Molluscum contagiosum – a skin virus

Molluscum contagiosum is a skin infection caused by a virus belonging to the pox family. The visible symptoms, which resemble lesions or bumps, are similar to warts, but are not caused by the same HPV-virus as warts. Molluscum contagiosum is non-threatening, and the lesions are, at their worst, a cosmetic nuisance. Most often, they disappear on their own, however this may take a considerable amount of time. A particular lesion can disappear within a couple of months but, since new lesions often develop and spread, one may continue to have the lesions from a couple of months to several years.

Appearance
Molluscum contagiosum often appear as small bumps and have a number of similarities with warts, however they also possess some distinguishing features that set them apart from warts. The skin infection usually begins as a little bump or a skin-coloured, bud-like structure. The size is usually about the same as the head of a needle. The molluscum lesion then grows larger and start to take on a more reddish colour and usually reach a size of 2-5 mm in diameter. A crater-like structure normally develops in the middle of the lesion when it is fully mature. White, waxy goo can sometimes appear in the crater, which gives it an appearance similar to a blackhead. Before the lesions disappear, they often become red and irritated, and eventually tear. The indentation in the middle is the most characteristic sign which distinguish a molluscum lesion from a wart.

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Molluscum lesions can also start to itch but, when this occurs, it is usually caused by an underlying eczema that makes the skin extra sensitive. Itching molluscum lesions are especially typical among children with for example atopic dermatitis. In order to avoid the risk of infection, one should not scratch the lesions. If you or your child are not able to refrain from scratching, it is important to keep your fingernails short and clean.

Infection and diagnosis
Infection occurs via skin contact. Upon contact, a poxvirus is transmitted that bears the visible symptom of infection, i.e. molluscum lesions. The virus can be transmitted via direct skin contact or indirectly via items such as towels, clothing or toys, which can carry the poxvirus with them. From the time of infection, it takes 2 to 8 weeks before the visible lesions start to develop. The extent of the lesions vary considerably, and the number of bumps can range from one to a high number.

Molluscum contagiosum can also be spread through sexual contact and is sometimes confused with genital warts/condyloma or herpes. Molluscum lesions in the genital area only cause cosmetic difficulties and are not considered a sexual transmitted infection such as genital herpes or condyloma.

Adults become infected to a noticeably lesser extent than children and adolescents. The probable reason for this is a combination of the immune system and the fact that previous exposure provides adults with a stronger defence against the virus. In addition, many children have molluscum lesions that neither they nor their parents have become aware of. This increases the risk of transmission to other children whom they come into contact with.

If you contract lesions which resemble molluscum lesions, but their appearance cause doubt, you should contact your doctor for a diagnosis. A doctor usually makes a diagnosis from visible symptoms, and tests are seldom necessary. A correct diagnosis can be important in order to exclude other changes in the skin, such as a skin-coloured birthmark, for example.

Most common in children
Molluscum contagiosum is most common in children and adolescents, but it can also spread to adults. In children and adolescents, the infection is common and is spread via direct contact with other children. In children and adolescents, molluscum lesions are most often found in the bends of the knees, on the throat, around the armpits, as well as on the face and hands. The entire body can become infected, however it is rare that the soles of the feet or the palms of the hands get affected.

Like children, adults may contract molluscum lesions over their entire body but, in most cases, the lesions are localised to the genital area, around the genitals, on the inner thighs, the lower abdomen and the lower back.

Treatment
There are no health-related reasons to get rid of molluscum contagiosum. The infection is non-threatening and the difficulties are primarily cosmetic. The viral infection usually disappears on its own, however it can take a long time. For persons with normal immunity, it can take a couple of months to several years. People with poorer immune systems may contract large numbers of lesions, and it can take many years before the body heals from the infection.

If you are unable to wait until the body rids itself of the lesions, you can speed up the process with a mild wart remedy or a molluscum contagiosum treatment. Treatment is often successful and almost always shortens the longevity of the lesions.

Occasionally, it can be necessary to remove the molluscum lesions surgically. Generally, you should refrain from resorting to surgery for removal of molluscum lesions if you have not tried to remove them with a wart remedy or a treatment for molluscum contagiosum. Surgical operation can cause scars and other complications which are usually unnecessary when dealing with a minor cosmetic difficulty. Surgery is most common when the molluscum lesions are located in a visible area such as the face, and when they appear unsightly or embarrassing.

Prevention of molluscum contagiosum
It is possible to prevent infection through some simple measures. Refrain from sharing clothing or towels with anyone who is infected with molluscum contagiosum. Always refrain from direct skin contact with infected persons.

In adults, sexual contact is one of the largest risks of infection. Since infection is carried out via skin contact, it is difficult for one to completely protect oneself, but the best protection is the use of a condom. Remember that the condom does not offer complete protection, and only protects the skin covered by the condom.