Molluscum contagiosum: Diagnosis and treatment
How do dermatologists diagnose molluscum contagiosum?
A dermatologist can often diagnose molluscum contagiosum by looking at your skin. Sometimes molluscum looks like another skin condition. The bumps can look like warts, chickenpox, and even skin cancer. If this happens, your dermatologist will scrape off a bit of infected skin, so it can be examined under a microscope.
How do dermatologists treat molluscum contagiosum?
When a child gets this skin condition, researchers have found that the skin often clears on its own. Clearing takes about 12 to 18 months. In many cases, children are not treated because treatment can have unwanted side effects for a child.
While molluscum can clear on its own, treatment has benefits. Treatment helps to prevent the virus that causes molluscum from:
- Spreading to other parts of your body
- Infecting other people
- Growing out of control in people who have a weakened immune system
For each patient, a dermatologist considers whether treatment is appropriate. If treatment is recommended, your treatment plan may include one or more of the following:
Procedures: Your dermatologist can perform these during an office visit:
- Cryosurgery: The dermatologist freezes the bumps with liquid nitrogen.
- Curettage: The dermatologist uses a small tool called a curette to scrape the bumps from the skin.
- Laser surgery: A dermatologist uses a laser to target and destroy the bumps. This can be an effective treatment for people who have a weakened immune system.
- Topical (applied to the skin) therapy: Your dermatologist can apply various acids and blistering solutions to destroy the bumps. These work by destroying the top layers of the skin. Tricholoracetic acid is often used to treat people who have a weak immune system and many bumps.
When a patient has many bumps or large bumps, a dermatologist may need to repeat a procedure every 3 to 6 weeks until the bumps disappear. These procedures cause some discomfort.
Medicines you apply at home: Medicines that your dermatologist may prescribe for you to use at home include:
- Imiquimod: This medicine is applied to the bumps. Imiquimod helps your immune system fight the virus. This is strong medicine. It also is used to treat stubborn warts and some skin cancers.
- Retinoid or antiviral medicine applied to the skin: Patients apply this medicine to the bumps as instructed.
While treating molluscum, it is normal for new bumps to appear as others fade.
If a person with a healthy immune system opts not to treat molluscum, the bumps will eventually go away on their own without leaving a scar. Until the bumps go away, the person is contagious.
When you choose to treat molluscum, you may get new bumps for as long as 6 months after you start treatment. Most people, however, have complete clearing in 2 to 4 months. It's important to remember that until the bumps clear, the infected person can give molluscum to others.
If a person has AIDS or another disease that weakens the immune system, the bumps will not go away without treatment — and the bumps can be a challenge to treat. Dermatologists often combine treatments to offer these patients some clearing. Complete clearing may not be possible.
Rush J and Dinulos JG. “Childhood skin and soft tissue infections: new discoveries and guidelines regarding the management of bacterial soft tissue infections, molluscum contagiosum, and warts.”Curr Opin Pediatr. 2016; 28(2):250-7.