Molluscum contagiosum treatment

Molluscum contagiosum; at a glance

  • Best Results1-8 weeks
  • Treatment Recovery2-6 days
  • Procedure Time5 minutes
  • Skin SpecialistDr Sarath Bodapati at Cutis Dermatology
  • Duration of ResultsPermanent
  • AnaestheticNumbing
  • Back to WorkNA
  • Cost$

About Genital Warts

Molluscum contagiosum is a common viral skin infection that causes small raised spots to appear on the skin. This infection is common in children & in young adults. It can spread to different areas on their own body & is very contagious. A dermatologist can diagnose & effectively treat molluscum lesions. 

Disclaimer: this section is written for the management of molluscum in adults, for lesions in the genital areas. For molluscum treatment in children, please consult a pediatric dermatologist at Cutis Dermatology, Brisbane.

FactsFacts On Molluscum

  • Molluscum in adults can be sexually transmitted 
  • Basic skin care & hygiene outlined below can reduce spread & transmission
  • Most cases resolve within 18 months
  • A dermatologist can speed up resolution & cure molluscum within one session
  • Molluscum in children follows a different diagnostic approach & treatment algorithm 
  • Dr Sarath at Cutis Dermatology, Brisbane can provide a solution

What is molluscum & what does it look like?

Molluscum presents as raised, round, skin-colored bumps, typically 2 to 5 mm in diameter. These bumps have a small dent or dot at the top near the center. 

This viral infection can occur on the limbs, trunk & frequently in the genital areas. Molluscum contagiosum is not always considered a sexually transmitted infection because you do not need to have had sex to become infected.

How do dermatologists diagnose molluscum?

Our dermatologist, Dr Sarath at Cutis Dermatology, Brisbane will diagnose molluscum contagiosum as soon as he examines your skin. Occasionally molluscum contagiosum looks like other skin conditions such as genital warts, Fordyce Spots, pearly penile papules & other sexually transmitted conditions. Most cases do not require testing to confirm molluscum.

What is the best Molluscum Treatment?

The good news is that lesions of molluscum will spontaneously resolve within 12 to 18 months as your immune system kicks in. The flipside is that there are effective treatments for molluscum, especially if it involves the genital areas. Treatments include freezing, hyfrecation, creams, tablets & lasers.

What is the fastest way to treat molluscum?

Dermatologists don’t muck around with molluscum, especially if it involves the genital area. We employ superfast methods to clear lesions, often within one to two sessions. We use a combination of- 

  • Freezing, de-roofing
  • Hyfrecation or laser ablation 
  • Adjunctive topicals to upregulate your immune system

The ideal treatment will depend on the number of molluscum lesions & your previous attempts of removal. Dr Sarath will discuss these options with you during the consultation.

What is hyfrecation & how does it work?

Hyfrecation employs electrical current to burn away skin lesions. It is commonly used for warts caused by the human papillomavirus (e.g. genital warts, verrucas). It is also effective for the removal of lesions caused by molluscum. It is usually performed under local anesthetic in a clinical setting. Treatments are painless, & if performed carefully, will not result in scarring of the genitalia. 

What creams are used to treat molluscum?

Creams are used to upregulate your immune system in order to clear molluscum virus. They are most effective & useful in non-genital areas as they all cause skin inflammation. For resistant cases of molluscum,  under supervision, they can be used in the private parts. Topicals include-

  • BPO or benzoyl peroxide (see the hack in Davin’s viewpoint below)
  • Salicylic acid
  • Cantharidin
  • Retinoids 
  • Imiquimod (probably the best topical to use) 
  • Podophyllotoxin
  • TTO or tea tree oil

Davin’s viewpoint: genital molluscum treatments

Molluscum has two peaks; childhood years (usually via swimming pools & contact with other children), & young adults (most, but not all cases are sexually transmitted). There are treatments for different age groups, in addition to the location of molluscum. 

Firstly, diagnosis. Molluscum tends to be flesh coloured with a central dell or umbilication (depression). Warts on the other hand are more ‘solid’, without a central dell &, in most cases verrucous. Pearly penile papules are on the glans penis, whilst Fordyce spots are smaller, yellow in color without a dell. 

Treatment is rather straightforward. Simple cryotherapy is effective, whilst if you are super careful, using a sterile needle angled obliquely can ‘rupture’ the enclosure. This was my preferred treatment (when I treated molluscum nearly two decades ago). A steady hand with a simple instrument can be super effective. From there I try to create controlled inflammation with a topical applied to a few lesions. The trick is to modulate the inflammation, not over cook it. My favorite was with simple Benzac AC or benzoyl peroxide at 10%, applied to half a dozen lesions with a cotton bud. The trick is to concentrate a moderate amount of inflammation in just a few lesions themselves, not all. The reason? Up regulation of your skin’s immune system to wipe out the rest- the good old bystander effect.

Failing that, the next topical of choice is Aldara or imiquimod. This off label treatment upregulates cytokines to destroy the virus. Application ranges from 2 to 3 times a week, to once a day for a period of 2 to 6 weeks. Side effects include skin irritation, tiredness & flu like illness. Be guided by your treating dermatologist.

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