Molluscum contagiosum
Created: 09.01.2025
Updated 20.04.2026
Approved by: Consultant Dermatologist, Dr James Denny
What is Molluscum contagiosum?
Molluscum contagiosum is a common viral skin infection caused by a poxvirus. It leads to small, raised skin lesions that are usually harmless but can persist for many months.
The virus spreads through direct contact with infected skin or by touching contaminated objects such as towels, clothing, gym equipment, or bath sponges. In adults, it may also spread through sexual contact, particularly when lesions occur in the genital area.
Children are most frequently affected, especially those with eczema or atopic dermatitis, as their skin barrier is more easily disrupted. Adults with a weakened immune system may also be more susceptible and can develop more extensive disease.
What are the symptoms of molluscum contagiosum?
Typical molluscum contagiosum symptoms include:
- Small, dome-shaped bumps
- Flesh-coloured, pink, or pearly appearance
- A central dimple or indentation
- Smooth, firm surface
- Size usually between 2 to 5 mm
Lesions are usually painless but may become itchy or inflamed. Redness around the bumps can occur as the immune system begins to clear the virus.
Common sites include the face, trunk, arms, and legs in children, and the lower abdomen, thighs, or genital region in adults.
Who is at higher risk?
While anyone can develop molluscum contagiosum, certain groups are at increased risk:
- Children, particularly those with atopic dermatitis
- Individuals with a weakened immune system
- People with underlying conditions affecting the immune system, including HIV infection
- Athletes involved in close-contact sports
- Individuals with frequent skin-to-skin contact
In people with significant immune suppression, lesions may be more numerous, larger, and slower to resolve. A rare but recognised presentation is giant molluscum contagiosum, where lesions grow significantly larger than usual.
Can molluscum contagiosum become complicated?
Molluscum contagiosum is generally mild, but complications can occur.
Scratching may lead to secondary bacterial infection, causing redness, swelling, crusting, or pus. In patients with eczema, surrounding inflammation may be more pronounced.
Unlike fungal infections, which often cause scaling or spreading ring-shaped rashes, molluscum contagiosum lesions are typically discrete and dome-shaped.
How is molluscum contagiosum diagnosed?
Diagnosis is usually clinical. A dermatologist can recognise the characteristic appearance of the lesions.
In atypical cases, particularly in adults or immunocompromised patients, a skin biopsy may be performed to confirm the diagnosis and exclude other conditions.
Specialist dermatology assessment is particularly important if lesions are widespread, persistent, unusually large, or affecting sensitive areas.
What are the treatment options?
Many cases resolve spontaneously as the immune system clears the virus. This can take several months and occasionally up to 18 months.
Treatment may be considered when:
- Lesions are spreading
- There is significant cosmetic concern
- The condition is causing discomfort
- There is secondary infection
- The patient is immunocompromised
Options include:
- Cryotherapy to freeze the lesions
- Curettage to remove lesions
- Topical treatments such as salicylic acid
- Other prescribed topical therapies under specialist guidance
Treatment choice depends on age, lesion location, number of lesions, and patient preference.
How can you prevent molluscum contagiosum?
To prevent molluscum contagiosum, the following measures are recommended:
- Avoid scratching or picking lesions
- Cover visible lesions when appropriate
- Avoid sharing towels, clothing, or personal items
- Maintain good hand hygiene
- Avoid close skin contact while lesions are active
Children with molluscum contagiosum can usually attend school or nursery, as exclusion is not typically required.
What is the prognosis?
The prognosis is excellent in otherwise healthy individuals. Most cases resolve without scarring once the immune system clears the virus.
In individuals with a weakened immune system, lesions may persist longer and require more active management. Early dermatology involvement ensures appropriate monitoring and tailored treatment where necessary.
Frequently Asked Questions
Is molluscum contagiosum contagious?
Yes. Molluscum contagiosum spreads through direct contact with affected skin or contaminated items such as towels or clothing. It can also spread to other parts of the body through scratching.
How long does molluscum contagiosum last?
In healthy individuals, lesions often clear on their own within 6 to 18 months as the immune system eliminates the virus. In people with a weakened immune system, the condition may persist longer.
Does molluscum contagiosum need treatment?
Not always. Many cases resolve without intervention. Treatment may be recommended if lesions are spreading, becoming inflamed, cosmetically distressing, or occurring in patients with underlying immune conditions.
Can molluscum contagiosum become infected?
Yes. Scratching can lead to secondary bacterial infection, causing redness, swelling, pain, or pus. If this occurs, medical review is advised.
When should I see a dermatologist?
Specialist assessment is recommended if lesions are numerous, unusually large, persistent, affecting the genital area, or occurring in someone with a weakened immune system. Early review ensures accurate diagnosis and appropriate management.
