Molluscum contagiosum

What is molluscum contagiosum?

Molluscum contagiosum (MC) is a common viral infection of the skin mainly affecting children but can arise at any age. MC normally gets better within a few months without treatment; however, it can spread around the skin and take up to 18 months or more for the condition to clear completely.

What does molluscum contagiosum look and feel like?

Usually several to many firm, skin-coloured or pink-red, dome-shaped spots (lesions), often less than 5 mm in diameter, with a central dimple. They are occasionally itchy and if scratched or traumatised they can become infected and feel sore.

The spots often develop in small clusters (close together) and can spread across various parts of the body. In a few cases, particularly when MC occurs through sexual contact, spots can develop on the genitals and nearby skin.

People with a weakened immune system (immunosuppressed) or who have an underlying skin condition such as eczema often have an increased number of lesions. Less commonly, there can be one or two larger lesions known as giant molluscum contagiosum, which can be up to 20 mm in diameter.

What causes molluscum contagiosum?

Molluscum contagiosum is caused by a type of virus called a poxvirus (the molluscum contagiosum virus).

What else can contribute to molluscum contagiosum?

MC is contagious (an infection that can be spread from one person to another) and can be passed on as a result of the following:

• Close direct contact - such as touching the skin of an infected person
• Touching contaminated objects - such as towels, flannels, toys, and clothes
• Sexual contact - this includes sexual intercourse and other intimate physical contact

It is not known exactly how long someone with MC is contagious for, but it is thought the contagious period may last up until the last spot has disappeared.

Many adults will have had MC when they were younger and so are unlikely to catch it from their children as they will have developed an immunity to the infection.

Things you can do to help yourself

• Avoid squeezing or scratching the spots as this will increase the risk of the infection spreading to other parts of the skin, and may cause permanent scarring

• Reduce the chance of passing the infection on to others by using your own towel, flannel, clothing, and bedding; and not sharing baths

• The chance of passing MC on to others during routine day-to-day activities is small; children do not need to be kept off school, or stopped from swimming, although it is sensible to keep affected areas of skin covered with clothing whenever possible and a waterproof bandage can be put over the affected area/s of skin when swimming

• If someone is also suffering with eczema and MC, the eczema should be managed in the usual way

• If an adult has developed MC through sexual contact it is important to make an appointment to see your GP as tests will be needed to look for other sexually transmitted diseases. Using barrier methods such as condoms can reduce the risk of passing on MC during sexual contact

Treatment options

It is important to remember that in the vast majority of cases, MC is a harmless condition which is self-resolving and no treatment is required.

Treatment may be sought in older children and adults, for example, if there is a significant impact on quality of life or if the person has a weakened immune system.

If you need advice then see your local pharmacist who may recommend a treatment called MolluTinc ®, that can be purchased from a pharmacy without a prescription. It can be used in children aged 2 years and older.

How to use MolluTinc ® (or comparable products such as Molludab ®)

If a child is being treated, the liquid must be applied by an adult. The treatment should be applied directly to the spots twice a day (preferably once in the morning and once in the evening). Occasionally, MolluTinc can cause a slight burning sensation or irritation; this usually only lasts for a few minutes after you apply it. Continue using the treatment until the spots become inflamed (red and swollen/crusty, or, in skin of colour the spots may become darker than the surrounding skin) which is usually around day 5. If the spots have not become inflamed by day 14 then stop treatment as this would suggest that the treatment is not going to work, which is the case in some people.

After applying the treatment, adults must wash their hands with soap and water to reduce the chance of spreading the virus.

Make an appointment at your GP surgery

If MC becomes persistent, troublesome, and does not respond to treatments described above then you may choose to make an appointment with a health professional.

Other stronger treatments such as freezing the lesions (cryosurgery) are only usually recommended for adults and older children who have persistent spots that are particularly unsightly and are affecting their quality of life. Treatment may also be recommended for people with weakened immune systems, as the condition can take several years to clear in these cases.

Cryosurgery and other stronger treatments are painful, generally not tolerated by younger children, and can leave permanent marks on the skin.

Referral to a specialist

The main reasons for referring a patient to a specialist is if the diagnosis is unclear. You may be referred to a dermatologist or a GPwER/GPwSI (a GP who has been trained in relevant areas of dermatology).

There is almost no reason to refer young children as treatment is likely to do more harm than good. Very occasionally an older child or adult may benefit from referral for the reasons discussed in the section above.

What will happen when you are referred?

The appointment may be face-to-face (the person attends the clinic), or a video call (teledermatology).

Helping with other skin conditions

If you, a family member, or friend have an undiagnosed skin condition; or you want to learn more about how to treat skin conditions, please view our short video on how to get the best from this website.