Tag: warts

Molluscum Contagiosum

Molluscum contagiosum is a very common childhood skin rash, that surprisingly, few parents seem to have ever heard of.

While most parents have likely have heard of eczema, ringworm, and impetigo, a diagnosis of molluscum might leave them with their head scratching. Hopefully their kids won’t be scratching too.

Molluscum is contagious!

Symptoms of Molluscum Contagiosum

Molluscum contagiosum lesions are typically small and dome shaped, with a small dimple in their center. Although often flesh colored, they can also be pink.

They are usually found alone or grouped on a child’s chest or back, arm pit, or around the skin folds of their elbow and knees.

For many children, molluscum don’t cause any symptoms and the rash is simply a cosmetic problem. Others can get redness and scaling on the skin around the molluscum rash, and it may be itchy.

Another characteristic is that molluscum will sometimes have a plug of cheesy material coming out of the central part of the lesion.

Spotting Molluscum Contagiosum

The diagnosis of molluscum is usually made based on their classic appearance.

Three molluscum lesions on a child's arm.
Three molluscum lesions on a child’s arm. Photo by Vincent Iannelli, MD

The diagnosis can be confusing at first though, when the molluscum are still very small. It may take a few weeks for the lesions to grow before they look like more typical molluscum lesions.

Molluscum might also be confused with other rashes if they are red and inflamed when you go see your pediatrician, or if there is a lot of redness around the rash. That might make your pediatrician think that your child has a small abscess or simple eczema.

Getting Rid of Molluscum Contagiosum

Since molluscum usually goes away in about six to nine months on its own, some pediatricians advocate not treating it. Keep in mind that it can sometimes last for two to four years and may spread aggressively, which is why others do recommend treating molluscum with:

  • Direct removal with a curette
  • Cryosurgery – freezing
  • Cantharidin – a blistering agent
  • Aldara cream (Imiquimod) – also used for genital warts, although they are not related to molluscum
  • Retin A cream (Tretinoin) – also used for acne

All of these treatments have their shortcomings though.

Direct removal and cryosurgery are painful. Cantharidin can cause large blisters. Aldara is expensive. And Retin A doesn’t always work well when used by itself. Also, both Aldara and Retin A can be very irritating to the normal skin that surrounds the molluscum rash.

More About Molluscum Contagiosum

So what should you do about your child’s molluscum?

Talk with your pediatrician or a pediatric dermatologist about your options, which might include:

  • Leaving the molluscum alone, especially if your child has already had them for several months and they are not spreading. Just avoid sharing towels and skin-to-skin contact with others, because they are contagious. It is not a reason to stay out of school or daycare though.
  • Trying direct removal with a curette or cryosurgery if your child only has a few lesions. Although it can be painful, your pediatrician can consider using a topical anesthetic.
  • Using cantharidin if your child doesn’t have a lot of lesions. It is not FDA approved in the United States though, so not all doctors have it, and it can sometimes produce large blisters.
  • Using Aldara cream or Retin A cream – either alone or together on alternate days.

Most importantly, if you do treat your child’s molluscum, watch for new lesions during treatment. They are contagious and start spreading the infection again, even if the initial treatment was successful. And molluscum has a very long incubation period – up to about two months!

Other things to know include that:

  • Molluscum contagiosum is caused by a double-stranded DNA poxvirus.
  • Molluscum can be spread by direct contact with an infected person, touching contaminated objects (such as towels, toys, or clothing), and on a child when they scratch a lesion and then scratch other areas of their skin (autoinoculation). So encourage your child to not pick at them.
  • Molluscum can grow aggressively in children who have a weakened immune system.
  • Molluscum can be a sexually transmitted infection in older teens and adults. It is so common in young children though, that unless there are other signs or suspicions, it is usually not considered a sign of abuse, even if you find an isolated lesion in the anogenital area.

Also keep in mind that a pediatric dermatologist can be helpful if your child has molluscum that isn’t responding to standard treatments.

What to Know About Molluscum Contagiosum

Molluscum contagiosum is a very common viral infection that can cause a skin rash in children. Although difficult to treat, it does typically go away on its own – eventually.

More Information on Molluscum Contagiosum

Treating Hard to Control Warts

Unfortunately, there are no quick and easy ways to treat warts.

In fact, because there are no quick and easy ways to treat warts, many pediatricians suggest that parents simply wait it out, and let the warts go away on their own.

Common Wart Treatments

If you don’t have the patience to wait for a wart to go away on its own, which can take months to years, you can try:

  • OTC topical liquid or gel wart remover treatments with salicylic acid
  • OTC wart remover treatments with salicylic acid on a pad
  • OTC wart remover treatments that freeze warts
  • duct tape

Your pediatrician might also try:

  • cryotherapy – “prescription strength” wart freezing, which may have to be repeated multiple times
  • cantharidin – not FDA approved in the US, but this blistering agent is often applied to warts to induce them to go away

And of course, your pediatrician might also simply recommend that you wait it out for a few more months or years, as the warts should eventually just go away.

But why not treat the warts if treatments are available? Many experts say that at best, standard wart treatments only work half of the time. And they can be painful or leave scars.

Treating Hard to Control Warts

Again, treating warts is often hard, even in the best of circumstances. Warts can be even harder to treat if they are around your child’s nails (periungal warts) or on the bottom of their feet (plantar warts).

Plantar warts can be hard to treat.
Plantar warts can be hard to treat. Photo by happyfeet34 (CC BY 2.0)

Still, if you are not getting anywhere, you should ask yourself these questions and share the answers with your pediatrician:

  • Does your child really have warts?
  • Did you follow the directions on the label carefully?
  • Are you gently rubbing away hard skin from the surface of the wart with a pumice stone or emery board each week?
  • Are you softening the skin on and around the wart by soaking the area in warm water for at least 5 minutes before your wart treatments?
  • Did your child’s wart mostly go away and then come right back in the same spot?
  • Did your child’s wart completely go away, but new warts came up in different places?
  • Did your child get a much bigger wart around the site of a previously treated wart (a ring wart)?

A dermatologist can treat your child’s truly resistant warts with cryotherapy, cantharidin, higher strength salicylic acid paste than is available OTC, yeast injections, electrosurgery, or pulsed dye laser therapy, etc.

What To Know About Treating Hard to Control Warts

Although multiple wart treatments are available, warts are not easy to treat and so it is not unreasonable to just leave them alone if they aren’t bothering your child.

More Information About Treating Hard to Control Warts