John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Molluscum Contagiosum

Patient Information Sheet

Molluscum contagiosum is a virus infection of the skin. It is passed from person to person. After infection with the virus, it takes about 2 to 6 weeks for the little bumps to develop. The bumps are pink and dome shaped with a central crater sort of like a volcano crater or a belly button. They occur most commonly in children on the face, arms, legs, and trunk. In adults, I more commonly see them in the genital area. There may be only one bump or there may be a hundred.

Left untreated, they tend to spread. There is a possibility that your body can cure them on its own. I prefer not to take chances. Treat it when there only 3 - 5 bumps. Don't wait until there are 30 or 100.

Molluscum is not a dangerous condition. It should be treated, but it is usually easier to treat than warts. It is not necessary to be distressed over it. We just keep treating it until it is gone and stays gone.

Molluscum is not a vitamin deficiency or sign of serious internal disease like diabetes or cancer. It is more of a nuisance.

Children touch each other a lot when playing and spread the virus in that manner. In adults, sexual contact is a common means of spread, but not the only way it is spread. When children develop molluscums on the genitals or anal area, sexual abuse may be considered.

Sometimes molluscum can imitate cancer, but it does not turn into cancer. Over the past 34 years I have removed three surgically thinking they were cancers. Two looked like basal cell cancer. The other looked like melanoma. But they were not.

Because molluscum is contagious, it is wise to treat all infected family members at the same general time. If one person gets treated, but not the others, reinfection can occur.

Myerson's Phenomenon

I see this rarely. If a child has atopic dermatitis and gets molluscum behind the knees or in front of the elbows, a rash develops in that area. It is the body's frustrated attempt to cure itself, but it is have trouble making it work. Let me know if this happens.

Treatments:

Surgical
It is my experience over the past 34 years that the best treatment is to incise and drain each bump. That hurts a little bit, but most people can tolerate it. Each bump contains a core of infected cells. If that can be squeezed out, usually the body will do the rest of the job. As soon as you leave my office, please take a thorough shower and clean the areas with soap. This is to prevent seeding of new bumps from the material extracted from the old bumps.
In general, if there are only a few molluscum bumps, this minor surgical approach is the most effective and practical. The depth of cutting is the thickness of a piece of paper and should not hurt much. Pinching out the core may hurt a little. I often rub an ice cube on it as I go along, before making the scratch, to reduce pain during the procedure.
The small nicks in the skin due to surgical treatment tend to heal quickly and usually do not leave scars.
Sometimes more bumps appear about 6 weeks after treatment. These represent infected areas that were present the first visit by were too small to be seen. Left untreated, they also tend to spread. The sooner the condition is treated the better.
Tagamet (Cimetidine)
Tagamet is a drug that has been around since the early 1970's. It is a pill developed to treat stomach ulcers. Few people know that it also boosts the portion of the immune system called cell-mediated immunity. It is nice because it usually does not have side effects, and it fits in with the natural way of getting rid of molluscum.
The dose for little kids is 100 mg twice a day for about 1-2 months. For adults, it is 400 mg twice a day for 1-2 months. Sometimes I will use this in addition to one of the other treatments.
Aldara (Imiquimod)
Aldara is a cream that boosts the immune system. You rub it right on the molluscum bumps daily. It may take 6 weeks. The bumps in the treated areas may go through a phase of irritation. If you don't get irritation, it may not work. Aldara is nice because you can apply it yourself, and it does not hurt.
The problem is cost. Aldara costs two to four times more than gold. But, if your insurance covers it, it is worth considering. I can explain in detail how to use it.
Freezing with Liquid Nitrogen
This is similar to treating warts. It hurts a lot for about 2-3 seconds. While adults tolerate it well, little kids don't like it.
Cantharidin (Cantharone)
It is not painful to apply Cantharone, the extract of the South American blister beetle (I call it tweet le beetle juice). It dissolves the glue that holds the epidermal skin cells together. This makes a small erosion that the molluscum body core can come out of. The problem is it is hard to precisely know how severe the reaction will be and how long to leave it on. It may make painful little blisters.

The information provided in these patient information sheets is offered for general informational and educational purposes only; it is not offered as and does not constitute medical advice. In no way are any of the materials presented meant to be a substitute for professional medical care or attention by a qualified practitioner, nor should they be construed as such.

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