If you’ve noticed new bumps on your skin, it’s natural to be concerned and look for answers. The U.S. Food and Drug Administration (FDA) advises that for any skin condition, including mysterious bumps, seeking advice from a healthcare professional, like a board-certified dermatologist, is the most prudent step. Self-diagnosing and treating skin issues can often lead to more harm than good.
Diagnosing Molluscum Contagiosum: The Dermatologist’s Expertise
When it comes to molluscum contagiosum, a board-certified dermatologist is typically the specialist who can accurately diagnose this common skin condition. Often, a dermatologist can identify molluscum contagiosum simply by visually examining the characteristic bumps on your skin. For many individuals, this visual inspection is sufficient for diagnosis.
In some instances, a dermatologist might require a closer look to confirm the diagnosis or rule out other conditions. In such cases, they may perform a quick and painless procedure during your office visit to scrape off a tiny sample of the affected skin. This sample is then examined under a microscope, providing detailed information to নিশ্চিত the diagnosis.
When is Molluscum Contagiosum Treatment Necessary?
A noteworthy aspect of molluscum contagiosum is that it doesn’t always necessitate treatment. Dermatologists often recommend allowing the condition to resolve on its own, particularly in individuals with healthy immune systems. The body’s natural defenses are usually capable of clearing the virus over time, leading to the disappearance of the bumps.
However, it’s important to understand that this clearance process can be gradual. For children, it commonly takes about 6 to 9 months for the body to fully eliminate the infection. In some cases, it might take longer for the skin to become completely clear.
Situations Where a Dermatologist Recommends Molluscum Treatment
While natural resolution is possible, there are situations where dermatologists advise active treatment for molluscum contagiosum. Treatment might be recommended for patients who have:
- Pre-existing chronic skin conditions, such as eczema, as molluscum can exacerbate these conditions.
- Molluscum bumps in the genital area, due to concerns about sexual transmission and discomfort.
- A weakened immune system and are experiencing a widespread outbreak of numerous molluscum bumps.
- Molluscum that is causing significant discomfort such as itching, pain, or emotional distress due to appearance.
Treatment is particularly crucial for individuals with HIV who develop molluscum contagiosum. In these cases, the bumps can become larger and spread across extensive areas of the skin. For individuals with HIV and molluscum, initiating antiretroviral therapy (ART) is often the primary treatment approach, helping to clear the skin and manage the underlying HIV infection.
The Risks of Over-the-Counter Molluscum Products
The FDA has issued warnings regarding unapproved products being marketed for molluscum contagiosum treatment. Some companies deceptively suggest FDA endorsement or approval on their product labels.
Be wary of misleading claims such as:
- “FDA approved”
- “FDA registered”
- “Made in an FDA-registered facility”
- “Complies with FDA Current Good Manufacturing Practices (CGMPs)”
Currently, the FDA has not approved any over-the-counter products for treating molluscum contagiosum. The FDA cautions that these unapproved products are unlikely to be effective and may contain ingredients that could cause harmful side effects.
Reported side effects associated with some unapproved products include skin irritation, redness, abrasions from scratching irritated skin, and even permanent scarring. Many of these products contain essential oils, which, despite being natural, can still trigger allergic reactions or irritate sensitive skin.
To safeguard your health and your family’s health, consulting a board-certified dermatologist for molluscum treatment is always recommended.
Dermatologist-Guided Molluscum Contagiosum Treatments
Dermatologists tailor treatment plans based on various factors, including the patient’s overall health, the number and location of molluscum bumps, and age, particularly for children.
Treatments prescribed by dermatologists can be categorized as:
- In-office procedures performed at the dermatologist’s clinic.
- Topical medications applied by the patient at home.
- Oral medications taken at home for a prescribed duration.
Regardless of the chosen approach, molluscum treatment usually requires time to show results. Here’s an overview of common dermatologist-recommended treatments:
In-Office Molluscum Treatments
The primary goal of in-office treatments is to eliminate the molluscum bumps effectively without causing damage to the surrounding healthy skin. Dermatologists may employ the following methods:
Cantharidin (Beetle Juice): This FDA-approved treatment, derived from blister beetles, is suitable for adults and children aged two years and older. Dermatologists have used cantharidin for warts and molluscum since the 1950s. The dermatologist applies cantharidin precisely to each bump, inducing a blister formation underneath. Blisters typically appear within 24 to 48 hours, and as the skin heals, the bumps resolve, usually within two weeks. Multiple in-office treatments, often at least two, are generally needed for effective clearance.
Important Aftercare for Cantharidin Treatment
Following cantharidin application, it’s crucial to wash off the treated areas at home with soap and water within the timeframe specified by your dermatologist. This step helps prevent excessive blistering and potential skin irritation.
When administered by a dermatologist, cantharidin is a safe and effective molluscum treatment, often favored for young children due to its painless application.
Warning: Cantharidin Application Should Be Confined to a Doctor’s Office
Obtaining cantharidin online and attempting self-application is strongly discouraged due to the risk of severe side effects, including deep chemical burns, intense pain, and scarring.
Cryosurgery: Despite the term “surgery,” cryosurgery doesn’t involve cutting. It’s an in-office procedure where the dermatologist applies an extremely cold substance, like liquid nitrogen, to each molluscum bump. The extreme cold effectively destroys the bumps. Because new bumps can emerge, repeat treatments every 2 to 3 weeks may be necessary until complete clearance. Cryosurgery can be painful and is generally not recommended for young children or patients with numerous bumps.
Curettage: In this procedure, the dermatologist uses a curette, a specialized medical instrument, to physically remove the molluscum bumps from the skin. When performed by a skilled dermatologist, curettage is effective and typically causes minimal bleeding. However, as it involves cutting into the skin, it can be frightening for young children and is usually reserved for older children, teenagers, and adults.
Pulsed Dye Laser (PDL): PDL can be a viable option for patients with widespread molluscum or bumps that are resistant to other treatments, including those with compromised immune systems. Studies have demonstrated PDL’s effectiveness in treating numerous bumps simultaneously. In one study, PDL treatment cleared all bumps within a month for 42 out of 43 patients with extensive molluscum. Facial skin treated with PDL generally heals within 1 to 2 weeks, while other body areas may take 2 to 4 weeks.
Important considerations for PDL treatment include:
- Insurance coverage is often limited, making it potentially expensive.
- While safe for children as young as 8, younger children might find it challenging to tolerate.
- Temporary skin color changes (lighter or darker spots) lasting 6 weeks to 6 months can occur in individuals with darker skin tones.
- PDL is not available at all dermatology offices, potentially requiring referral to another specialist.
Forceps or Scalpel Core Removal: This technique involves squeezing each molluscum bump to extract the virus-containing core. Due to potential pain, a numbing medication is applied beforehand. Attempting this at home is strongly discouraged as it can lead to infection and viral spread.
At-Home Molluscum Treatments Prescribed by Dermatologists
For certain cases, dermatologists may prescribe topical medications for at-home application. While numerous online treatments exist, only dermatologist-recommended options should be considered.
Prioritize Dermatologist Consultation Over Online Molluscum Treatments
The Centers for Disease Control and Prevention (CDC) emphasizes that online over-the-counter molluscum treatments may be ineffective and potentially harmful. Seeking professional guidance is crucial.
Imiquimod Cream: This cream boosts the body’s immune response to clear the bumps. It’s typically applied 2 to 3 times weekly, left on for a prescribed duration, and then washed off. Consistent application for up to 16 weeks is usually needed. Skin swelling and irritation can indicate the medication is working. The CDC generally doesn’t recommend imiquimod for children due to variable effectiveness in pediatric molluscum cases. Prescription required.
Salicylic Acid: Commonly used for warts, salicylic acid can also be effective for molluscum. Your dermatologist will advise on application frequency, aiming for a skin reaction as a sign of effectiveness. Prescription not required, but dermatologist recommendation is crucial.
Sinecatechin (Green Tea Extract): FDA-approved for genital and anal warts, sinecatechin may also be effective for molluscum in these areas. Prescription required.
Tretinoin: Proper application, often guided by a dermatologist using a toothpick to target the bumps, is key. Tretinoin irritates the skin surface, stimulating the immune system to combat the virus. Prescription required.
Oral Medication for Molluscum
Cimetidine: Primarily used for ulcers and acid reflux, cimetidine may be considered for severe eczema patients with widespread molluscum when other treatments have failed. Prescription not required, but dermatologist recommendation is essential.
Molluscum Contagiosum: Long-Term Outlook
In most individuals, molluscum contagiosum resolves naturally within 18 months, although some may experience bumps for a longer period. Treatment can expedite clearance, but recurrence or re-infection is possible. Adhering to dermatologist-recommended self-care practices can help prevent new bumps. For self-care guidance, refer to resources like “Molluscum contagiosum: Self-care.”
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Written by: Paula Ludmann, MS
Reviewed by: Elaine T. Kaye, MD, FAAD Ata Moshiri, MD FAAD J. Klint Peebles, MD, FAAD
Last updated: 11/6/23
