Molluscum contagiosum (MC), also known as water warts, is a viral infection that can affect any area of the skin. Many patients notice that the skin lesions, also known as molluscum bodies, are not painful but can be extremely itchy. Scratching the molluscum bodies may cause spreading of the infection responsible for molluscum contagiosum (an additional bacterial infection) as well as scarring. Molluscum contagiosum is more common in children between the ages of 1-11 years old; however, MC can affect adults with roughly 122 million people worldwide having it. Molluscum contagiosum is contagious until the skin lesions have cleared. It is worth mentioning that some molluscum bodies may remain for up to 4 years, if not treated.
Molluscum contagiosum is caused by a DNA poxvirus called the molluscum contagiosum virus (MCV). The molluscum contagiosum virus may spread through direct contact of the affected skin. It can also spread if the affected skin rubs against any surface (e.g. clothing, towels, tools) and a non-infected individual comes into contact with that surface. Those that are at a higher risk for contracting MC are individuals who are immunocompromised as well as those who are sexually active.
Molluscum bodies are generally dome-shaped, translucent, flesh-colored, and can have a similar appearance to a wart. Molluscum bodies typically have an overall diameter of 0.04–0.97 inches with a pimpled, small pus-filled white dot at the center. As mentioned above, molluscum bodies can appear anywhere on the skin yet are generally found on the face, arms, legs, torso, armpits (in children), and commonly seen in the genital region in adults inferring that the virus was transmitted through sexual activity. In about 10% of cases, eczema develops around the molluscum bodies.
We may diagnose molluscum contagiosum by examining the clinical appearance of your skin. Typically, we will complete a biopsy where either the whole lesion or a portion of the lesion is removed and sent to the laboratory for analysis. Based on the pathological findings, an excisional biopsy may confirm if you have molluscum contagiosum.
In most cases, molluscum contagiosum may clear up without treatment; however, we recommend that you do seek treatment. The first line of treatment would be over-the-counter (OTC) medications, prescription medications, or both. For mild cases, medications such as salicylic acid and topical creams have been shown to be effective in eliminating molluscum contagiosum. Other forms of medication found to be effective are Imiquimod (topical anti-tumor medication) and Cantharidin (keratolytic/dermatological medication). Surgical treatments include: curette scraping and cryosurgery (freezes off lesions with liquid nitrogen).