Parents, it’s time for some real talk: molluscum contagiosum is a pain. It’s highly contagious, it takes a while to clear up, kids get it all the time, and parents are the ones who have to manage it.
Plus, when you visit a dermatologist, their answer is often the same: go home and wait it out. That sounds like great advice…if you were dealing with a responsible adult. But for a young kid, when you’re trying not to get the whole family infected? Not so much.
The good news? It is possible to manage and prevent molluscum contagiosum at home. Here’s a closer look at what molluscum contagiosum is, how it works, and what home remedies work best.
Molluscum contagiosum is a skin infection caused by a form of poxvirus, the molluscum contagiosum virus. Poxviruses are characterized by the formation of lesions, skin nodules, or a disseminated rash, and molluscum contagiosum is no different.
Molluscum contagiosum infection is characterized by round, firm, painless bumps on the surface of the skin, lesions known as Mollusca. These can range in size from a pinhead to a pencil eraser. They’re usually white, pinkish, or flesh-colored, often with a pearly appearance and with a dimple or pit in the center.
Where Does It Come From?
As previously noted, molluscum contagiosum is the result of a poxvirus infection, specifically the molluscum contagiosum virus. The smallpox virus is part of the poxvirus family, though it no longer exists in the wild.
Molluscum contagiosum is the only member of the Molluscipoxvirus genus. The word “molluscum” comes from the Latin “molluscum”, meaning “snail” or “clam”. Despite the word’s origin, humans are the only known hosts of the molluscum contagiosum virus, and we don’t get it from snails or clams.
Symptoms of Molluscum Contagiosum
Molluscum contagiosum is a viral infection of the skin, which means all the symptoms are on your skin’s surface. And because it’s a poxvirus, it has one characteristic feature: lesions, or small raised bumps on the skin called Mollusca.
Mollusca range in size and can occur individually or in clusters. Each individual Mollusca contains particles of the virus, though they don’t go any deeper–once the lesions are gone, you no longer have molluscum contagiosum in your system.
Mollusca can occur anywhere on the body. Common sites include the face, neck, arms, legs, abdomen, armpits, and the genital area. If the lesions show up around the genitals, that typically means it was transmitted via sexual contact with someone who has the virus, at which point molluscum contagiosum is treated as a sexually transmitted infection (STI). Lesions do not occur on the palms or bottoms of the feet, though it’s not clear why.
Mollusca may look like body acne, and they’re easy to remove by scratching–a common occurrence, since bumps may be itchy. If scratched or picked, mollusca can become red and inflamed. The bigger issue is scratching, as touching lesions or scratching them off spreads the virus to the adjacent skin.
The virus enters your system through small breaks in your skin. Mollusca appear at the infection site two to six weeks later.
Molluscum contagiosum is considered a mild skin infection, as the lesions are usually benign and resolve without any scarring.
The good news is that molluscum contagiosum isn’t like chicken pox. It’s only a skin infection, which means the virus is no longer in your system once the lesions are gone (unlike chicken pox or the herpes virus, which can remain dormant in your system for years only to reappear without warning).
Unfortunately, also means that unlike chicken pox, recovering from a previous molluscum contagiosum infection does not protect you against future infections. It is possible to become infected with molluscum contagiosum any time you come into contact with an infected person, no matter how many times you’ve had it before.
For most people, molluscum contagiosum is a mild (if annoying) skin infection that resolves without issue, so there is no concern about potential complications.
The only patients who typically see complications from molluscum contagiosum are immunocompromised patients, such as those with HIV/AIDS or those taking immunosuppressant drugs. For these patients, the most common complication is an opportunistic secondary infection caused by bacteria.
In those cases, the doctor will recommend further treatment to prevent the secondary infection from spreading.
Molluscum contagiosum can affect anyone of any age, but it’s most common in children between the ages of 1 to 12. It’s not necessarily that children are more susceptible to the virus so much as the fact that young children aren’t as good about hygiene as adults.
That said, the virus can infect anyone. Other than young children, it’s most commonly seen in:
- Athletes in close contact with each other, such as wrestlers
- Athletes who share equipment, such as gymnasts
- Those with chronic skin conditions, such as eczema
- Those with weakened immune systems
- People living in warm, humid climates
The key feature all of these people have in common is the potential for physical contact with an infected person, either skin-to-skin contact or by touching something they touched. A gymnast, for example, may get molluscum by touching a mat that an infected gymnast touched, if the mat hasn’t been cleaned and disinfected between uses.
Generally, molluscum contagiosum is spread by:
- Skin-to-skin contact
- Contact with contaminated objects
- Sexual contact with an infected person
- Touching, rubbing, or scratching the bumps
Molluscum contagiosum is highly contagious, but it only spreads via physical contact–unlike the flu, it’s not airborne.
A common site of infection is actually swimming pools. It’s not clear if chlorinated water helps the virus spread. Currently, scientists believe the more likely answer is that swimmers transmit the virus directly through skin-to-skin contact, shared equipment, or shared towels.
A child, for example, may get molluscum contagiosum from another child if they share pool toys.
Because molluscum contagiosum is so contagious (thus the name) it’s a highly common virus. Don’t be surprised if someone in your family gets it, or if the rest of the family gets it shortly thereafter–it happens all the time. Think of it like passing around the flu.
While the virus is most commonly seen in children between the ages of 1 and 12, certain people are at a higher risk of contracting the infection. These include:
- Immune-suppressed or immune-compromised patients, such as those with HIV or those receiving treatment for cancer
- Patients with atopic dermatitis (a.k.a. eczema)
- People who live in warm, humid climates, especially in crowded living conditions
Mollusca in immune-suppressed or immune-compromised patients may look different, be larger, and be more resistant to treatment since the immune system can’t fight it off very well. For those with eczema, molluscum contagiosum is more common because of frequent breaks in the skin. And for those in warm climates and close quarters, it’s all about skin-to-skin contact.
Unfortunately, molluscum contagiosum may be mistaken for acne to the untrained eye. What brings most parents to the dermatologist’s office is the persistence of the lesions–mollusca can last anywhere from six months to a year, though it can take as long as four years for some patients.
A board-certified dermatologist can diagnose molluscum contagiosum by looking at the lesions. If they’re not sure, they may scrape off a bit of skin to take a closer look under a microscope. This can be done in the course of a simple office visit.
When Dermatologists Recommend Treatment
Most of the time, dermatologists don’t actually treat molluscum contagiosum. They usually recommend letting the virus run its course and allowing the lesions to resolve on their own, since mollusca will usually clear with no scarring without the need for treatment.
That said, it can take time for lesions to clear. In kids with healthy immune systems, most mollusca clear between six to nine months. Some patients continue to have bumps for three to four years, and there are some rare reports of bumps showing up for five years.
However, mollusca lasting for years on end are rare and usually only seen in immune-compromised patients with treatment-resistant molluscum contagiosum.
Your dermatologist will usually only recommend treatment for patients who have:
- Compromised immune systems
- A chronic skin condition that makes them more prone to repeated infection
- Mollusca in the genital area
- Extremely bothersome mollusca
For immune-compromised or immune-suppressed patients, such as those with HIV/AIDS, treatment will look different.
The good news is that there are a variety of treatment options and there is no best treatment. Your dermatologist will choose therapies based on your child’s health, the number of mollusca, and where the mollusca appear, among other factors.
Dermatologist-recommended treatments are either performed in the office, applied at home, taken for a prescribed period, or some combination thereof.
One common option is physical removal of the lesions. This would include things like:
- Pulsed dye laser
- Removal of the core with forceps or a scalpel
Cryotherapy involves applying an extremely cold substance to the bumps, which effectively kills them. Because new mollusca can still form, you’ll have to go back every two to three weeks until the bumps are completely clear. This is not recommended for young children since it can be quite painful.
Curettage uses a tool called a curette to cut the skin and remove the bumps. A skilled dermatologist can do this with little or no bleeding. Again, this is not recommended for young children, as it can frighten them.
Pulsed dye laser (PDL) treatment is effective for those with many mollusca or treatment-resistant mollusca–it can actually treat dozens of mollusca in under two minutes, and treated skin tends to heal completely after four weeks. However, not all dermatologists have the technology for this treatment, and insurance rarely covers it, so it’s expensive.
Removing the core is a lot like popping a pimple. The dermatologist applies topical numbing cream and squeezes the mollusca to remove the substance inside. This should only be done by a dermatologist, as doing it improperly can result in serious, widespread infection.
If a dermatologist decides to pursue treatment for a young child, they typically opt for oral therapy, since it’s much less painful. Plus, parents can administer oral therapies at home, which makes it much less frightening for the child.
One common oral option is oral cimetidine, a medication intended to treat conditions which cause the stomach to produce too much acid (ulcers, for example).
This is often used for small children who are afraid of pain associated with cryotherapy or similar treatments. It’s also used for patients with severe eczema or widespread mollusca.
It’s generally effective, though facial mollusca typically don’t respond to cimetidine as well as mollusca elsewhere on the body.
There are a lot of treatments available online, but your dermatologist will typically recommend:
- Imiquimod cream
- Podophyllotoxin cream
- Salicylic acid
The choice of topical cream depends on the patient. Imiquimod cream, for example, stimulates the immune system, though it isn’t recommended for young children.
Therapy for Immunocompromised Patients
Because immunocompromised patients often have treatment-resistant molluscum contagiosum, their treatment options look a little different.
Generally, immunocompromised patients respond well to most treatments used for other patients. The exception to the rule is patients with HIV/AIDS or similar conditions which suppress the immune system. In fact, low CD4 cell counts linked to widespread facial mollusca are now considered a marker for severe HIV.
With immune-compromised patients, the best options tend to be the ones which boost the immune response.
In short? Treatment from a dermatologist works, but it’s often expensive, and many techniques can’t be used on small children. Plus, your dermatologist usually won’t recommend treatment except in specific cases, which means you have to deal with the bumps for a few months on your own. What’s a parent to do?
Time to turn to home remedies.
Home treatments don’t cure molluscum contagiosum. However, they can make molluscum contagiosum easier to manage, especially if your dermatologist recommended against in-office treatment and you’re waiting it out.
Here are some of the best at-home treatments for parents to try.
Good Skin Hygiene
No matter what other home remedies you use, good skin hygiene should always be your first port of call. Again, this does not cure molluscum contagiosum, but it makes it manageable and reduces the risk of spreading.
For one thing, keeping the bumps clean reduces the risk of an opportunistic infection. For another, rigorously washing your hands after cleaning the bumps reduces the risk of spreading your child’s mollusca to yourself or the rest of the family. Always wash your hands thoroughly for at least 20 seconds or more (you can sing the Happy Birthday song, or try this list if you’re sick of singing when it’s not anyone’s birthday).
Colloidal Oatmeal Bath
Oatmeal baths have long been used as a home remedy for skin conditions like eczema, for the same reason you’ll often see lotions that advertise having oatmeal in them.
Colloidal oatmeal is basically finely ground oatmeal, which you can buy ground or you can make yourself by grinding old fashioned oats. Either way, oatmeal is packed with triglycerides, a type of fatty acid with anti-inflammatory properties which can coat the skin and help rebuild the protective outer barrier.
To do a colloidal oatmeal bath, just add oatmeal to warm (not hot) water and soak for 10 to 15 minutes. Don’t soak for longer–it may dry your skin out. Alternately, if you don’t want to scrub the whole bathtub (or you’re worried about clogging the pipes), you can mix warm water and colloidal oatmeal in a bowl and dip a washcloth in it, applying the washcloth to affected areas.
If you opt to make colloidal oatmeal yourself, test it first. Add a spoonful of ground oats to warm water. If you’ve ground them enough, the water should turn into a milk-like texture. If not, keep grinding.
This won’t reduce signs of mollusca, but it will help prevent itchiness, which can help limit the spread in kids.
Tea Tree Oil and Iodine
One home remedy that does significantly reduce the appearance of mollusca is tea tree oil and iodine.
One study, published in the Journal of Drugs in Dermatology, tested twice-daily topical applications of tea tree oil and iodine in 53 children. The study looked at three groups: those using tea tree oil alone, those using iodine alone, and those using a combination of the two.
Of the 48 children available for follow-up after 30 days, 16 of the 19 children treated with tea tree oil and iodine had a greater than 90% reduction of lesions, while only 1 of 16 and 3 of 18 children met the same criteria in the iodine-only and tea tree oil-only groups. No child discontinued treatment due to adverse effects.
If you opt for tea tree oil, test it on a small area of your child’s skin. If there’s no allergic reaction after 24 hours, it’s safe to use tea tree oil. However, tea tree oil should only be used on children old enough to understand that they should not eat it.
Ultimately, the best thing you can do to manage molluscum contagiosum is to prevent an infection in the first place.
That can feel like scaling Everest (especially if you have young children). But the truth is, you can avoid molluscum contagiosum (and contain its spread) with a few simple techniques that even young children can manage.
Keep Skin Clean
First and foremost, always keep your skin clean.
Here’s the good news: if you teach your kids the importance of washing up and make hygiene a regular habit, kids can sustain the routine on their own. That said, make sure to teach your kid how to wash their hands the right way.
For kids, the best way to do that is by turning a chore into a game. Tell them to sing 20 seconds of a song. Keep a library of favorite songs on hand so that you can tell them to sing their favorite song, or put on their favorite song and tell them to keep scrubbing until the song ends.
Manage Skin Conditions Like Eczema
Unfortunately, skin conditions like eczema (which causes dry skin and rashes) make children more likely to get infected with molluscum contagiosum. That’s because the virus gets in your system through breaks in your skin, which means it takes eczema as an engraved invitation.
Eczema does not go away on its own. Atopic dermatitis specifically is a chronic condition that flares periodically. If you live in an area with all four seasons, for example, your child’s eczema may flare in the winter (when the air is dry).
The key to eczema management is keeping the skin hydrated. Unfortunately, eczema isn’t regular dry skin and may not respond to regular lotion. Some over-the-counter lotions with ceramides, like CeraVe, can help rebuild the skin barrier with regular use. Kids with severe eczema may also need prescription lotion to keep their eczema under control for extended periods.
Be Careful During Sports
Unfortunately, it’s quite easy to spread molluscum contagiosum during sports, which means that active children may be at a higher risk than their peers. Again, your best option is to preach good hygiene 24/7/365.
For children in contact sports, good hygiene is a must. If your child already has molluscum contagiosum, they shouldn’t participate in contact sports unless they can cover the lesions with bandages. Swimming should be avoided unless all lesions are covered with watertight bandages and they have extra towels.
For kids who don’t have mollusca, good hygiene is the name of the game. Make sure your kids wash up religiously and don’t let them share towels, clothing, or other items.
We get it. Skin hygiene with kids is hard. You know, kind of like swimming upstream is hard–it’s a constant effort. But your life gets ten times easier when you have the right skincare products to keep your little one clean and healthy.