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Molluscum Contagiosum Treatment and Prevention

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Molluscum contagiosum is a viral skin infection that results in skin-colored, pink, or white bumps with a waxy appearance. These bumps are harmless but can spread to other parts of the body or other individuals.

Molluscum contagiosum is self-limiting, meaning that in immunocompetent individuals, it will heal by itself, usually within 6 to 18 months. Therefore, in some cases, your doctor may advise you to wait for the bumps to clear themselves

However, in many situations, one might want to get these bumps treated, such as:

  • If they are a cosmetic issue and you want them removed.
  • If the bumps are on the genitalia.
  • If they are bothersome or cause any other symptoms. 
  • If a person has a history of atopic dermatitis/eczema.
  • If a person is immunosuppressed due to conditions like HIV, transplant, or taking medications such as chemotherapy.

Read about symptoms and stages of molluscum contagiosum here.

Treatment options for Molluscum contagiosum.

A word of caution: Do not pop

Before we discuss treatment options for molluscum contagiosum, it’s important to note that attempting to pop the lesions yourself can spread the virus to other areas or other individuals. It can also introduce bacteria, leading to secondary bacterial infections. Additionally, popping increases the risk of scarring.

Are there any effective home remedies or natural treatments?

Many natural compounds, such as tea tree oil, apple cider vinegar, and coconut oil, have antimicrobial properties. However, this doesn’t guarantee effectiveness against every virus. The dosage and frequency of application are also not standardized.

You may also find many over-the-counter options that claim to treat molluscum contagiosum. However, it’s important to note that none of these are approved by the FDA for treating the condition. Therefore, you should never try these treatments unless instructed to do so by your doctor.

Treatment types

There are different types of treatments for molluscum contagiosum, some are done in a doctor’s office while others are applied or taken at home. Your doctor will choose the right treatment based on your symptoms and presentation.

Topical treatments – To be applied at home

1. Imiquimod cream

This is an immune response modifier that stimulates the body’s immune system to fight the virus. Imiquimod is applied to the bumps weekly (around 2-3 times) and washed off after a certain amount of time. It may take several weeks for the bumps to clear.

Imiquimod is not used in children and also may not be very effective as a treatment for molluscum contagiosum in children. 

2. Podophyllotoxin cream

This cream has antiviral properties and can be used to treat molluscum contagiosum in adults. However, it is contraindicated in pregnancy due to the possible risk of toxicity to the fetus.

3. Sinecatechin

This compound is derived from green tea and is FDA-approved for topical use for genital and anal warts. It may also be used for the treatment of molluscum contagiosum in the genital and anal areas.

4. Salicylic acid

A keratolytic agent commonly used to treat warts, salicylic acid may be recommended by your doctor for molluscum lesions. Your doctor may recommend a product with a specific concentration that can induce a reaction/inflammation of the molluscum bump, following which the bumps heal.

5. Tretinoin

Tretinoin, a retinoid commonly used to treat acne, can also be used for molluscum contagiosum. Its purpose is to induce an irritation reaction that helps clear the bumps.

The application method should be determined by your doctor. They may recommend applying it at home using a toothpick for some cases, while for others, they may administer it in a medical setting. It’s important to follow your doctor’s instructions when using it.

6. Berdazimer (Newly approved topical medication)

Berdazimer is the first topical prescription medication approved (in 2024) for the treatment of molluscum contagiosum that can be applied at home by the patient (if adult) or the parent (if child).

Berdazimer topical gel, 10.3% (ZELSUVMI), is a nitric oxide-releasing agent that has been shown to have antiviral properties. It is expected to be available in the US in the second half of 2024. This medication is approved for use in adults and children 1 year of age and older in the USA.

Oral treatment

Cimetidine 

Cimetidine is a drug taken by mouth that can be useful in children who cannot tolerate physical procedures such as curettage or cryotherapy. It can also be used in individuals with atopic dermatitis and multiple molluscum bumps.  

The mollusca bumps on the body respond to it, but the lesions on the face do not respond as well.

Treatments and procedures done in a doctor’s office

1. Cantharidin

Cantharidin is a blister-inducing agent made from blister beetles. YCANTH (cantharidin) topical solution, 0.7%, is the only FDA-approved treatment for molluscum contagiosum (approved in 2023). It is approved for use in adults and children ages 2 and older.

It is applied to each lesion every 3 weeks (or as needed). The medication needs to be washed off after a certain period, so follow the instructions given by your doctor. This treatment results in blister formation, which eventually heals and clears the bumps.

Cantharidin must be administered by a healthcare professional. Application without medical supervision can result in severe blistering, deep burns, and scarring.

2. Cryotherapy

This procedure involves freezing the bumps. Often, liquid nitrogen is sprayed on the bump. In some cases, liquid nitrogen may be applied with a cotton tip applicator. Frosting or a white layer will be seen on the bumps. Freezing destroys the molluscum bumps. 

Treatment is repeated every 2-3 weeks until all lesions resolve. This procedure can be painful and scary for little children so is often not recommended in them.

If someone has multiple molluscum contagiosum bumps, this treatment option may not be suitable.

3. Curettage

Curettage is a procedure that involves using a tool called a curet to scrape off the lesion using its sharp edge.

4. Pulsed dye laser (PDL) therapy

This laser therapy has proven highly effective in treating molluscum contagiosum lesions, particularly in HIV patients and those with numerous bumps. However, it is often not recommended for small children.

In individuals with darker skin tones, the treatment may cause pigment alterations (hypo- or hyperpigmentation). It’s important to note that this procedure can be expensive and may not be covered by health insurance.

Treatment in HIV or immunocompromised individuals

Most treatments are effective in immunocompetent patients; however, patients with HIV/AIDS or other immunosuppressive conditions often do not respond well to the standard treatments.

For long-term control of molluscum contagiosum in HIV individuals, it is recommended to use antiretroviral or HAART therapy. In some cases, intralesional or subcutaneous interferon-alfa may be used or recommended.

Preventative measures

To prevent spreading of the infection to other parts of the body

  • Moisturize your skin to keep your skin barrier intact (especially if you have atopic dermatitis).
  • Avoid touching the molluscum contagiosum lesions repeatedly.
  • Always wash your hands after touching or treating the bumps.
  • When bathing, use separate towels to dry the affected area and the unaffected area.
  • Do not shave or wax the area with bumps, as that can spread the virus.
  • Do not pop the bumps.
  • Treat the molluscum bumps as recommended by your doctor.

To prevent the spread to other individuals

  • Wash your hands after touching the lesions.
  • If you have bumps on your external genitalia, avoid intimate contact and seek medical attention.
  • If using swimming pools, use a waterproof covering or a bandage.
  • If participating in contact sports such as wrestling, make sure to cover all affected areas.
  • If your child has molluscum contagiosum:
    • Bathe them separately from other kids and use a separate towel for the affected areas.
    • When your child goes to school, make sure to cover the areas.
    • Wash your hands every time after touching or treating your child’s bumps.
    • Keep personal items such as bath toys separate.
    • Have your child sleep in a separate bed.
    • Encourage your child to wash their hands frequently.

To prevent getting molluscum contagiosum infection

  • Avoid direct skin-to-skin contact with an infected person’s lesions.
  • Do not share personal items, such as towels or clothing, with someone who has the infection.
  • Practice good hygiene and wash hands frequently.

Takeaway

Molluscum contagiosum is a common viral skin infection that usually resolves on its own. While it is contagious, simple preventive measures can help reduce the spread of the virus. If treatment is necessary, several options are available, ranging from topical medications to procedures.

References

Disclaimer: This article is for information purposes only and does not replace medical advice.

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