What is molluscum contagiosum?

Good news: This is a harmless condition.

What does molluscum look like?

The rash consists of raised, round smooth bumps that look like thick-walled pimples or small warts. The bumps are skin- colored and sometimes have a dimple in the center. There can be only 5-10 bumps in just one area, or there can be dozens all over the body. Bumps can be the size of a pinhead to 1/4" across. The rash doesn't hurt, but occasionally will itch.

What causes molluscum?

It is caused by a virus (poxvirus.) It is transmitted only by close skin-to-skin contact. The incubation period is 4-8 weeks. Children usually catch the virus as toddlers or preschoolers. If a child picks at a bump, then scratches elsewhere, the bumps can spread to other parts of the body. There is no need to keep a child out of day care for molluscum.

How long will molluscum last?

Most bumps will disappear on their own without treatment, but it usually takes 6-18 months. They can last even longer if the child has sensitive dry skin (atopic dermatitis) or if the child picks at the bumps and they become infected.

Can anything be done to remove them faster?

There is no consensus among doctors about the best way to treat molluscum. In general, the three proven treatments are similar to wart removal: freezing the bumps in the office, extracting the bumps in the office or applying an acid-like medication to the skin at home. The first two can be painful or frightening for young children. The latter can cause significant skin irritation, even worse than the molluscum, and requires faithful application to all the lesions. Other medications, such as Tagamet, imiquimod cream, and Retin-A have been used sometimes, but they are effective only 50-80% of the time.

We generally don't recommend molluscum removal unless they are a severe cosmetic problem or if they are in a high-friction area (such as the armpit.) In those cases, we can remove the bumps in the office by one of the above two methods. Be aware that, because this is a cosmetic therapy, insurance sometimes does not pay for treatment.

There is evidence that a home remedy is safer and just as effective as any of these: duct tape! Cleaning the lesions, applying duct tape to the lesions at bedtime, then removing the duct tape the next morning has shown to work well for many children.