The Association of Minimally Invasive Gynecologic Surgeons
…dedicated to safe, state-of-the-art surgery and health life-styles for women of all ages
R. Wayne Whitted MD, MPH
Paul A. Pietro MD
Marina Santana MMS, PA-C
Rebecca Karousatos MSRD, LD/N
8740 N Kendall Dr. Suite 101
Miami, Florida 33176
Phone: 305-596-3744
Molluscum Contagiosum
Molluscum Contagiosum Overview
Molluscum contagiosum (MC) is a skin rash caused by a virus first described in 1817. It is a
member of the Poxvirus family. It is common worldwide and accounts for about 1% of all skin
disorders in the United States. It primarily affects children (boys more often than girls) and
young adults. Overall, the incidence of molluscum contagiosum is increasing.
Molluscum Contagiosum Causes
A person can contract molluscum contagiosum primarily by direct contact, either person-to-
person or by shared items, such as clothing, towels, and washcloths. MC can be spread by
touching the rash and then another part of the body. Although the likelihood of infection is
generally low, it is unknown how long a person is contagious.
Outbreaks have occurred in the following settings:
Swimming pools (in children)
Wrestling matches
During surgery, by a surgeon with a hand lesion
Via tattoos (although rarely)
Sexually: It is likely that genital lesions are sexually transmitted. Lesions develop within
2-3 months after exposure. Not all genital lesions in adults are sexually transmitted,
however. Check children with MC involvin
enitals for possible sexual abuse. Genital
lesions in children, however, do not always mean that sexual abuse has occurred.
No cases of MC contracted from exposure to a contaminated toilet seat have been reported.
Although theoretically possible, this means of transmission would appear to be extremely rare.
Molluscum Contagiosum Symptoms
After an incubation period of 2-7 weeks, a molluscum contagiosum rash begins as tiny papules
(small raised bumps), each measuring 3-6 mm (about one-eighth to one-quarter inch). Some
lesions may be as large as 3 cm (1.2 inches) across.
The MC rash appears as smooth, pearly to flesh-colored, dome-shaped papules initially.
With time, the center becomes soft and indented (umbilicated) with a
white curdlike
core. This core may be squeezed out easily. Some redness and scaling are possible at
the edges of a lesion. This may be the result of inflammation or from scratching.
Lesions may be located on any area of the skin and on mucous membranes. They are
usually grouped in 1 or 2 areas, but may be widely spread. Most commonly, they are
located on the face, eyelids, neck, underarms, and thighs. Adults often get them in the
genital area. Usually, fewer than 20 lesions appear, but several hundred are possible.
The rash only rarely involves the mouth, palms, or soles.
The rash usually causes no itching or tenderness. There are no generalized symptoms
such as fever, nausea, or weakness.
People with impaired immune systems can develop multiple widespread, persistent, and
disfiguring lesions, especially on the face and possibly involving the neck and trunk.
These lesions can come together to form giant lesions. Examples of people with
weakened immune systems include those with cancer or AIDS or people taking
medications such as steroids that cause impairment of the body’s defense mechanisms.
In some cases, development of severe MC may be an indication of infection with the
AIDS virus, HIV. Most people with MC, however, have no such serious underlyin
When to Seek Medical Care
Sometimes the lesions can become irritated, inflamed, and infected by bacteria. If this
occurs, consult a doctor to discuss the need for antibiotics.
Lesions involving the eyelids may be associated with conjunctivitis (pinkeye) and
require special treatment.
Exams and Tests
The doctor usually diagnoses molluscum contagiosum based on its distinctive
appearance. For most cases, no tests are necessary.
The diagnosis can be confirmed by squeezing the core of a lesion onto a slide for
examination, or by getting a biopsy if the diagnosis is uncertain.
Conditions that can mimic MC include some skin cancers, warts, infections, and a numbe
of other skin conditions.
Molluscum Contagiosum Treatment
Medical Treatment
Treatment for molluscum contagiosum is not always mandatory. The lesions often disappear by
themselves and heal without scarring unless infected by bacteria. Removal of lesions reduces
the rate of spread to other people as well as from one part of the body to another, which
happens by touching the lesions (called autoinoculation). Genital lesions in adults should be
treated in order to prevent spread through sexual contact.
The most popular treatments are scraping of the lesions (called curettage), or removal
using heat (called cautery) or cold (called cryotherapy, and performed with liquid nitrogen).
Your doctor may prescribe creams to be applied to the lesions:
Trichloroacetic acid
Topical podophyllotoxin cream (such as Condylox), which is derived from plant resins
Cantharidin (Cantharone, obtained from a blister beetle), applied by the doctor
Imiquimod (Aldara), a topical cream that works by boosting the immune system -
Although this drug is currently approved only for treatment of genital warts, it has been
found to be effective against MC and can be applied at home.
Cimetidine (Tagamet), the anti-ulcer and anti-heartburn medication - This dru
has been
reported to be useful in the treatment of MC. This is not officially approved by the FDA
for the treatment of MC.
Cidofovir (Vistide), used through IV for eye infections in people with AIDS - This dru
been shown to be effective when applied topically to severe MC lesions. This is not
officially approved by the FDA for the treatment of MC.
Next Steps
It is not necessary to keep children who are infected with molluscum conta
iosum out of school,
although physical contact and sharing of clothes and towels should be discouraged.
Good personal hygiene is a key factor in avoiding transmission of this disease.
MC is spread by close personal contact with infected people. Avoid skin-to-skin contact
with others in order to prevent transmission.
Transmission has been shown to occur in children from swimming pools and in the
sharing of baths, towels, gym equipment, and benches.
Because the rash can spread by autoinoculation (spread from one part of the body to
another by touching the lesions), avoid scratching the lesions.
Because sexual transmission is common in adults, avoid sexual contact with infected
people. It is unclear whether condoms are effective in preventing spread of MC.
The overall prognosis is excellent. Spontaneous cure is the rule in people who have intact
immune systems, but the process may take months or even years.
Individual lesions may last 2-4 months, and the development of new lesions by
autoinoculation is common.
Most cases go away by themselves in 6-12 months.
Those cases that last for years typically occur in people with impaired immune systems.
Re-infection can occur.