Molluscum Contagiosum in Children: What You Should Know
Molluscum contagiosum in children is a benign and fairly common condition of the skin surface. It’s characterized by typical lesions and is highly contagious. Although it is not a serious health concern, it is important to diagnose the condition early and begin treatment.
What is molluscum contagiosum?
Molluscum contagiosum is caused by a poxvirus called molluscum contagiosum virus. It’s a fairly common medical skin condition that occurs all over the world. In fact, it’s a frequent reason for consultation in pediatric dermatology.
Atopic dermatitis even alters the immune function and the skin barrier. Therefore, lesions tend to be more numerous due to the reactive and erythematous skin they present.
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How are they transmitted?
Molluscum contagiosum manifestations are transmitted by direct skin-to-skin contact. It can also occur by indirect contact through towels, toys, underwear, razors, or tattoo supplies. It can even spread by autoinoculation to healthy, normal skin after the affected persons scratch their lesions. Although there are no studies to prove it, it’s believed that transmission may occur by sharing wet environments or swimming pools.
The incubation period of molluscum contagiosum can vary from two weeks to six months. In turn, skin lesions are limited to the epidermal layer only, as they have no systemic spread. When the lesions are touched, they may expel a whitish content from within the lesions. This fluid is highly contagious and is the “molluscum body”, so it’s not a good idea to try to pop them.
Clinical manifestations of molluscum contagiosum
Molluscum contagiosum is usually asymptomatic, but may occasionally become itchy or painful. Therefore, scratching may cause bleeding underneath the lesions. In addition, inflammatory reactions as a result of scratching are evident and should be distinguished from secondary bacterial infections. The lesions are characterized as pearly white to flesh-colored, firm, pearly papules with a central umbilication.
The papules are usually between one millimeter and one centimeter in diameter, according to FP Essentials publications. The most common locations largely include exposed areas, such as the following:
- Face
- Trunk
- Extremities
- Axillary regions
Lesions may be single, multiple, or grouped. They may even be pedunculated or have an erythematous halo.
Therapeutic options for molluscum contagiosum in children
There are multiple treatments to be performed, but their choice depends on parental preference. The condition usually resolves spontaneously, but treatment is initiated to prevent autoinoculation and transmission of lesions. Therapeutic options include topical medications, physical removal of the mollusks, and systemic treatment.
Physical removal of lesions
The two most commonly used procedures are liquid nitrogen cryotherapy or curettage. In fact, both techniques may be associated. Laser treatment is also an option, but not as first-line therapy.
- Physical excision: This is often very painful for children and may require local anesthesia. Consequently, these interventions have a high potential for residual scarring.
- Curettage: This is a surgical technique that, by means of a curette, removes the characteristic lesions of the molluscum.
Topical medications
Some of the drugs used topically for the destruction of the lesions include the following:
- Podophyllotoxin
- Potassium hydroxide
- Salicylic acid
- Benzoyl peroxide
- Tretinoin
The drugs are used locally on each lesion to generate an inflammatory reaction and accelerate recovery. The topical solutions usually have different concentrations and are applied for several consecutive days. After 4 weeks, the lesions should disappear, but if they persist, the procedure should be repeated.
Systemic treatment for molluscum contagiosum
The use of oral cimetidine has been suggested as a safe alternative for the physical removal of lesions in children who are fearful of pain.
Prevention measures
Molluscum contagiosum infection isn’t one of the simplest to anticipate, although it can be prevented with certain measures. Here are some general recommendations:
- Wearing the correct footwear that insulates the foot from surfaces
- Washing hands regularly
- After water activities, adopting a rinsing routine
- Not sharing towels or swimsuits
- Drying the body properly, including folds
- Moisturizing the skin after daily hygiene.
Molluscum contagiosum and its evolution
Although molluscum contagiosum lesions cause aesthetic concerns because they’re asymptomatic, they should be treated promptly. In this way, self-inoculation can be avoided. In addition, home remedies or manipulation of the lesions aren’t recommended. On the contrary, it’s best to consult a physician to initiate specific and appropriate treatment.
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Peterson AR, Nash E, Anderson BJ. Infectious Disease in Contact Sports. Sports Health. 2019 Jan/Feb;11(1):47-58. doi: 10.1177/1941738118789954. Epub 2018 Aug 14. PMID: 30106670; PMCID: PMC6299350.
- Rayala BZ, Morrell DS. Common Skin Conditions in Children: Skin Infections. FP Essent. 2017 Feb;453:26-32. PMID: 28196318.
- Rush J, Dinulos JG. Childhood skin and soft tissue infections: new discoveries and guidelines regarding the management of bacterial soft tissue infections, molluscum contagiosum, and warts. Curr Opin Pediatr. 2016 Apr;28(2):250-7. doi: 10.1097/MOP.0000000000000334. PMID: 26900921.
