Molluscum contagiosum
Last reviewed
Molluscum contagiosum is a viral skin infection causing small (1–5 mm), smooth, dome-shaped bumps with a central dimple. Common in children, spread by direct contact or shared towels. Most cases resolve on their own over months but treatment is reasonable for cosmetic, social or risk-of-spread reasons — cryotherapy, curettage, topical cantharidin and the body's own immune response over time are the main options.
Molluscum contagiosum is one of the most over-treated and over-worried-about skin conditions in paediatric dermatology. Parents bring in children with a dozen small bumps and a printout of all the things they've read online. The truth is gentler: most cases clear on their own within 6–18 months, and the question is usually whether to wait or speed it along.
The reasons to actively treat are practical: spread to siblings, classroom transmission, bumps on visible areas like the face, eczema-prone skin where lesions can become inflamed, or adult patients in whom diagnosis or speed matters more.
How molluscum shows up
- Small (1–5 mm), pearly, dome-shaped bumps with a central dimple (umbilication)
- Skin-coloured to pink; sometimes slightly inflamed around the base
- Usually painless and non-itchy — though can be itchy if the surrounding skin is eczematous
- Common locations: face, trunk, armpits, behind knees in children; genital area in adults (often sexually transmitted in adults)
- Often appear in clusters of 5–20 lesions
- May develop a red flare and crust as the body clears them (the BOTE — beginning of the end — sign)
- Spread by direct skin contact, shared towels, swimming pools and gym mats
What causes molluscum
- Molluscum contagiosum virus — a pox virus, spread by skin contact
- Close contact with affected siblings, classmates, daycare contacts
- Shared towels, bath toys, sports equipment, gym mats
- Eczema-prone skin allows easier viral entry — children with atopic dermatitis are more susceptible
- Swimming pools (the virus survives in pool water briefly)
- Sexual contact in adults
When to see a dermatologist
See a dermatologist if there are many lesions, they're spreading rapidly, they're on the face or genital area, the child has eczema and the lesions are getting inflamed, siblings or classmates are getting affected, or for adult cases (especially genital) where treatment and STI screening may both be relevant.
How molluscum is treated at SkinWise
Active treatment options include cryotherapy (quick freezing, the most common approach), curettage (gentle scraping under topical anaesthetic, often preferred for older children and adults), topical cantharidin (a blistering agent applied in clinic, wiped off at home a few hours later) and immune-activating approaches. For children with many lesions, sometimes the best path is reassurance and waiting — most cases clear naturally. Topical treatments at home (potassium hydroxide, salicylic acid) help in select cases.
Services that treat molluscum
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Frequently asked questions
Will it spread to other family members?
It can — especially with shared towels, bathwater or close skin contact. Practical measures: separate towels, no shared baths until lesions clear, cover lesions if possible. Adults usually catch it from sexual contact rather than household exposure.
Should we treat or wait?
For a few lesions in a school-age child with no spread and no eczema, watchful waiting is reasonable — most cases clear within a year. For widespread lesions, facial involvement, eczema-prone skin, or genital location in adults, active treatment is usually justified.
Is cryotherapy painful for children?
It's quick and produces a brief stinging sensation per lesion — most school-age children tolerate it. We use topical numbing for very young or anxious children and limit the number of lesions treated per session. Curettage under topical anaesthetic is often gentler than cryo for some patients.
When does the eczema connection matter?
Children with atopic dermatitis get more and more inflamed molluscum lesions. Treating the eczema in parallel — barrier care, gentle moisturisers, prudent topical steroids during flares — reduces both the count and the discomfort.
Ready to start with a consult?
A focused 15-minute first consultation is where we slow down, map your concern and build the smallest plan that will actually move the needle. No oversell, no fixed menu.