Clinical Reference Systems: Pediatric Advisor 10.0
Molluscum Contagiosum
DESCRIPTION (Diagnosis must be confirmed by a physician.)
- raised, round, smooth-surfaced bumps on the skin that
look like thick-walled pimples
- waxy or skin-colored surface on bumps
- dimple (indent) in center of bumps
- firm, white material rather than pus in cores of bumps
- found on just one area of body
- usually many different sizes, from pinhead to 1/4 inch
across
- not painful, but occasionally itchy.
This diagnosis usually requires that the child be examined
by a physician.
CAUSE
Molluscum is caused by a poxvirus. It is transmitted by
skin-to-skin contact (close contact) with an infected
person. Children 2 to 12 years old are most likely to be
infected by this virus. Molluscum can spread to other parts
of the body if a child picks at a bump and then scratches
elsewhere (this process is called auto-inoculation).
EXPECTED COURSE
Most molluscum disappear without treatment in 6 to
18 months. Molluscum can spread rapidly and last longer in
children who also have atopic dermatitis. If repeatedly
picked at, molluscum can become infected with bacteria and
change into crusty sores (impetigo). Most children develop
only five to ten molluscum, but some acquire more.
Regardless of the number, they are a temporary condition.
TREATMENT
- To treat or not to treat?
Because molluscum are harmless, painless, and have a
natural tendency to heal and disappear, some physicians
recommend not treating them. The treatment itself may
be painful and frightening, especially to younger
children. In addition, treatment may be unsuccessful or
need to be repeated. Treatment doesn't leave scars.
Treatment of molluscum will be considered if your child
picks at them, the molluscum are in areas of friction
(for example, the armpit), you feel they are a cosmetic
problem, or the molluscum appear to be spreading
rapidly.
- Removal techniques
There is no successful home treatment for molluscum.
The following techniques must be performed in a
physician's office. The molluscum can be destroyed with
freezing (cryotherapy) or burning with a mild acid.
Another type of treatment involves piercing the center
of the molluscum with a needle or scalpel and scraping
out the core. Newer techniques may become available.
- Preventing the spread of molluscum to other areas of
your child's body
Every time your child picks at a molluscum and then
scratches another area of skin with the same finger, a
new site of molluscum can form. To prevent this spread
of molluscum, discourage your child from picking at the
molluscum. Use distractions to stop younger children
from picking. Chewing or sucking on molluscum can lead
to similar bumps on the lips or face. If your child is
doing this, cover the molluscum with a Band-Aid. Keep
your child's fingernails cut short and wash your child's
hands more frequently.
- Contagiousness
Molluscum is only mildly contagious to other people.
(The incubation period is 4 to 8 weeks.) Your child can
attend child care, preschool, and school without undue
concern about spread.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- A molluscum becomes open and looks infected.
- Your child continues to pick at the molluscum.
- The molluscum are spreading rapidly.
- You have other questions or concerns.
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