Molluscum contagiosum by Dr Sarah Brewer - MolluDab Blog

Molluscum contagiosum by Dr Sarah Brewer

Molluscum contagiosum by Dr Sarah Brewer

Molluscum contagiosum is far less harmful than it sounds. Essentially, this tongue-twister is a viral skin condition – a bit like warts - that forms round, firm, blister-like lumps with a characteristic central dimple, or white head. These vary in size from two to five millimetres in diameter (a pinhead to a petit pois pea) and are usually pink or whitish in colour. Sometimes, only a single lump is present, but usually they form in clusters of up to 20 (occasionally more). They can appear on the face, neck, hands and arms. They particularly like the warm, cosy environment of the armpits where I've found them lurking, unexpectedly, during routine check-ups.

Although molluscum is often symptomless, it can cause itching and discomfort and, when on a visible part of the body, can cause considerable distress. The skin around them can also become red and inflamed, either as part of the body's immune reaction, or as a result of a secondary bacterial infection if they are scratched.

However tempting it is to squeeze them, try to avoid this, as it releases a creamy, infectious fluid that spreads them further over the body. As the name suggests, they are also contagious and can be passed on to others through direct contact (although many people are naturally immune). Scratching also increases the chance of scarring.

Molluscum can affect anyone, but is most common in children up to the age of 14. In the UK, it is most common between the ages of one and four years, with at least one in twenty children affected at any one time. Children with eczema are particularly vulnerable, possibly because their skin barrier is disrupted (making it easier for the virus to take hold) and because eczema triggers scratching, which spreads the infection. A possible link with swimming has also been identified, although I often see more of them in winter when children stay indoors more, allowing them to spread more easily with close contact. I suspect lower vitamin D levels in winter are a factor, too, although this is not proven.

Several different conditions can cause blister-like spots, including chickenpox, so it's a good idea to see your doctor to confirm the diagnosis, especially if the child affected seems unwell. When molluscum is extensive, or the bumps unusually large, it can be a sign of reduced immunity, which may need investigation, too. If left to heal naturally, the lumps usually disappear within six to twelve months. In my experience, parents and children want them gone more quickly, however. They can be treated medically by cryotherapy (freezing) or with creams that boost local immunity or suppress the virus. New topical treatments are now available for use at home, both on prescription or to buy from pharmacies. These include MolluDab which has been used extensively in Germany for several years, especially for Molluscum contagiosum in children.

To help prevent the spread of molluscum contagiosum:

Wash your hands regularly, especially after applying any treatment to the lumps.

Try not to touch or scratch them, although this is easier said than done.

Avoid shaving over the infected area.

Don't share personal items such as towels, sponges, flannels or hairbrushes.

Cover the bumps with a bandage, if practical, especially before swimming or playing contact sports. Some doctors recommend avoiding contact sports but it seems rather mean to tell a child he can't play football for a year!

In adults, molluscum can be spread by intimate contact, so this is best avoided if possible until the lumps have gone (again, this advice is often impractical considering they could be present for a year or longer)

See your doctor (or pharmacist) to find out if any treatment is needed.

Above all, don't fret. In most cases, although they look unsightly, they do not indicate any particular health problem and new treatments are available.

References

http://fampra.oxfordjournals.org/content/31/2/130.long

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796559/

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2813%2970109-9/fulltext?_eventId=login

AL/1838/12.14/0.001. Date of prep: December 2014.


Dr Sarah Brewer MSc (Nutr Med), MA (Cantab), MB, BChir, RNutr, MBANT

Sarah qualified from Cambridge University with degrees in Natural Sciences, Medicine and Surgery. After working in general practice, she recently gained a master's degree in nutritional medicine from the University of Surrey.

As well as being a licensed doctor, Sarah is now also a Registered Nutritionist, Registered Nutritional Therapist and an award winning health writer. Sarah writes widely on all aspects of health and nutrition, including complementary medicine and the safe use of herbal remedies and vitamin supplements. She has written over 50 popular self-help books, is the Editor of YourWellness magazine, and a regular contributor to Prima, the Daily Mail, Daily Telegraph and other newspapers.

Sarah lives in the Channel Islands with her husband, three children, three tortoises, a cat and Jack Russell.

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