Molluscum
Introduction
Molluscum contagiosum is a viral infection that causes small, raised bumps to appear on the skin. It is very common among young children, and although it is harmless and painless it is very infectious, so good hygiene is important to prevent spread.
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Molluscum contagiosum rash on the face and eyelid of a young child
Who gets it?
Molluscum is particularly common in Australia because of our warm climate.
Molluscum generally affects young people, most commonly infants and children. Children under the age of 10 are more commonly affected than adolescents. Boys and girls are affected equally.
Molluscum tends to be more severe and lasts longer in children with eczema.
What causes it?
Molluscum is a skin infection caused by a common, contagious virus. It can take some time after infection for molluscum spots to become apparent, so it may not be immediately clear that infection has occurred. It can spread by:
Direct skin-to-skin contact between one child to another
Direct scratching, which can spread the virus from one location to another on a child’s skin
Indirectly through water, such as when children share a bath or warm paddling pool
Indirectly through shared items with close contact to skin, such as towels or clothes.
What does it look and feel like?
Looks like…
Clusters of small, smooth, round bumps that are usually only a few millimetres in size.
Can be skin coloured, white, pink or red bumps with shiny appearance
Bumps have a slight dent in the middle.
They can affect any area, but are often found in warm, moist areas, such as the underarms, nappy area and back of the knees. They do not occur on palms and soles.
Sometimes, molluscum can cause dermatitis in surrounding skin, particularly in children with sensitive skin or dermatitis (see atopic dermatitis fact sheet).
Sometimes molluscum can look red and irritated which makes parents worry that it is infected. But this is actually a sign of that particular molluscum being attacked by your child's immune system and a good sign that the spot is about to resolve.
Feels like…
Normally there are no symptoms
Occasionally itchy, especially if surrounding eczema
What tests might be needed?
Molluscum is usually diagnosed by examination of the skin as it has a distinct appearance. Most of the time, your child's GP or dermatologist will not need to perform any tests. Sometimes they may look at it with a special magnifying device.
Very rarely, the doctor may need to take a small sample of your child's skin (called a biopsy) to confirm the diagnosis, but this is uncommon.
What treatments are available?
What can I do?
Although molluscum is infectious, it does not require children to stay home from school or daycare, as it is harmless. However, good hygiene is important to prevent spread to other children or other areas of skin.
Here are some tips to prevent spread:
- Encourage your child not to scratch
- Practice regular hand washing with your child and washing of clothes regularly
- Cover their lesions with clothes or bandaids
- Avoid sharing personal items such as towels, hair brushes, clothing between children
- Avoid using loofahs when showering, avoid rubbing with towels, pat dry instead
- Avoid sharing warm baths and hot tubs between siblings (cool pool water and ocean swimming is not an issue)
Medical therapies
Like many viruses, molluscum can be quite difficult to treat, as we do not have a specific cure. However, because molluscum is harmless, no treatment is needed in most cases and the spots will resolve on their own, with time. Wihtout treatment, most children will take between 6-24months to clear their infection. If your child has an underlying immune problem or is on immune modifying medications then they may develop a more severe outbreak and may take much longer than average to clear the infection.
If molluscum is bothering your child, or persists for a long time, a dermatologist will be able to recommend some appropriate treatment options.
Cream based treatments:
Various creams can be used to irritate the mollusca so that your child's immune system can trigger a response and get rid of the virus. Sometimes the cream treatment aims to peel the top layer of the skin and thereby remove the bump with it. These treatments are applied by the doctor in a clinic. Some commonly used cream treatments for molluscum include:
Over the counter wart treatment
Cantharidin (doctor applied)
Tricholoacetic acid (doctor applied)
Retinoid creams
Imiquimod
Physical treatments:
Some of the treatments include physically destroying the molluscum. Although these methods are effective, they do have some complications.
Pricking (very effective, non-painful, cheap and non scarring)
Cryotherapy (possible scarring, painful and possible colour change)
Curratge and cautery (possible scarring, painful)
Laser (scarring, painful, costly)
What happens after treatment?
Although uncommon, it is possible to get re-infected with molluscum, so good hygiene is still important even after the infection has passed. Rarely, molluscum can leave small scars, which can be treated if your child wishes (see scar fact sheet).
What support is available?
Your GP or dermatologist will be able to support you and your child in the management of molluscum, and answer any questions that you may have about this condition.
Authors/Reviewers:
Author: Dr Imogen Kate Thompson
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
