Tiny skin coloured or white bumps are characteristic of molluscum contagiosum. The centre of the bumps have a little indentation referred to as an umbillication.
What is molluscum contagiosum?
pronounced (mol-us-kim con-tay-jee-o-zim)
Molluscum contagiosum is a viral infection which mainly affects children. As the name suggests, it is contagious. It is usually acquired through direct contact but may be contracted by sharing a bath, towels or clothing. It is quite common in nursery schools, play groups and primary schools. Children often pick up the infection while playing together.
It is not common in adults because of the higher immunity in this group.
Does one always need to treat molluscum contagiosum?
Molluscum contagiosum is a self limiting condition and often goes away on its own within about 6 months in most children. If there are only a few bumps, they could quite safely be ignored.
Active intervention may be necessary, however, under the following circumstances:
if the number of bumps is increasing
if steroid creams (cortisone / corticosteroids) are used eg. if there is underlying eczema. In such a situation, the number of bumps can increase to several hundred as the immunity of the skin is further suppressed.
if the bumps begin to spread to other family members
How is molluscum contagiosum treated?
Potassium hydroxide solution
Potasium hydroxide solution (a clear liquid) is applied on the molluscs daily until the skin becomes inflamed. The medication is then discontinued. The condition usually resolves with disappearance of the molluscs.
Potential side effects include a slight burning reaction but it is seldom necessary to discontinue the medication as a result. Potassium hydroxide is available from the practice.
Moluscum contagiosum treated with potassium hydroxide
Should the molluscs not disappear with potassium hydroxide, please discuss alternative treatments with your doctor.
Imiquimod (Aldara cream)
This cream is used for the treatment of viral warts and is registered for use in this country for individuals over the age of 18. Aldara does not kill viruses but stimulates the body to make Interferon, a chemical substance which destroys viruses. It is especially useful for treatment of viral warts affecting the genitalia.
This freezes the entire bump, inside which the viruses are found. When liquid nitrogen is used, the molluscum body is not physically removed. A blister forms within a day or two and the molluscum body usually comes off as the blister dries. However, if the viral particles survive the freezing, the bump may remain.
Electrocautery and curettage
The bump is first cauterised with an electrical instrument and then opened up using a sharp instrument. The molluscum body is then picked out. Electrocautery makes it easier for the molluscum body to be removed. Curettage refers to the act of scraping away the molluscum body.
The fluid from the Blister Beetle is sometimes used to create a blister and remove the mollusc.
This device uses heat to destroy the molluscs
Manual removal of molluscum body
It is also possible to use a sharp instrument such as a comedone expressor and 'fish' out the white substance inside the molluscum bump. The procedure is facilitated by use of EMLA local anaesthetic cream.
Are these procedures painful?
EMLA cream is applied to make the skin numb before removal. This renders the procedure virtually pain free.