune system, a doctor may inject certain drugs to clear the molluscum infection.
Molluscum contagiosum medications
Because most molluscum contagiosum infections go away naturally in six to 12 months, many dermatologists are wary of treating the condition with drugs. It is not entirely certain that drugs help, so a dermatologist will make a judgment based on the patient’s situation. First-line therapies often include topical medications that destroy the infected lesions. For extensive or stubborn infections, dermatologists may turn to drugs that stimulate the immune system.
Topical agents
Cantharidin, a blistering agent, is often the first-line medical therapy used by a dermatologist. Because cantharidin can irritate the skin and cause blisters, it is applied to the infected area by a dermatologist as an office procedure. It must be washed off in two to six hours to prevent skin damage and scarring. Blisters form in one or two days. If effective, the molluscum infection will clear within seven days after application.
The dermatologist may prescribe any number of other drugs to help clear the molluscum skin lesions: podophyllotoxin cream, salicylic acid, benzoyl peroxide, tretinoin cream, or potassium hydroxide. Many of these medications are common acne treatments. Unlike cantharidin, these are medications that may be applied daily for several weeks.
Immunomodulators
Immunomodulating drugs stimulate the immune system to more effectively fight the molluscum virus. A common front-line therapy for molluscum is topical imiquimod, particularly for sexually-transmitted molluscum infections. When applied to the infected skin area, imiquimod provokes an inflammatory response that destroys the lesions.
Young children may be prescribed cimetidine, an over-the-counter tablet normally used to reduce stomach acid. Cimetidine works by blocking histamine, which is known to suppress certain immune cell activity. Unlike some topical medications, cimetidine does not carry a risk of skin irritation or scarring.
Antiviral medications
For patients with extensive infections and a weakened immune system, cidofovir may be used off-label to directly stop the growth of the molluscum virus. It is administered as a topical cream or an intravenous infusion.
What is the best medication for molluscum contagiosum?
For most people with healthy immune systems, molluscum contagiosum goes away within six to 12 months. Medications may help the infection clear up faster, although treatment will be determined on a case-by-case basis. There is, then, no “best” medication for molluscum contagiosum. A dermatologist will weigh the severity of the infection, the patient’s overall medical situation, and the risk of side effects in determining the most appropriate drug treatment, if any.
| Best medications for molluscum contagiosum | ||||
|---|---|---|---|---|
| Drug Name | Drug Class | Administration Route | Standard Dosage | Common Side Effects |
| Cantharidin | Blistering agent | Topical | Applied to the affected area only by a dermatologist | Pain, burning, redness |
| UltraSal-ER (salicylic acid) | Keratolytic agent | Topical | Apply once or twice daily as directed by a doctor for up to 12 weeks | Skin irritation, burning, redness |
| Condylox (podophyllotoxin) | Keratolytic agent | Topical | Apply twice daily to the affected area for three consecutive days then discontinue for four consecutive days. Continue this weekly cycle for up to four weeks | Itching, burning, pain |
| Retin-A (tretinoin) | Retinoid | Topical | Apply to the affected area once per day | Redness, burning, irritation |
| BP Gel (benzoyl peroxide) | Keratolytic agent | Topical | Apply to the affected area once or twice daily | Dryness, peeling, redness |
| Aldara (imiquimod) | Immunomodulatory agent | Topical | Apply to the affected area three times per week for up to 16 weeks | Itching, burning, redness |
| Tagamet HB (cimetidine) | Immunomodulatory agent | Oral | 30 to 40 mg/kg per day in two to three doses per day | Headache, dizziness, drowsiness |
| Vistide (cidofovir) | Antiviral | Topical or intravenous (IV) infusion | As directed by a doctor | Burning sensation, irritation around the area of application or injection |
Many of the standard dosages above are from the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of molluscum contagiosum medication?
All medications have possible side effects that will depend on the type of medication being used. This is not a complete list of possible side effects. A healthcare provider can provide guidance about both side effects and possible drug interactions.
Topical medications are intended to destroy and remove the molluscum lesions. Typical side effects of topical medications include skin irritation, burning, stinging, itching, redness, drying, peeling, and blistering. Some topical agents can cause skin injury, bleeding, or scarring if used improperly. Therefore, these medications should only be used as prescribed by a dermatologist.
Imiquimod cream generally produces infrequent and mild side effects such as skin redness, swelling, blistering, and scabbing.
Cimetidine is a safe, over-the-counter drug that reduces stomach acid. However, when taken as an immunomodulator for a molluscum infection, cimetidine is prescribed at higher doses, which can make side effects more likely to occur. As an antihistamine, cimetidine affects the nervous system. Common side effects include headache, drowsiness, dizziness, confusion, and nausea.
When taken orally, cidofovir and similar antiviral medications usually produce side effects such as nausea, vomiting, diarrhea, loss of appetite, and headache. Serious side effects may include blood problems and kidney damage. Off-label topical cidofovir can cause burning and irritation around the area of application.
What is the best home remedy for molluscum contagiosum?
Treatment for molluscum contagiosum often involves waiting it out. Molluscum contagiosum, however, is highly contagious. It is easily spread through direct contact with an infected person or from contaminated surfaces and objects, like towels, clothes, and razors. People with molluscum can also infect other parts of their body by scratching or rubbing the infected area, or by using towels, razors, or clothes that are contaminated. The primary goal of home treatment, then, is to prevent the spread of the infection.
Do not scratch the lesions
The surest way to spread the infection to other parts of the body is to scratch or pick at the lesions. Avoid shaving any infected area.
Do not try to remove or “pop” the lesions
Molluscum lesions are packed with viruses. Cutting off the lesion or squeezing out the fluid can spread the infection.
Wash regularly
Wash your hands after touching the affected area to prevent spreading the infection. Keep the infected area clean by washing it regularly.
Always use two towels
Use one towel to dry the infected area. Use a different towel to dry non-infected parts of the body.
Do not share personal items
Keep towels, washcloths, brushes, food utensils, and bedding used by an infected person separated from other people’s items.
Cover the infected area
If you can’t keep the infected area covered with clothing, use a bandage, surgical tape, or other covering when you are with other people, especially if you are playing contact sports.
Stop having sex
A molluscum infection in the genital area puts a hold on genital contact until the infection passes. Otherwise, you risk spreading it to your partner.
Frequently asked questions about molluscum contagiosum
Can molluscum contagiosum be cured?
In most cases, molluscum contagiosum goes away on its own. In some cases, a dermatologist may treat the infection by physically removing the infected lesions.
Can molluscum be dangerous?
Molluscum contagiosum is a benign condition that is limited to the upper layers of the skin.
Can you pop molluscum?
Do not “pop” or squeeze molluscum lesions. The fluid inside is packed with the molluscum virus, which can easily infect other parts of the skin.
Can I remove molluscum myself?
Even though molluscum lesions look a bit like acne and can sometimes itch, do not scratch, cut, squeeze, or try to remove them. Unlike acne or warts, molluscum is highly contagious, so playing with the lesions risks spreading the infection.
How do you get rid of molluscum contagiosum at home?
For most people, the standard treatment for molluscum contagiosum is to patiently wait while the body clears the infection. Self-treatment consists largely of preventing the spread of the infection.
How long does it take for molluscum to go away?
Most molluscum contagiosum infections resolve in six to 12 months, but stubborn infections may persist for as long as three to four years. If an infection is still hanging around after 18 months, it’s a good idea to see a dermatologist.
How do you know molluscum is healing?
Molluscum contagiosum infections often have beginning-of-the-end (BOTE) symptoms caused by the immune system aggressively fighting off the virus. The lesions swell and the skin around them grows bright red or pink. Lesions typically disappear a few weeks after the BOTE sign.
What is the fastest way to get rid of molluscum contagiosum?
Physical removal of molluscum lesions through cryotherapy, curettage, or dye laser therapy is the fastest way to get rid of the infection. However, these procedures are not always necessary and may leave scars.
What cream can I use for molluscum?
Molluscum may or may not be treated with topical medications and creams. More often than not, a doctor or dermatologist will counsel patience as the body clears the infection. There are no over-the-counter creams or medications that have been proven effective at treating molluscum. A dermatologist may recommend a prescription cream, gel, or liquid depending on the extent of the infection, the patient’s medical situation, risk factors, complications, or cosmetic concerns.
Does duct tape get rid of molluscum?
There is some evidence that duct tape—or any other strict skin barrier—put over molluscum papules for three days can clear the lesions in a few weeks. Anyone who has had a bandage on for two or three days notices that, when the bandage is removed, the skin under the adhesive has turned pale, thin, soft, moist, and wrinkly, a condition called maceration.
Skin occlusion—totally covering the skin—traps moisture and oversaturates the skin. This produces the same effect as many molluscum topical medications: it causes the hard, outer layer of skin to break down (keratolysis) and peel off. Maceration does, however, raise the risk of skin sores, skin damage, swelling, and infections. For this reason, healthcare providers generally frown on macerating the skin on purpose. Consult a dermatologist before trying duct tape treatment at home.
Does apple cider vinegar cure molluscum contagiosum?
There is no research or evidence that shows that apple cider vinegar, garlic, or tea tree oil cures molluscum contagiosum. Some people may find success using natural methods. Just take care not to spread the infection when applying the treatment. You may want to consult a doctor before trying this method.
Is saltwater good for molluscum?
Despite anecdotal evidence, there is no research or scientific evidence that saltwater or Epsom salt baths are effective at treating molluscum lesions. However, salt water may help relieve symptoms and draw out the infection. Consult a doctor before trying at-home treatments.