Molluscum contagiosum

Small pearly bumps caused by a virus, common in children. They clear by themselves, and squeezing or freezing them usually makes things worse.

What it is

A common viral skin infection producing small, firm, dome-shaped bumps with a dimple in the centre.

It mainly affects children, and spreads by direct skin contact, shared towels and baths, and scratching, which moves it around the person's own body.

**It clears by itself.** Individual spots last a couple of months, and the whole episode typically resolves within 12 to 18 months, sometimes longer. Because it clears, and because treatments are uncomfortable and often ineffective, doing nothing is the standard recommendation for healthy children.

That advice is frequently unsatisfying to parents, and it helps to explain what will happen: spots often become red, swollen and inflamed shortly before they resolve, and this is a sign the immune system is clearing them rather than a sign of infection.

Two situations differ. In people who are immunosuppressed, lesions can be numerous, large and persistent, and treatment is appropriate. And in adults, molluscum in the genital area is usually sexually transmitted and warrants a sexual health check.

Children with eczema get more extensive molluscum, because the skin barrier is broken and scratching spreads it, so controlling the eczema helps.

School exclusion is not recommended and is not helpful.

Signs you might notice

Small, firm, pearly, flesh-coloured or pink bumps, 2 to 5 millimetres across.

A central dimple or pit, which is characteristic.

Usually in clusters, often in warm moist areas: armpits, behind the knees, the trunk and the groin.

Sometimes itchy, and often surrounded by eczema.

Redness, swelling and crusting of individual spots before they clear, which is normal.

See a GP for: lesions on the eyelid or near the eye; spots in an immunosuppressed person; extensive or very large lesions; genital lesions in an adult; or signs of bacterial infection with spreading redness, pain and fever.

Consider a sexual health check for an adult with genital molluscum, and consider safeguarding for genital molluscum in a child, though it is usually spread innocently.

How it can affect day-to-day life

The most useful message is that this is a waiting game, and that the wait is long. Parents told it will go in a few weeks lose confidence when it has not gone in a year.

The inflammatory phase before resolution reliably prompts a trip to the GP for antibiotics that are not needed; warning about it in advance saves that.

Avoiding spread within the family: no sharing towels, flannels or baths where possible, covering lesions with clothing or a plaster for swimming and contact sport, and not scratching.

Treating eczema properly reduces spread substantially.

Cryotherapy, curettage and topical treatments exist and are painful, can scar, and are generally reserved for adults, immunosuppressed people, or lesions in awkward places. For a child with dozens of spots, they are usually the wrong answer.

Squeezing or picking spreads the virus and risks scarring and bacterial infection.

Supporting someone well

Expect it to clear by itself, over 12 to 18 months. Say the timeframe honestly.

Do not squeeze, pick or scratch.

Expect a red, inflamed, crusty phase before spots clear; this is normal and not usually infection.

Treat any eczema well; it reduces spread.

Avoid sharing towels, flannels and baths, and cover lesions for swimming and contact sport.

Do not keep a child off school; exclusion is not recommended.

Get lesions near the eye, in immunosuppressed people, or genital lesions in adults assessed.

Get spreading redness, pain and fever treated as bacterial infection.

Avoid painful treatments in young children unless there is a specific reason.

Where to get help

A pharmacist or GP practice for reassurance and for eczema treatment.

A GP practice for lesions near the eye, in immunosuppressed people, or where infection is suspected.

A sexual health clinic for genital molluscum in adults.

British Association of Dermatologists publish a patient leaflet.