Molluscum Contagiosum

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First the Facts

  • Molluscum contagiosum is a common poxvirus infection that causes spots on the skin of both children and adults.
  • It is generally harmless and in most cases will go away within 18 months without treatment.
  • Treatment is only needed if symptoms are severe or the eyes are affected.

How Is Molluscum Contagiosum Transmitted?

  • Molluscum contagiosum is caused by a poxvirus.
  • It is spread by skin-to-skin contact with somebody who is infected. This does not have to be sexual contact, but most commonly involves contact with the affected area.
  • Molluscum contagiosum can also be spread by sharing bedding or towels with somebody who is infected.
  • It is unusual to become re-infected with molluscum contagiosum if you have had it before.

How Will I Know If I Have Molluscum Contagiosum?

  • Molluscum contagiosum spots usually take a few weeks to appear following infection.
  • Molluscum contagiosum spots are:
    • Generally small (2–6 mm) although they can grow up to 10–20 mm.
    • Dome-shaped with a shiny surface and a central dimple.
    • Usually skin-coloured although they may be red or pink.
    • Sometimes have an area of dry, red skin around the spots.
    • Sometimes itchy but most of the time do not give symptoms.
  • If they are scratched, they may bleed slightly or become infected with bacteria causing pain and swelling.
  • There might only be one or two spots and there are usually fewer than 20; however, if you have eczema or are immunosuppressed, you might have a large numbers of spots.
  • Individual spots usually last a few weeks then crust over and disappear, but new spots may appear following this.
  • The most common areas to get the spots are face, chest, armpits, upper legs or genital area. It is rare to get spots on the palms of your hands or soles of your feet.
  • Spots may occur in clusters or spread across different parts of the body.

How Can I Protect Myself?

  • Using a condom while having sex can reduce the risk of you catching or spreading molluscum contagiosum from or to the skin around the genital area. Skin-to-skin contact may still cause the virus to pass between two people.
  • You should not share towels, bedding or clothing with a person who is infected.

Where and When Can I Get a Test?

  • You should see a doctor if you think you have molluscum contagiosum. This can be at your GP or local sexual health clinic.
  • Getting medical advice is especially important if you have severe symptoms, think you have a bacterial infection, are immunosuppressed or have spots on your eyelid or near your eye.
  • Molluscum contagiosum is usually diagnosed on visual examination and does not require further tests. Occasionally your doctor may want to take a sample (biopsy) from one of the spots to confirm the diagnosis.
  • If you have acquired molluscum contagiosum from a sexual contact, you are also advised to get screened for other sexually transmitted infections.

What Happens If I Have Molluscum Contagiosum?

  • Molluscum contagiosum usually clears in 6–18 months without treatment, but it can occasionally take a few years.
  • If you have severe symptoms, are immunosuppressed or have spots on or near your eyelid, your doctor may refer you to a specialist for treatment.
  • If the spots become infected by bacteria, you may need treatment with antibiotics.
  • You should take measures such as not sharing towels, clothing or bedding to stop the spread of molluscum contagiosum to other members of your household. You should also keep the affected area of skin covered whenever possible.
  • You can still go to work or school and continue activities such as swimming.
  • Once the spots have completely disappeared, you are usually no longer contagious.
  • There are a few treatments which can speed up clearance of the spots but these can cause side effects. As the molluscum are harmless, treatments are usually not advised except in severe disease.
  • Treatments include:
    • Salicylic acid and potassium hydroxide: although the spots may disappear quicker, this causes inflammation of the spots and can result in scarring.
    • Cryotherapy (freezing) with liquid nitrogen: this usually requires multiple treatments and may be painful.
  • Squeezing, scratching or cutting the spots is not recommended as it could result in scarring, bacterial infection and further spread of the virus to other parts of the body.

What If I Don’t Get Treated for Molluscum Contagiosum?

  • Molluscum contagiosum usually resolves spontaneously, rarely causes any complications and usually does not require treatment.
  • If you have spots on or near your eyelid, an eye infection may develop.
  • Molluscum contagiosum do not usually scar, but scarring is more common if there has been a bacterial infection or after treatment.

 

Written by: Dr Alice Llambias-Maw, Dr David Rook and Dr Paula Briggs
Last updated: January 2021

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