JAMA DERMATOLOGY PATIENT PAGE
Molluscum Contagiosum
Molluscum contagiosum is a common viral infection that causes small bumps on the skin.
Molluscum most often occurs in healthy children. The molluscum
virus can be spread to other people by direct skin-to-skin contact
with the bumps, and to other areas of the patients’ own skin
(“auto-innoculation”) by scratching or rubbing. It can also be
spread by contact with an object (eg, towel, gym mat, razor) that
gets virus on it by rubbing the bumps. Molluscum that develops
in teenagers and adults may be due to sexual activity. Molluscum
virus only affects the surface of the body and never spreads
internally.
Molluscum bumps usually appear 2 to 6 weeks after viral expo-
sure. The condition lasts for several months to a few years, with an
average of about 1 year. During this time, some bumps may disap-
pear on their own, and new ones can develop.
Symptoms
Molluscum lesions begin as dome-shaped, shiny bumps with a cen-
tral dimple or whitish “core.” They are pink to skin-colored, and pin-
head- to pencil eraser–sized. Molluscum may occur anywhere on the
skin except the palms and soles. Common sites are the neck, arm-
pits, sides of the chest, thighs, buttocks, genitals, and face. The num-
ber of bumps ranges from 1 to dozens, and they are often grouped
together.
Skin around the molluscum may become pink, rough, and itchy.
This eczema-like reaction can lead to scratching, which can lead to
viral spread. The molluscum bumps themselves may become red and
swollen, sometimes forming pus-filled pimples. This is usually a good
sign that the immune system is fighting the virus and starting to
clear the infection. When molluscum bumps go away, they may leave
pink-purple or white spots that fade over time.
Diagnosis
Doctors can typically recognize molluscum by looking at the skin.
Occasionally, scraping or biopsy is done to confirm the diagnosis.
Management
Because molluscum clears on its own over months to a few years,
treatment is not needed if the bumps are not bothersome. There is
no reason to keep children home from day care or school. The vast
majority of people with molluscum, even those with many persis-
tent bumps, have normal immune systems. However, patients with
immune disorders may have severe infections.
To prevent viral spread:
• Avoid scratching or picking at the bumps.
Authors: Julie V. Schaffer, MD; Emily M. Berger, MD
Correction: This article was corrected on October 9, 2019, to clarify the function of
skin creams used at home.
Conflict of Interest Disclosures: None reported.
Section Editor: Misha Rosenbach, MD
1072 JAMA Dermatology September 2016 Volume 152, Number 9 (Reprinted)
Downloaded From: https://jamanetwork.com/ on 12/09/2020
© 2016 American Medical Association. All rights reserved.
• If there is an itchy rash or eczema, apply a topical steroid (over-
the-counter hydrocortisone or prescription) daily for 1 or 2 weeks.
• Avoid towel sharing and skin-to-skin contact while bathing with
siblings.
• Avoid shaving over, or sexual contact, with areas that have mol-
luscum.
If treatment is desired for children, a common in-office therapy
is cantharidin (“blister beetle juice”). This is applied to individual
bumps and washed off in 2 to 4 hours; fluid-filled blisters then form,
and ideally the bumps resolve as the blisters heal. In-office “curet-
tage,” or scraping off the molluscum bumps, and freezing the bumps
with liquid nitrogen are more often done in older children, teens, and
adults. At-home use of creams that irritate the bumps’ surface is
sometimes helpful.
Molluscum Contagiosum
Molluscum bumps are usually small,
dome-shaped, and shiny. The bumps
usually have a central dimple.
The bumps can become red, swollen,
or pus-filled. Scratching may cause Eczema-like skin may develop
the bumps to spread.
around the molluscum.
FOR MORE INFORMATION
• Society for Pediatric Dermatology
http://pedsderm.net/site/assets/files/1028/6_spd_molluscum_web
_final.pdf
• Centers for Disease Control and Prevention
http://www.cdc.gov/poxvirus/molluscum-contagiosum/
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