by Julia Gaines MD FAAP
Molluscum contagiosum – sounds dreadful, doesn’t it? In fact, molluscum is a very common, completely benign viral skin condition that we probably see weekly in the office. Children infected with this virus will usually develop 2-20 small, pearly, dome-shaped bumps that will often have a central dimple in the center. They are usually on the trunk, extremities, or face. Kids with eczema will often have lesions in the same area as their eczema, as in the picture above. Individuals who are immunosuppressed can have much more severe infections and are treated much differently than healthy children.
Will it make my child sick?
No, not at all. Other than occasional itchiness, most kids don’t even know they have molluscum. The virus does not cause fever or any other symptoms.
How long will it last?
Ah, well, here’s the annoying part. Molluscum lesions generally last for several months to several years. However, it is unusual for us to see a child who is bothered by these lesions (moms, on the other hand, are often bothered by them!).
How did my child get infected?
Molluscum is spread by direct skin contact with other infected individuals. It is not spread by animals. As I’m sure you have noticed, kids like to wrestle, snuggle, sit on each other, and generally have constant contact with their friends and siblings.
What about contagiousness?
If you do an Internet search on molluscum, you’ll usually see advice to keep the lesions covered and limit contact between infected and non-infected individuals. I don’t recommend anything of the kind. This is a very common, very minor skin infection that, in my opinion, does not warrant limiting a child’s activities in the slightest, especially given the long duration of the infection.
Are there any complications of molluscum?
The only real concern with molluscum is a secondary bacterial infection. In 20 years, I can only recall a handful of times that I had to treat a child with antibiotics for infected molluscum but there are those kids that just can’t stop picking at things. If the lesions are left to resolve on their own, scarring is rare. Not surprisingly, the risk of scarring increases if the child (or parent) tries to “pop” them or pick them off or if they become infected.
Why are some of the bumps red in the picture?
Most molluscum lesions will be flesh colored. However, there are a few reasons why they can become red. One common reason is if someone is picking at them and traumatizing the skin. If this is the case, stop it. The bumps will also turn red if they’re infected. The big tip-off for infection, in this case, is pain. If the lesions hurt, they should be looked at by your child’s provider. The last and best reason for redness is that the bumps may be resolving. Generally, a few weeks before a molluscum bump goes away, the immune system will cause some local, non-tender inflammation as part of the healing process. So, if they’re red but don’t hurt, keep an eye out and you will likely see them clear.
But how can I make them go away?
If your child is not bothered by the lesions, my best advice is to ignore them and wait for them to go away. Fortunately, this infection generally affects younger kids and, most of the time, they really don’t care. There are some treatments for molluscum that can be done in our or a dermatologist’s office but they can be painful, expensive, and increase the risk of scarring. If your child is very bothered by the cosmetic appearance or just can’t leave them alone, speak to your provider about your options. Otherwise, just sit back and wait for them to go away!
Call Cobb Pediatrics to schedule an appointment if you believe your child may have molluscum contagiosum at (770)425-5331.