Molluscum Contagiosum: Tiny Bumps on the Skin of a Child By Dr. David Robles

                                   

Molluscum contagiosum is a common viral infection seen mostly in children. Molluscum lesions are small, round, pearly papules that can occur anywhere on the skin, including the genital area. A close up exam of these tiny bumps reveals a central indentation, which is very characteristic of these lesions. It is often associated with a patch of eczema (rash), but may occur by itself.  Since eczema is itchy and is associated with a defective skin barrier, the scratching helps spread the molluscum papules. Good control of the eczema is very important in limiting the spread of the molluscum.

Molluscum contagiosum is transmitted via skin-to-skin contact. I generally reassure the parents that this is a benign skin infection and let them know that this is not a sign of a weak immune system, and does not imply that anything more ominous is happening with their child. I remind the parents that their child's immune system is still learning how to defend against viruses in the environment and that this infection will help “educate the immune system” on how to clear the molluscum virus in the future.  Recurrences in the future are very unlikely.

Although molluscum contagiosum may resolve spontaneously, treatment is often requested when there are many of them or when they are cosmetically significant. In children, the best treatment option is one that is the least painful.  In my clinic, I frequently use cantharidin, which is a blistering beetle extract.  Cantharidin is safe, effective, relatively painless and nontraumatic. Sometimes people get blisters at the site of treatment and antibiotic ointment and tylenol or ibuprofen is usually sufficient.


Molluscum contagiosum can occur in adults and when it does, it is usually in the genital area and considered a sexually-transmitted disease. There are two molecular subtypes of the molluscum contagiosum virus  (MCV); MCV1 is the culprit in children and MCV2 is the cause in adults. The actual molluscum lesions caused by MCV1 and MCV2 are indistinguishable. When adults present with them in the genital area we counsel them about the likelihood of sexual transmission and offer additional STD testing. This is generally not the case in children.

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