Molluscum contagiosum is a common skin infection in children, with an increasing incidence.  It causes bumps that are flesh colored with a dimple or white “plug” on the top.  The bumps are small, about 2-5 millimeters in diameter (occasionally larger).  They can become red and inflamed, especially as the body begins to fight off the virus or if it becomes secondarily infected with bacteria.  The rash usually does not itch, hurt, or cause other symptoms.

Cause:
Molluscum is caused by the molluscum contagiosum virus, from the poxvirus family.  It is spread through direct skin to skin contact and contact with contaminated objects.  The incubation period is 2-6 weeks.  It can spread from person to person and from one part of a person to another part on the same body by direct contact or rubbing.  It can infect any skin and sometimes mucus membranes (lips, eyelid).  If on the eyelid, an ophthalmologist needs to be involved in treatment.

Prevention:
To help prevent the spread of the virus:

• Avoid touching, rubbing or scratching the bumps.
• Don't share your clothing, towels, hairbrushes, razors or other personal items.

Treatment:
Treatment for molluscum is not mandatory, but helps to control the spread to others.  Molluscum contagiosum is self resolving, if given time (6 months to 3 years).  There are also many treatment options with some benefit. 

The most common treatments involve “popping” the lesions, creams and an oral medication.  When the lesions are popped to express the cheesy core, the virus may spread and cause more lesions.  This might also induce scarring. 

Benzoil peroxide (sold as acne treatments) can be applied and covered.  Remember that Benzoil peroxide can bleach the clothes, so wear overnight with a white shirt and wash off in the morning!

There are prescription creams that can help.  These creams are applied directly to each bump, might irritate the skin, and only sometimes work.  They can be expensive, so see how your insurance covers Aldara before filling!

Covering the lesions with duct tape overnight and removing in the morning for several weeks is a well-tolerated treatment by many children. 

The oral medicine cimetidine has been used for treatment of molluscum in small children.  This medicine is available in liquid form only by prescription but is over the counter for those who swallow pills.  As with all medications, cimetidine may cause unwanted side effects, but is generally well tolerated and is taken twice daily for 2 months.