Monday, June 3, 2013


My son was exposed to another child who has molluscum. What is this and is it contagious?

Molluscum contagiosum, commonly referred to as molluscum, is a common and benign viral infection that affects the skin.  Rare among infants less than 1 year old, this condition is common among pre-school and school age children.  Molluscum is sometimes confused with common skin warts, cysts, milia, or chicken pox.

What does molluscum look like?
Molluscum lesions typically have the appearance of a small dome shaped bump on the skin that is pearly or flesh colored and with a small crater in the center.

How does molluscum spread?
Molluscum lesions are commonly spread via skin to skin contact.  It can be also be contracted from coming in contact with mats, gym equipment, towels, wash cloths, etc. which have been used previously by a child with molluscum.
·         After exposure, infection may show up as one or a few bumps on the skin anywhere from several days or weeks later.
o   Not all children who come in physical contact with a child who has molluscum will develop the lesions.
·         Lesions can spread over most areas of the body, but are not found in the mouth or on the palms of the hands.
·         Molluscum lesions can be itchy at times which can cause them to spread more quickly to other areas of the body.
o   It is important to discourage scratching of the lesions and if necessary, topical anti-itch or oral anti-itch medications are available. Talk with your pediatrician prior to starting any new medication.
·         Children with eczema have been found to be more prone to molluscum infections, likely because of the dry and broken skin that accompanies eczema.
o   A small subset of children who acquire molluscum will also have eczema-like skin around the lesions which will clear up when the molluscum resolves. 

Is there a treatment for molluscum?
While occasionally itchy or located in unsightly locations, an infection with molluscum does not cause serious medical problems. In the vast majority of cases, the best treatment is to do nothing at all.

Molluscum lesions will heal on their own, however, it can take several months or up to a few years to completely resolve.
·         Commonly, the lesions which appeared first will heal after a few months.  However, new lesions can erupt as a result of scratching or rubbing existing lesions causing them to spread to new areas.
o   Eventually, the body’s immune system will recognize and eliminate the infection, but it is a very slow process and parents should be aware that it may take several months for complete resolution.
§  In some children (up to 30% in some studies), molluscum lesions can recur after they have previously completely resolved.
For children whose lesions are extensive, in unsightly locations, or very bothersome, there are a few treatment options available.
·         One of the first-line therapies for molluscum is cryotherapy. This method uses a freezing agent to shrink the lesion, causing it to die off and disappear.
o   Another common treatment is curettage. This involves opening the top of the lesion with a needle or scalpel. Curettage can be very successful in resolving the lesions over a short period of time, but can be painful and time consuming, making it difficult to accomplish in young children.
o   Other topical medications (such as cantharidin, salicylic acid, or imiquimod) or laser treatments exist, but are often very expensive or prone to side effects which can be much worse than the molluscum lesions.   

Does my child need to stay home from school?
Children with molluscum do not need to miss school. They should avoid physical contact with other children if possible to prevent spreading the infection to others. Additionally, lesions can be discretely covered with clothing or in some cases a band-aid if they are bigger or inflamed from chronic scratching.
·          Molluscum lesions do not cause fever and should not be a reason why a child has fever, cough, vomiting, diarrhea, or other common cold symptoms.

For more information on molluscum contagiosum, its treatment, or other pediatric skin conditions, please consult with your pediatrician.  Always consult with a physician prior to starting any new medication, even if it is over-the-counter.

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