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Weekend Doctor: Molluscum contagiosum

By Mike Patrick, MD
Medical Director for Interactive Media, Nationwide Children’s Hospital

Despite its big, scary-sounding name, molluscum contagiosum is a common and relatively harmless skin condition seen in many children. It comes in the form of bumps that range in size from a pinhead to a pencil eraser. The bumps are caused by a skin virus and appear as painless domes that are typically flesh-colored, although they may develop a white center and/or redness around the edges. The telltale sign of molluscum contagiosum is a small dimple (umbilication) on top and near the center. Although one bump may appear alone, they are often seen in clusters or scattered on different areas of the skin.

Because the bumps are caused by a virus, they can spread to other areas of skin and from one child to another. The bumps are somewhat fragile and can break open if bumped or scratched. This spills virus onto the surface of the skin, which can spread to nearby skin or get picked up by fingers and transferred to other children or objects. While the bumps are not painful, they may be mildly itchy, which contributes to scratching and spread.

A healthy immune system can eliminate the virus, but it’s a slow process, lasting up to a year. If there are a small number of bumps, and your child leaves them alone, a wait-and-see approach is best. But it’s important to understand the bumps will be there for a while. Covering molluscum bumps with clothing or a bandage helps keep little fingers away, and itching can be minimized with antihistamine medicine, such as cetirizine.

If there are many bumps, they become unsightly or children will not leave them alone, several treatment options can help the bumps go away faster. These include scraping the bumps open and removing the infectious material, freezing the lesions or application of a blistering agent. These treatments should always be done by a medical professional because skin infection and scarring may result. Even when great care is taken to remove the bumps, they often return. When this happens, the new bumps can be treated or patience may prevail as you give the immune system time to get the job done.

Preventing molluscum contagiosum from spreading is accomplished by keeping fingers away, covering the bumps and washing hands frequently.

Molluscum bumps can become infected with bacteria when the skin covering them is disrupted. If a bump breaks open, wash the area with soap and water and apply an over-the-counter antibiotic ointment. This will prevent spread of the virus and decrease the risk of bacterial infection. It’s normal for molluscum lesions to have some redness around the edges (this is evidence the immune system is working). However, if redness spreads to surrounding skin, fever develops, a lesion becomes tender, firm or has persistent drainage, seek medical attention right away.

Through a collaboration between Blanchard Valley Health System and Nationwide Children’s Hospital, the content of this article was provided courtesy of Nationwide’s 700 Children’s® blog by pediatric experts.

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