Spreading Little Skin Bumps: Molluscum Contagiosum

There isn’t a week that goes by that I don’t see a common skin disease called Molluscum Contagisosum. As the name implies, it is a wildly contagious problem. It’s one of those things you’ve never heard of until your kid gets it and then you start asking around. When you do, you find out that everyone has had it. The problem with Molluscum Contagiosum is that it is really common, there isn’t a cure, and consequently, there are a million different opinions on what to do about it.

Here are the facts. Molluscum contagiosum is caused by a virus. It is spread by direct contact with the virus. For example, it spreads in families when kids share towels, all take tubs together (I’ll see entire families where all the kids have it on their butts), etc. It can also spread on the same person (e.g. if you pick one of the little bumps and the viral material inside the bump spreads to other parts on the skin). It can last anywhere from a couple of months to years. Some people only get a bump or two, while others may get hundreds of bumps. It thrives and spreads when the integrity of the skin isn’t good (like someone who has really dry skin or eczema).

The bumps usually appear as small, firm, and dome-shaped. They are pink or flesh-colored and classically have a little depression in the center. Sometimes they will be filled with a white, cheesy material (and almost look like a zit). When the body mounts a response to get rid of them, the bumps will usually turn red. They can leave a scar (hence the fear of molluscum spreading to your child’s face). The key to getting rid of the virus is getting the body to mount an immune response to it. This is where all the various ideas on treating it (and innumerable home remedies) come into play.

As for treatment, a good doc will always counsel you on how to prevent spreading it (both on the infected person and to others). Tips include: wash hands, don’t pick at the bumps, improve the integrity of the skin around the bumps (good moisturizers, etc.), don’t share towels, etc. The generally accepted options for treatment include:

1. Do nothing. Because it is a virus and the body will eventually conquer it, some people opt to do nothing. The fear with “do nothing” is that it will spread. However, “do nothing” is an oft accepted option if there are too many bumps for a child to tolerate another treatment (e.g., a small child could never tolerate you burning off 50 spots).
2. Cryosurgery. This is freezing the bumps with liquid nitrogen.
3. Curettage. This involves using a small tool to scrape the bumps off.
4. Topical therapy. This involves applying various acids or solutions to destroy the bumps.
5. Laser Surgery. The laser is used to target and destroy the bumps.
6. Home Remedies. This is the tricky area. I think I’ve heard of every treatment (from apple cider vinegar to wart medications—although, to be clear, molluscum is not a wart to essential oils). I get the most mixed reports on effectiveness with these treatments. I think sometimes they can work. It’s all a matter of whether they help your immune system mount a response or not.

I generally recommend that my patients come in and get any bumps taken care of as soon as they appear. It’s much easier (and less painful) to take care of molluscum when there are only a few spots. Here’s hoping you never have to deal with mollsucum contagiosum, but if (or rather when) you do, we’re here to help.

Thanks to my patient who let me snap a couple picks of her leg yesterday for all of you to see (FYI, the spot at the crease of her knee is the most classic appearing). She was a champ when I applied the medication to her spots.