Molluscum: Maybe best to leave them alone

The Pediatric Insider

© 2017 Roy Benaroch, MD

Alina wrote in, “If Molluscum Contagiosum is limited to a few bumps, 10 or less, does it necessarily need treatment or will it pass on its own?”

Molluscum (plural, mollusca) will usually go away on its own. Eventually. Except when they don’t.

Some things I can say for certain: molluscum is one of the least-favorite things for pediatricians and dermatologists to deal with. There’s no great therapy, and they don’t always do what they’re supposed to do. Parents hate them, and whatever we try doesn’t work anyway. Stupid molluscum!

Molluscum contagiosum looks like little, waxy-looking, skin-colored bumps that usually affect children less than 10 or so. They sometimes show up in little clusters, or can be more widespread. They’re triggered by a viral infection – but the virus itself is ubiquitous and impossible to avoid, so pretty much all of us are exposed to it. We don’t know why some kids with this virus get bump, while many others never do. The good news is that this isn’t a serious issue, and doesn’t lead to any serious issues.

But the bumps can look ugly. And though most of the time they do go away entirely on their own, that process can take months or years. And sometimes they just insist on sticking around. So parents, understandably, want to find some way to get rid of them.

There are no FDA-approved medications that treat these, and no OTC or “natural” types of products that have ever been shown to be more effective than placebo. Dermatologists can scrape them off (ow!), or freeze them off (ow!), or dabble blistering agents on them (ow!). Though all of these methods work sometimes, they also sometimes lead to scarring or more lesions popping up nearby.

From my point of view, after about 20 years of fighting with these dang things on my patients, I usually encourage families to leave them alone. If they’re in a cosmetically important area or somewhere that’s hard to keep covered with clothes, I’ll sometimes try a gentle topical agent that seems to irritate them a bit, which hastens their destruction by the body’s immune system. But usually, if there aren’t a lot of them, and the family can just ignore them until they disappear, that’s the way to go.

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