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Molluscum

Molluscum contagiosum (MC) is a very common skin infection that causes pearly/whitish bumps, often with indented centers. It is caused by a virus. It is especially common in children, but adults can get it as well. The bumps can occur anywhere on the body. Sometimes the patient has only a few bumps, but sometimes they have dozens of them.

The virus is usually spread by skin-to-skin contact. Kids often transmit them to one another by playing together at school. In adults, MC can be transmitted by sexual contact, but this is seldom an issue with kids.

MC do not stay “forever” b/c the body’s immune response eventually finds them and destroys them on its own. But they can sometimes stick around for months or (rarely) years.

Treatment for MC is dependent upon the patient’s case. The following treatment options are reasonable, but patient age and the risk of pain are factors in decision making.

  1. No treatment – If the patient has only a few lesions and they are not bothering the patient, simply ‘waiting it out” is an option.
  2. Freezing/Liquid Nitrogen – Freezing lesions is sometimes an option, but it is painful. Therefore, this is only used when necessary.
  3. Potassium Hydroxide (KOH) – This is a chemical that works well for MC and is used at home. It has been used for decades. With this method, the parent applies a small drop of KOH to the MC lesions at bedtime and allows it to dry. The blunt end of a toothpick is a good applicator. If the patient has dozens of lesions, it is OK to just apply the KOH to the 5-7 largest ones rather than to every single one. Expect a brisk reddish reaction within 2-8 days. This is the desired response. Once the reaction reaches tenderness/irritation, simply stop application and wait. If the MC lesions don’t resolve after another week, restart the process. Within 6 weeks, this method will clear the MC 90% of the time.
  4. Sal Acid (Compound W, etc.) – These products are purchased at the pharmacy over-the-counter. They are used exactly like the KOH (above), but they take longer to generate the desired reaction. It usually takes 2-3 weeks to get the MC lesions to get red/inflamed. Nonetheless, it is very effective and safe if you are patient.
  5. Scraping lesions with a curette – A sharp instrument can be used in the office to scrape the MC lesions. However, this is painful and rarely necessary.
  6. Cantharone – This substance is nicknamed “beetle juice” since it is acquired from a beetle. It causes a very brisk reaction. It is only occasionally used since other treatments (above) are easier and more predictable.

Don’t ‘stress out’ about MC. Nothing “bad” is going to happen. Your provider can help you decide what is best for your case! Keep us posted on your progress!

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