Molluscum contagiosum is probably one of the more common skin rashes in children that parents usually seem to know little about.
In fact, a diagnosis of molluscum contagiosum is often met with surprise, as most haven't heard of molluscum. Instead, they likely have heard of eczema, ringworm, or impetigo.
Like warts, molluscum is a viral infection that is common in school-age children.
Molluscum Symptoms
Molluscum contagiosum lesions are typically small, dome shaped, and can have a small dimple in their center. Although often flesh colored, but can also be pink. They are usually found alone or grouped on a child's trunk, axilla, or skin folds of their elbow and knees.
For many children, molluscum don't cause any symptoms and the rash can simply be a cosmetic problem. Others can get redness and scaling on the skin around the molluscum rash, which may be itchy.
Another characteristic is that molluscum will sometimes have a plug of cheesy material coming out of the central part of the lesion.
Molluscum Diagnosis
The diagnosis of molluscum is usually made by the classic appearance of the molluscum lesions.
The diagnosis can be confusing at first though, when the molluscum are still very small. It may take a few weeks for the lesions to grow before they look like more typical molluscum lesions.
Molluscum Treatments
Since molluscum usually goes away in about six to nine months on its own, some pediatricians advocate not treating it. Keep in mind that it can sometimes last for two to four years and may spread aggressively, which is why others do recommend treating molluscum with:
- Direct removal with a curette
- Cryosurgery - freezing
- Cantharidin - a blistering agent
- Aldara (Imiquimod) - also used for genital warts, although they are not related to molluscum
- Retin A (Tretinoin) - also used for acne
All of these treatments have their shortcomings though. Direct removal and cryosurgery are painful. Cantharidin can cause large blisters. Aldara is expensive. And Retin A doesn't always work well when used by itself.
So what should you do about your child's molluscum?
Talk with your pediatrician or a pediatric dermatologist about your options, which might include:
- Leaving the molluscum alone, especially if your child has aleady had them for several months and they are not spreading.
- Direct removal with a curette or cryosurgery if your child only has a few lesions. Although it can be painful, your pediatrician can consider using a topical anesthetic.
- Cantharidin is another option if your child doesn't have a lot of lesions. It is not FDA approved in the United States, so not all doctors have it.
- Either using Aldara cream and Retin A cream alone, or using them together on alternate days.
Most importantly, if you do treat your child's molluscum, watch for new lesions during treatment. They are contagious and start spreading the infection again, even if the initial treatment was successful.
What You Need To Know
- Molluscum contagiosum is caused by a double-stranded DNA poxvirus.
- Molluscum can be spread by direct contact with an infected person, touching contaminated objects (such as towels, toys, or clothing), and on a child when they scratch a lesion and then scratch other areas of their skin (autoinoculation).
- Molluscum can grow aggressively in children who have a weakended immune system.
- A pediatric dermatologist can be helpful if your child has molluscum that isn't responding to standard treatments.
Sources:
Dohil MA. The epidemiology of molluscum contagiosum in children. J Am Acad Dermatol. 01-JAN-2006; 54(1): 47-54.
Habif: Clinical Dermatology, 4th ed.
Long: Principles and Practice of Pediatric Infectious Diseases, 3rd ed.
