If you’ve noticed new bumps appearing on your skin, it’s natural to seek answers. The U.S. Food and Drug Administration (FDA) strongly advises consulting a healthcare professional, such as a board-certified dermatologist, for any skin concerns. Attempting self-diagnosis or treatment can potentially worsen the condition. This recommendation is particularly relevant when considering conditions like molluscum contagiosum.
How Dermatologists Perform Molluscum Contagiosum Diagnosis
A crucial first step in managing molluscum contagiosum is accurate Molluscum Contagiosum Diagnosis. Fortunately, diagnosing molluscum contagiosum is often straightforward for experienced professionals. In most cases, a board-certified dermatologist can diagnose this common skin condition simply by visually examining the characteristic bumps on your skin. This visual molluscum contagiosum diagnosis is typically sufficient for most patients.
During a visual examination for molluscum contagiosum diagnosis, dermatologists look for specific features of the bumps. Molluscum contagiosum bumps are typically small, raised, and pearly or flesh-colored. A key characteristic is a central dimple or pit in the middle of the bump. These bumps can appear anywhere on the body, but are commonly found on the face, neck, arms, legs, and trunk.
In some instances, to confirm the molluscum contagiosum diagnosis or rule out other skin conditions, your dermatologist may need to gather more information. This might involve a simple procedure performed right in the office. The dermatologist will gently scrape off a tiny sample of the infected skin. This skin sample is then examined under a microscope. Microscopic examination allows for a definitive molluscum contagiosum diagnosis by identifying the characteristic viral structures within the skin cells. This procedure is quick and causes minimal discomfort.
Molluscum Contagiosum: When is Treatment Recommended After Diagnosis?
Following a molluscum contagiosum diagnosis, it’s important to understand that treatment isn’t always necessary. For individuals with healthy immune systems, dermatologists may recommend a watchful waiting approach. This is because the body’s immune system is usually capable of clearing the molluscum virus on its own over time. As the immune system fights off the virus, the bumps will naturally disappear, and the skin will clear. In rare cases, a faint, depressed scar might remain after the bumps resolve.
The natural clearance process for molluscum contagiosum can take time. In children, the infection often clears within 6 to 9 months. However, it’s important to be patient, as it can sometimes take longer for the body to eliminate the virus completely.
Despite the possibility of natural resolution, dermatologists may recommend treatment for molluscum contagiosum in certain situations following a molluscum contagiosum diagnosis. Treatment might be advised for patients who have:
- Pre-existing chronic skin conditions, such as eczema (atopic dermatitis). Molluscum can exacerbate eczema and vice versa, making treatment beneficial.
- Molluscum bumps located in the genital area. Genital molluscum is considered a sexually transmitted infection in adults and may warrant treatment to prevent spread.
- A weakened immune system due to medical conditions or medications. In immunocompromised individuals, molluscum can be more widespread, persistent, and difficult to clear naturally.
- Molluscum bumps that are extremely bothersome. If the bumps are causing significant itching, pain, or are located in cosmetically sensitive areas, treatment can provide relief and improve quality of life.
Molluscum Contagiosum Diagnosis and Treatment in HIV-Positive Individuals
For individuals diagnosed with HIV infection and molluscum contagiosum diagnosis, treatment is strongly recommended. In this population, molluscum bumps can be more extensive, larger, and cover a significant area of skin. Starting antiretroviral therapy (ART) is crucial for overall health and is also considered the primary treatment approach to help clear molluscum in HIV-positive individuals. Effectively managing HIV with ART can significantly improve the body’s ability to fight off the molluscum virus.
Navigating Non-Prescription Products After Molluscum Contagiosum Diagnosis
It’s common for individuals seeking solutions after a molluscum contagiosum diagnosis to encounter numerous non-prescription products marketed for treatment. However, it’s critical to exercise caution and seek guidance from a dermatologist before using any over-the-counter remedies. The FDA advises against using non-prescription products for molluscum unless specifically recommended by a dermatologist.
The FDA highlights that many non-prescription products marketed for molluscum contagiosum make claims that are not supported by evidence. These products may not be effective in treating molluscum and could potentially cause adverse side effects. The FDA has received reports of both children and adults experiencing side effects from using these unproven products. Reported side effects include skin irritation, redness, abrasions from scratching irritated skin, and even permanent scarring.
A concerning trend is the misleading marketing tactics employed by some companies selling non-prescription molluscum treatments. These products may contain misleading statements suggesting FDA endorsement or approval, such as:
- “FDA approved”
- “FDA registered”
- “Made in an FDA-registered facility”
- “Complies with FDA Current Good Manufacturing Practices (CGMPs)”
It’s crucial to understand that these statements are false and misleading when applied to non-prescription molluscum treatments. The FDA has only approved prescription medications for the treatment of molluscum contagiosum. While prescription medications are the only FDA-approved options, certain non-prescription treatments, when recommended and guided by a dermatologist, may have a role in managing molluscum in some individuals. A dermatologist can help you navigate the options and determine the most appropriate and safe course of action following a molluscum contagiosum diagnosis.
Dermatologist-Guided Molluscum Contagiosum Treatment Options
Following a molluscum contagiosum diagnosis, if treatment is deemed necessary, dermatologists consider various factors to determine the best approach. These factors include the patient’s overall health, the number and location of molluscum bumps, and the patient’s age (especially for children).
Treatment strategies can involve in-office procedures, at-home topical medications, or, in rare cases, oral medication. It’s important to remember that regardless of the chosen treatment, clearing molluscum contagiosum takes time and consistency.
In-Office Molluscum Contagiosum Treatments
The goal of in-office treatments for molluscum is to directly target and destroy the bumps while minimizing harm to the surrounding skin. Dermatologists have several effective in-office treatment options:
Cantharidin (Beetle Juice): Cantharidin is an FDA-approved topical medication derived from blister beetles, often referred to as “beetle juice.” It is approved for use in adults and children aged 2 years and older. Dermatologists have utilized cantharidin for treating warts and molluscum for decades. In treating molluscum, the dermatologist precisely applies a small amount of cantharidin to each bump. This application causes a blister to form beneath the bump within 24 to 48 hours. As the skin heals, the molluscum bumps are effectively cleared, typically within about two weeks. Most patients require at least two in-office cantharidin treatments for optimal results.
Important Aftercare for Cantharidin Treatment
After receiving cantharidin treatment in the dermatologist’s office, it’s crucial to follow aftercare instructions carefully. Your dermatologist will advise you on the specific time frame, but it’s generally necessary to wash off the cantharidin at home with soap and water within a few hours of application. This timely removal helps prevent excessive blistering and potential skin irritation.
When applied by a dermatologist, cantharidin is considered a safe and effective treatment for molluscum contagiosum, particularly for young children due to its relatively painless application. It is available under the brand name Ycanth.
Warning: Cantharidin is for Professional Use Only
It is critical to understand that cantharidin should only be applied by a trained healthcare professional in a clinical setting. Purchasing cantharidin online and attempting self-application at home is extremely dangerous and can lead to severe side effects, including deep chemical burns, intense pain, and permanent scarring.
Cryosurgery: Cryosurgery is another in-office procedure that dermatologists use to treat molluscum. Despite the term “surgery,” cryosurgery does not involve cutting. Instead, the dermatologist applies an extremely cold substance, typically liquid nitrogen, to each molluscum bump. The extreme cold effectively freezes and destroys the virus-infected cells. Cryosurgery may require repeat treatments every 2 to 3 weeks until the bumps resolve completely. Cryosurgery can be painful, which may limit its use in young children or in patients with numerous molluscum bumps.
Curettage: Curettage is a procedure where the dermatologist uses a specialized medical instrument called a curette to physically remove the molluscum bumps from the skin. When performed by a skilled dermatologist, curettage is an effective treatment that usually results in minimal bleeding. However, because it involves physically scraping the skin, curettage can be frightening for young children and is typically reserved for older children, teenagers, and adults.
Pulsed Dye Laser (PDL): Pulsed dye laser (PDL) therapy can be a valuable option, especially for patients with numerous molluscum bumps or molluscum that has been resistant to other treatments. It is also considered for immunosuppressed individuals. Studies have demonstrated that PDL can effectively treat a large number of molluscum bumps simultaneously. In one study, nearly all patients with multiple molluscum lesions experienced complete clearance within a month of PDL treatment. Healing time after PDL treatment is generally quick, with facial lesions healing in 1 to 2 weeks and lesions on other body areas healing in 2 to 4 weeks.
However, it’s important to note that PDL treatment can be expensive, and insurance coverage is not always guaranteed. PDL may also cause temporary pigment changes (lighter or darker spots) in the treated skin, particularly in individuals with darker skin tones, which can last for several weeks to months. Furthermore, PDL is not available in all dermatology offices, potentially requiring referral to a specialist.
Forceps or Scalpel Core Removal: In this procedure, the dermatologist uses forceps or a scalpel to squeeze or gently incise each molluscum bump and physically remove the central core, which contains the infectious virus. This procedure can be painful, so a numbing medication is typically applied to the skin beforehand. Attempting this type of removal at home is strongly discouraged due to the risk of infection and spreading the virus.
At-Home Topical Molluscum Contagiosum Treatments
For some patients, at-home topical medications are a suitable treatment option following molluscum contagiosum diagnosis. While numerous treatments are available online, consulting a dermatologist first is essential to ensure you receive the most effective and safest treatment, minimizing potential side effects like skin discoloration or scarring.
Commonly prescribed topical medications for at-home molluscum treatment include:
Berdazimer Gel: Berdazimer gel is a prescription medication specifically FDA-approved for treating molluscum contagiosum in patients aged 1 year and older. The medication is dispensed as two separate tubes – one containing berdazimer gel and the other hydrogel. Prior to application, equal amounts from each tube are mixed together. A thin layer of the mixture is then applied evenly to the molluscum bumps, avoiding application to unaffected skin. Hands should be washed thoroughly after application. This mixture is typically applied once daily for up to 12 weeks. Potential side effects may include pain (burning or stinging), redness (in lighter skin tones), or mild skin discoloration (in darker skin tones). It is available under the brand name Zelsuvmi.
Imiquimod Cream: Imiquimod cream is another prescription medication that works by stimulating the body’s immune system to fight off the molluscum virus. The cream is applied directly to the bumps, usually 2 to 3 times per week, and left on for a prescribed duration before being washed off. Many patients apply imiquimod at bedtime and wash it off in the morning. Treatment with imiquimod typically continues for up to 16 weeks, or until the bumps clear. Skin irritation and swelling in the treated areas can be signs that imiquimod is activating the immune system. It’s important to be aware that the Centers for Disease Control and Prevention (CDC) does not recommend imiquimod for children with molluscum, as studies have shown limited effectiveness in this population. Imiquimod cream is available under brand names such as Aldara and Zyclara.
Salicylic Acid: Salicylic acid, commonly used for wart treatment, can also be effective for molluscum contagiosum. Your dermatologist can advise on the appropriate frequency of application. Treatment continues until a reaction occurs, indicating the medication is working. While salicylic acid is available over-the-counter, it should only be used for molluscum treatment under the guidance of a dermatologist.
Tretinoin: Tretinoin is a prescription retinoid medication that can be used to treat molluscum. Proper application technique is crucial for effectiveness. Your dermatologist will demonstrate how to apply tretinoin precisely to the bumps using a toothpick or fine-tipped applicator. The goal is to gently irritate the skin surface, which can stimulate the body’s immune response to clear the virus. Tretinoin is available under various brand names, including Altinac, Atralin, Avita, Renova, Retin-A, and Tretin-X.
Oral Medication for Molluscum Contagiosum
Cimetidine: Cimetidine is an oral medication primarily used to treat ulcers and acid reflux conditions. In dermatology, it may be considered as a treatment option for patients with severe eczema and widespread molluscum contagiosum when other treatments have been unsuccessful. While cimetidine is available over-the-counter, it should only be used for molluscum under a dermatologist’s recommendation and supervision, as it is not a first-line treatment.
Molluscum Contagiosum Prognosis and Prevention
For most individuals, the prognosis for molluscum contagiosum is excellent. The skin typically clears completely without treatment within 18 months. However, some individuals may experience bumps for a longer duration. Treatment can expedite clearance, but recurrence is possible, and reinfection can also lead to new bumps. Following dermatologist-recommended self-care measures is crucial for preventing the spread of molluscum and minimizing the risk of new bumps. More detailed self-care recommendations can be found in resources such as “Molluscum contagiosum: Self-care.”
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Written by: Paula Ludmann, MS
Reviewed by: Elaine T. Kaye, MD, FAAD Elan Newman, MD, FAAD Brittany Oliver, MD, FAAD
Last updated: 3/10/25
