Molluscum Contagiosum

Molluscum contagiosum is a benign viral skin infection (a poxvirus) that causes small, smooth bumps that often have a central dimple. ^(1–3) It’s common in children, but adults get it too, and lesions can appear anywhere on the body. ^(1–4)

What is molluscum contagiosum?

Molluscum contagiosum is a viral infection limited to the upper layers of skin. It causes clusters of small bumps that can appear on the trunk, limbs, skin folds, and sometimes the face. In adults, it can also occur in the genital area (managed a little differently because of skin sensitivity and transmission context). ^(1–4) It is not dangerous and is not linked to skin cancer.

What does it look like?

Typical features:

• small (often 1–5 mm) smooth, dome-shaped bumps
• flesh-coloured, white-pearly, or pink
• a central dimple (“umbilication”) is common
• bumps may become red and inflamed when the immune system starts clearing them ^(1–3)

How it spreads

Molluscum spreads via: ^(1–4)

• direct skin-to-skin contact
• shared items (towels, razors, gym gear)
• autoinoculation (self-spread) from scratching, shaving, or friction

Practical steps that help:

• don’t pick or squeeze lesions
• avoid shaving over lesions
• keep nails short (reduces scratching damage)
• cover lesions for sport/swimming where practical
• don’t share towels or razors ^(1–4)

Molluscum and eczema: the most common reason it spreads widely

If you or your child has molluscum that seems to be “multiplying” quickly, a very common driver is poorly controlled eczema (atopic dermatitis). ^(1–3) Here’s why:

• eczema makes the skin itchy → scratching spreads virus
• eczema creates microscopic breaks in the skin barrier → the virus can seed into nearby skin far more easily
• inflamed, dry skin is simply a better “surface” for molluscum to propagate ^(1–3)

This is why treating the eczema is often the turning point. Learn more about effective treatment of Eczema here

Treatment options

Treatment is optional, but often worthwhile if lesions are:

• spreading quickly
• itchy/inflamed or causing eczema flares
• cosmetically bothersome
• in areas of friction (where they spread easily)
• persistent over many months ^(1–3)

Common options include:

• Watchful waiting (often reasonable, especially if mild) ^(1–3)
• Cantharidin (in-clinic) (excellent for multiple lesions) ^(2,3,5)
• Curettage (physical removal; quick but can be uncomfortable) ^(1–3)
• Cryotherapy (freezing; effective but can sting and may require repeats) ^(1–3)
• Topical prescriptions in selected cases (e.g., topical retinoids or clinician-directed options; evidence and tolerability vary) ^(1–3)

Cantharidin treatment: step-by-step (what to expect)

Cantharidin is a topical blistering agent used in-clinic to create a controlled separation of the lesion from the skin surface as it heals. It’s widely used because it can be efficient for multiple lesions, and there is usually no pain at the time it’s applied (discomfort, if it occurs, is typically later when blistering begins). ^(2,3,5)

In the clinic

We confirm the diagnosis and select lesions appropriate for cantharidin (site and skin sensitivity matters). Dr Chris applies a tiny drop of cantharidin solution directly onto each lesion. We then place a lightly-attached occlusive dressing over the treated area. This helps protect the area and encourages controlled contact with the lesion.

At home (the incubation phase)

You go home and keep the dressing on for about 4 hours, or until blistering begins (your exact timing will be explained on the day based on skin site and sensitivity). After the incubation time, you remove the dressing and wash the area thoroughly with soap and water to ensure all medication is removed.

What happens next

Over the next 12–48 hours, treated lesions may blister, become tender, then crust and heal. Lesions typically resolve as the blister roof sheds and healthy skin reforms. Some people need more than one treatment session depending on lesion number, size, and how reactive the skin is. ^(2,3,5)

Why we like cantharidin for multiple lesions

• Efficient when there are many bumps
• Often well tolerated in children because the application itself is usually painless
• Minimises the need for repeated freezing pain or curettage discomfort ^(2,3,5)

Safety warnings (especially for young children)

This section is important.

Eye risk during home incubation

While cantharidin is on the skin under a dressing, young children must be closely supervised. If a child removes the dressing, touches the medication, and then touches their eyes, it can cause serious irritation and injury. ⁽⁵⁾ What we advise:

• keep the treated area covered and supervised during incubation
• avoid naps unsupervised in very young children during the incubation window
• wash hands after any contact with the treated area
• remove the dressing and wash promptly at the instructed time

Where we avoid or use extra caution

Cantharidin is generally used cautiously on very sensitive areas and near mucous membranes (especially eyes). Your suitability depends on lesion location and skin sensitivity. ^(2,3,5)

Aftercare and prevention

• Don’t pick crusts (reduces scarring and pigment marks)
• Keep the area clean and follow dressing instructions
• Manage itch and eczema aggressively to prevent new lesions (see Eczema patient hub page)
• Avoid shaving over lesions and avoid sharing towels/razors ^(1–4)

Book

If you want confirmation of diagnosis, advice on spread prevention, and treatment options that fit your situation, book a review at our Ivanhoe or Diamond Creek clinic.