Molluscum Contagiosum

Treatment Overview

Treatment for molluscum contagiosum is not always necessary because most bumps will go away within 2 to 4 months, although they may last longer. However, if bumps are visible or embarrassing, or in order to prevent their spread, you may want them removed. Removal or other treatment is recommended for bumps in the genital area.

Treatment varies depending on your age and health and the location of the bumps. There has been little research on how well any of the treatments work, or how they compare to each other.⁵

Non-prescription treatment includes:

• Salicylic acid. You apply this non-prescription medication directly to the bumps. It is usually not painful and is often regarded as the first treatment to try.⁴

Self-administered prescription medication includes:

• Imiquimod, a form of immunotherapy. Immunotherapy triggers your immune system to fight the virus causing the skin growth. Imiquimod is applied 3 times per week, left on the skin for 6 to 10 hours, and washed off. A course may last from 4 to 16 weeks. Small studies have indicated that it is successful about 80% of the time.⁶
• Topical medications such as podophyllotoxin (Condyline 0.5%) and tretinoin (Rejuva-A, Renova). These medications are put directly on the bumps. Podophyllotoxin is more often used in the treatment of genital warts.

Treatment by your health professional includes:

• Curettage. The viral material in the centre of the bump is scraped out. A local or topical anesthetic can be used to numb the area. A small scraping instrument called a curette is used to quickly remove the bumps. This procedure is very effective and not too painful. It may cause scarring.
• Topical medications. Your health professional applies a chemical to the bumps. This destroys the top layers of the skin, allowing a new layer to form. When the chemical is applied, you may feel a burning sensation. Side effects may include mild scarring. How often and how long the chemical is applied will vary. Chemicals used include trichloroacetic acid, podophyllin resin, potassium hydroxide, and cantharidin. Trichloroacetic acid is often used in people with a weak immune system. Cantharidin causes the bumps to blister and go away. It may cause pain as the blister develops. Cantharidin is considered safe and effective.⁷
• Cryotherapy. The bump is frozen with liquid nitrogen. A local anesthetic may be used to numb the area. The liquid nitrogen is sprayed or applied with a cotton-tip applicator for 5 or more seconds. This procedure usually is not too painful, is not as likely as curettage to cause scarring, and usually is effective. More than one treatment is often necessary.
• Laser surgery. Bumps can be removed through laser surgery.

Treatment for children

Treatment is not always necessary for children because molluscum contagiosum usually goes away on its own. Whether to treat depends on many factors. For example, if a bump is near a child's eye, it may be treated to prevent conjunctivitis—or it may not be treated, to avoid possible eye damage. Pain caused by treatment and the potential for scarring are important considerations when deciding about treatment for children.

Although it is acceptable to leave molluscum contagiosum untreated, treatment helps to prevent the spread of the virus to other parts of the body or to other people.

Initial treatment options for children include cryotherapy, curettage, and topical medication.

Treatment in the genital area

Molluscum contagiosum in the genital area is often treated to prevent spreading through sexual activity. Common treatment procedures include cryotherapy, curettage, or imiquimod.

Treatment for people with other medical conditions

If you have molluscum contagiosum and an impaired immune system, treatment will usually be recommended to help prevent the spread and severity of the bumps, but they are often difficult to treat. The main treatment options are cryotherapy, curettage, oral medication, or topical medications. Treatments for widespread, difficult-to-treat cases include laser therapy and trichloroacetic acid.

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Author:	Carrie Henley Robin Parks, MS	Last Updated: March 15, 2007
Medical Review:	Patrice Burgess, MD - Family Medicine Adam Husney, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine Alexander H. Murray, MD, FRCPC - Dermatology
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