What is molluscum contagiosum?

Molluscum contagiosum is an infection of the viral skin which is normal and contagious. This causes the skin to have nodules or papules elevated like pearls.

Such papules are known as molluscum heads, Mollusca, or subcutaneum condyloma. The disease is called molluscipoxvirus.

Molluscum contagiosum virus (MCV) affects many children under 15.

The papules are usually painless, and don’t itch. They can affect any area of the skin, but the body, arms, and legs trunk particularly. According to the Centers for Disease Control and Prevention (CDC), they usually recover within 6 to 12 months without intervention, and leave no scars. Nonetheless, in some cases it may take up to 4 years to resolve.

Nobody knows how many people are producing molluscum contagiosum, as many people are not seeking medical advice.

Treatment may stop MCV from spreading, but this is usually not sufficient as the condition typically improves without intervention.

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Symptoms

Symptoms only show up on the skin for most people. It can take from 7 days to 6 months for signs to appear after initial infection.

The American Academy of Dermatology states that the bumps frequently take 7 weeks to appear.

The papules appear on the skin like tiny, hard, flesh-coloured, dome-shaped, pearly, wart-like spots.

We usually have a diameter of 1 to 5 millimeters (mm) with a dimpled middle. Such Mollusca tend to develop on any part of the skin that is not normally covered, such as the arms, ears, and hands. These can happen on the chest and stomach, too.

Mollusca that is sexually transmitted usually occurs on the genitalia, groin, lower abdomen and inner thighs. They usually develop in small clusters and remain on top of the skin layer, but they can spread to other body parts.

Most Mollusca have a small white dot of pus, and when they burst, they emit a dense, white fluid. The part that was dimpled can bleed.

Many people will have a limit of 20 papules, but some may have more than 100. If there are many, or if they are greater than 5 mm in length, medical advice should be sought because this may indicate that there is an immune system problem.

The Mollusca will crust over after about 6 to 12 weeks, and then recover. A tiny patch of lighter skin or a pitted mark may remain, but no marks usually occur.

New Mollusca can continue to grow in other parts of the body for a year or more, as old ones recover and crust over. Unless they completely disappear, it is highly unlikely they will return.

The Mollusca will live for years, in rare cases.

Causes

MCV can spread via close, direct contact with an infected person, usually through skin-to-skin contact, for example through sexual activity. It can also spread to different parts of the body, and if they touch infected items, such as towels, to others.

Many people are virus resistant, and are unlikely to get infected unless their immune system is compromised.

The infection stays infectious until the bumps go down.

MCV is popular among children but there’s no need to skip school days because it’s mild and self-limiting.

Risk factors

While anyone can get mollusc contagiosum, certain people are at higher risk including:

• children under 10 years of age
• people in tropical climates
• people involved in contact sports where skin-on-skin contact is more common
• anyone with a weak immune system
• individuals with atopic dermatitis

Treatment

As the disorder is self-limiting, medical advice isn’t always required. If the individual has large face or neck lesions, an existing skin condition or worries about virus spreading, treatment may be advised.

Treatment options include:

Curettage: scraping the papule away using a curette, a spoon-shaped instrument with a sharp edge, possibly under local anesthetic.

Cryotherapy: The papule is freezed using pressurized liquid spray. Each lesion is frozen over the spot and surrounding skin for up to 10 seconds, or until a layer of ice forms. Multiple sessions are sometimes required.

Diathermy: It uses a heated electrical device under a local anesthetic to burn off the Mollusca.

Laser therapy: It takes advantage of powerful, narrow light beams to treat MCV.

Chemical therapy: The practitioner drops a sharp metal instrument into either podophyllin or phenol and then pricks every mollusca. These finally exploded and drained their contents. Chemical treatment is said to be painful and may cause scarring.

When dermatitis or eczema develops around the papules, a hydrocortisone cream, an ointment to alleviate any discomfort, or a prescription topical steroid may be recommended. Which refer to the dermatitis areas and not to the papules.

Anyone with a weakened immune system would need specialist care, depending on the extent of the MCV and the cause for the weakened immune system.

MCV is not kept inactive in the body, and is not reappearing. It is unlikely to return when it is gone, unless there is a new outbreak.

Complications

Though the papules are not usually painful or itchy, there may be other conditions.

In some cases, eczema may occur around the Mollusca, causing scratching, swelling and sometimes discomfort. Eczema can lead to scratching, which can increase the risk of infection and virus transmission and slow down the process of healing.

Collecting or rubbing the bumps may also result in bacterial infection and itching. The health care professional may prescribe antibiotics.

Complications have a higher chance of affecting individuals with weakened immune systems. That may be due to HIV, chemotherapy, or the use of other medicines.

Scarring can remain as paler skin patches or tiny indents. When infection occurs, the risk of scarring is greater.

Complications of the eyes, such as conjunctivitis or keratitis, may occur when MCV is around the eye. They will be sent to an eye specialist.

Prevention

Several precautions will help to curb MCV spread.

• Practice good hand hygiene, especially if there is someone with MCV in the household.
• Cover the Mollusca if there is a risk of other people having skin-to-skin contact.
• Avoid contact sports, such as judo, wrestling, or rugby.
• Do not touch, scratch, or rub the papules. After touching them, the individual should wash their hands at once with warm water and soap.
• Do not shave over affected areas of skin, because this can encourage the infection to spread.
• Do not share personal items, such as clothing, towels, flannels, and hairbrushes with a person who has MCV.

An person with MCV will avoid physical contact until the Mollusca is gone altogether. Condoms do not provide complete protection from the transmission of MCV, as the virus may travel through areas of the skin not lined by a condom.

MCV is most likely transmitted in swimming pools by objects that are reached outside the pool, such as towels and diving boards, instead of in the chlorinated water. Until bathing, papules should be covered with watertighten bandages.

Conclusion

Generally, molluscum contagiosum does not pose a serious complaint. In general, within 6 to 12 months it will vanish by itself. Nevertheless, measures should be taken to avoid spread like with any disease. However, it is important to see a doctor if the symptoms appear to be getting worse.