The starting point for most doctors is to do nothing and advise a sufferer to wait for molluscum contagiosum to go away.
The expert view is that a molluscum contagiosum infection usually clears up eventually on its own without leaving marks or scarring on the skin
- conventional advice is to let the molluscum contagiosum infection run its course
- there are a number of treatments available
- conventional treatments may be costly, painful and time-consuming
- a sufferer should always seek medical advice when genital or anal molluscum bumps are present to rule out other STDs ( sexually transmitted diseases)
Conventional Treatments At A Glance
- Benzoyl Peroxide
- Potassium Hydroxide
- Trichloroacetic Acid Peel
- Laser Therapy
- Salicylic Acid and Lactic Acid
- Silver Nitrate
It’s science time again.
There are a number of conventional treatments currently available, but they are not routinely suggested, particularly in cases of young children.
A molluscum contagiosum infection usually has no other symptoms apart from the sores.
So, the accepted general wisdom from doctors is to do nothing.
However, where genital or anal molluscum bumps are present, a sufferer should attend, or be referred to a genitor-urinary medicine clinic to be screened for other STDs.
But, two of the consistently biggest concerns of sufferers, or parents of children with the infection are the cosmetic appearance of the sufferer, and the desire to stop the infection spreading any further on the sufferer’s body or being passed on to other people.
Some of the current treatments can cause pain, leave scarring or be distressing, particularly for young children.
Antiretroviral medications may be supplied in appropriate circumstances to strengthen the immune system until the molluscum has disappeared or, at least, significantly improved in extent and appearance.
Treatment may involve time off work to go to the doctor themselves or to attend with their child or children.
The following topical treatments may be offered under the guidance of a paediatrician, dermatologist, or other suitably qualified doctors.
These treatments were originally formulated to treat a variety of other types of health conditions but were then found to have some impact on molluscum contagiosum.
The one thing in common coming from the medical profession is that there is no one “best” cure or “one size fits” all solution.
Treatments for Molluscum
Podophyllotoxin ( poh-doh-fye-loh-tox-in) is available in both cream and solution form and may be prescribed for the removal of warts.
It is a topical cream or solution and is administered with a special application stick which allows for the prescribed dosage of the medication to be administered onto each spot. Care should be taken to avoid getting the preparation on normal skin and should not be applied on skin which is broken or bleeding.
The treatment usually involves Podophyllotoxin being applied twice a day on the lesions for three days followed by four days without treatment on the first cycle. Many people require 4-5 treatment cycles, therefore it may take a number of weeks before there is a noticeable improvement of the condition.
This medication should only be prescribed with special care and with full knowledge of a patient’s medical history.
It should not be prescribed at all for a child, or during pregnancy or while breast feeding.
Other names for this preparation include Condyline and Warticon.
Imiquimod ( ih-mih-KWEE-mod) is available in cream form and may be prescribed for the removal of genital warts, small superficial skin cancers and actinic keratoses.
The cream is applied directly to the spots 3-4 times a week. It may take a number of weeks before there is a noticeable improvement of the condition. It may be applied to treat larger spots or clusters of the bumps.
It is an immune response modifier (used to stimulate the body’s natural immune defence system).
It should not be prescribed at all for a person under the age of 12 years, or during pregnancy or while breast feeding.
It is not suitable for people with auto-immune conditions, inflammatory skin conditions or those who are auto-immune compromised, for example following cancer treatment or organ transplantation.
This treatment may be applied at home and involves applying the cream directly to the lesions 3-4 times a week. The cream is rubbed in until it has disappeared and is then left for 6-10 hours before being washed off with soap and lukewarm water. The recommendation is that the cream is applied at night and washed off in the morning.
It should not be applied to wounded or broken skin.
Imiquimod may cause some degree of permanent scarring and may cause itching, pain, rash, swelling or inflammatory dermatitis.
This preparation may also increase a person’s sensitivity to the sun or UVA light and precautions should be taken prior to any exposure.
Other names for this preparation include Aldara and Zyclara.
This oral medication has been used for treatment of molluscum contagiosum in small children.
It is available only on prescription.
Benzoyl Peroxide is available in a cream or gel preparation.
It should be used once or twice a day and used sparingly as excessive use may damage the skin.
Care should also be taken to avoid contact with hair, clothes, towels or bed linen as it may bleach anything with which it comes into contact.
It is advised that this treatment may make skin more sensitive to sun and UVA light.
Benzoyl Peroxide may cause redness, peeling, dry, burning or itching skin.
Potassium Hydroxide comes in liquid form and is a strong alkali. It is typically 5% in strength.
It should be applied twice a day on each, individual lesion over a period of 4-6 days after which it may take around 1-5 weeks for the molluscum to resolve.
It may cause the skin to flake or harden, or there may be burning, itching or swelling.
Tretinoin is available as a gel or cream.
It is applied 1-2 times a day on individual lesions.
It is advised this treatment may make skin more sensitive to light and UVA and precautions should be taken prior to exposure.
Tretinoin is not suitable for use during pregnancy because it can cause birth defects and so, it is important to use a reliable method of contraception while taking Tretinoin if you are a sexually active woman.
It may cause irritation or stinging of the skin and take up to several months for the clearing up of the molluscum contagiosum infection.
Trichloroacetic Acid Peel should be administered only by suitably qualified health professional.
It may be used to deal with the more cosmetically distressing, and potentially stigmatising situations where the sufferer has molluscum contagiosum on the face.
It may cause some pain or irritation, and it may leave some scarring.
Medical professionals have found this treatment to be safe, effective and tolerable for the patient.
Now, for the bad news…it is very expensive.
But, great news for those who may benefit from it.
Salicylic acid and Lactic Acid combination in cream form.
The cream is applied a couple of times a day to dissolve the hard layer of molluscum.
Results from this treatment are highly variable and recurrence of the infection is common.
Silver Nitrate is applied in paste form to individual lesions to burn them off.
Cantharidin is a solution derived from the green blister beetle. It is sometimes called “beetlejuice” or “spanish fly”.
It acts as a blistering agent.
The solution is applied by a health care provider to the active molluscum contagiosum lesions.
It is left for four hours and then washed off.
Within 1-2 days, blisters should appear and destroy the molluscum bumps.
Further treatments will then be made every 3-4 weeks until the molluscum contagiosum infection has fully resolved.
It may cause painful blistering and leave skin reddened, which usually resolves with time.
Cidofovir comes in cream form in 1-3% strength preparations.
It is applied to the individual bumps twice a day for two weeks followed by a thirty day rest.
There is usually another two cycles of the treatment to reach resolution of the molluscum infection.
Cryotherapy involves freezing the bumps or lesions with liquid nitrogen to burn them off. The effect of this on the skin is literally to induce frostbite. Each spot is frozen for 5-10 seconds. This treatment can involve many visits to the doctor, as each spot is treated individually, and there needs to be breaks between treatments. This treatment can be painful, and would be particularly tough on children.
Diathermy involves a local anaesthetic to numb the location being treated before being burned off with an electrical gadget.
Curettage gets rid of the bumps by scraping them off with a thin metal instrument called a curette. Just like diathermy, a local anaesthetic may be applied to numb the skin prior to having this type of treatment.
Without treatment, molluscum contagiosum infection is regarded as a moderate, “self limiting” skin infection.
It can easily linger for 12-18 months or longer, but will eventually go away.
As molluscum contagiosum infection is a self limiting disease, in the absence of complicating factors, the approach taken in general by most medical professionals is that the condition will sort itself out without treatment over a period of time, and it does not require aggressive treatment.
The duration, intensity and length of molluscum contagiosum infection treatment varies from person to person.
However, in a significant number of cases, it can often take much longer to clear up and, again, those with weakened or impaired immune sysytems may be affected for years rather than months.