Molluscum Contagiosum: What It Is, How It Spreads, and Realistic Treatment Options

When your child comes home from swim class with a few tiny, pearly bumps on their arm, it’s natural to panic. Are these warts? Are they contagious? Will they scar? The truth is, those little bumps are likely molluscum contagiosum - a common, harmless viral skin infection that affects millions of kids every year. Despite how alarming they look, most cases clear up on their own without treatment. But knowing what to do - and what not to do - makes all the difference.

What Exactly Is Molluscum Contagiosum?

Molluscum contagiosum is caused by a virus called MCV, part of the poxvirus family. It’s not dangerous, not cancerous, and doesn’t lead to long-term health problems in healthy people. The virus creates small, round bumps on the skin - usually 2 to 6 millimeters across - with a dimple or dot in the center. They can be white, pink, or skin-colored, and often look like little pearls. These bumps aren’t painful, but they can itch, especially if the person has eczema.

The virus spreads easily through direct skin contact. Think sharing towels, hugging, playing sports, or even swimming in a pool. Kids get it from other kids at school or daycare. Adults usually catch it through sexual contact. If someone has eczema, they’re 30% more likely to get molluscum because their skin barrier is already compromised. The incubation period is 2 to 6 weeks, so you won’t see bumps right after exposure.

How Is It Different From Other Skin Issues?

Many people mistake molluscum for warts, herpes, or chickenpox. But here’s how to tell them apart:

• Warts (HPV) are rough, raised, and lack the central dimple. They’re firmer and often appear on fingers or feet.
• Herpes causes painful blisters that break open and crust. Molluscum bumps are firm and don’t hurt.
• Chickenpox spreads all over the body and includes fluid-filled blisters that turn into scabs. Molluscum stays localized and doesn’t change shape quickly.
• Impetigo is bacterial, oozes, and forms honey-colored crusts. Molluscum stays dry and intact.

A dermatologist can confirm it with a quick visual exam. In rare cases, they might use a dermatoscope - a magnifying tool - to see the central core clearly.

Why Most Cases Don’t Need Treatment

The American Academy of Dermatology says the best treatment for healthy children is no treatment at all. Why? Because molluscum usually goes away on its own in 6 to 24 months. Studies show 92% of cases clear up within 18 months without leaving scars. Aggressive treatments like freezing, scraping, or burning can cause pain, redness, and even scarring - especially on the face.

Dr. Adam Friedman, a leading dermatologist, says: “The bumps are more of a nuisance than a threat. Treating them aggressively often does more harm than good.”

Parents often feel pressured to “do something.” But watching and waiting is not neglect - it’s evidence-based care. The CDC updated its guidelines in 2023 to say: “No child should be kept out of school or swimming because of molluscum.”

When Treatment Might Make Sense

There are times when treatment is worth considering:

• Lesions on the face or genitals that cause emotional distress or bullying
• Large clusters that keep spreading despite hygiene measures
• Children with weakened immune systems (like those with eczema or HIV)
• Teenagers or adults with genital bumps who want to avoid spreading it to partners

In these cases, options include:

• Cantharidin - a blistering agent applied by a doctor. It causes a small blister to form, lifting the bump off. Studies show 73% clearance after 12 weeks.
• Topical potassium hydroxide - available in over-the-counter creams like MolluDab. Used daily, it clears lesions in about 8 weeks for 63% of users.
• Cryotherapy - freezing with liquid nitrogen. Effective but can be painful and risky on delicate skin. Many parents regret this choice for facial bumps.
• Immunomodulators - new topical drugs in clinical trials (like those tested in NCT05217892) are showing 82% clearance, but aren’t widely available yet.

The Cochrane Review (2022) found no single treatment is clearly better than others. But cantharidin and potassium hydroxide consistently outperform placebos.

How to Stop It From Spreading

Prevention is easier than treatment. Here’s what actually works:

• Don’t share towels, clothing, or toys. One CDC study showed this cuts household spread by 57%.
• Cover bumps during swimming. While the virus can survive in water, most pools are chlorinated enough to kill it. Still, many swim programs require coverage to avoid complaints from other parents.
• Keep nails short and discourage scratching. Scratching spreads the virus to other parts of the body. Mayo Clinic data shows scratching can triple the number of bumps.
• Wash hands often. Simple, but effective. Especially after touching bumps or applying cream.
• Use separate bath time. If you have multiple kids, bathe the infected child last and clean the tub afterward.

A 2022 survey by the National Eczema Association found that kids with both eczema and molluscum had faster spreading and worse itching. For these children, managing the eczema with moisturizers and gentle cleansers helps control both conditions.

What Parents Are Really Doing

Real-world behavior tells a different story than medical guidelines. A BabyCenter survey of 452 parents found 78% chose no treatment. They watched, waited, and focused on hygiene. Only 12% used over-the-counter creams. Just 10% went for doctor procedures.

But on Reddit and parenting forums, the emotional toll shows up. One user, “MolluscumSurvivor69,” shared how genital bumps caused 14 months of anxiety before they cleared. Another parent wrote: “I felt judged at the playground. No one said anything, but I could feel it.”

That’s why some doctors now recommend early treatment for visible facial bumps - not for medical reasons, but for mental health. A 2021 study found 45% of school-aged kids with facial molluscum experienced teasing or social withdrawal.

What Doesn’t Work (And Can Hurt)

There are tons of “miracle cures” online: tea tree oil, apple cider vinegar, duct tape, iodine. None of these are proven to work. Worse, some cause chemical burns or allergic reactions.

The FDA issued a warning in 2022 to three companies selling unregulated molluscum creams with no dosage instructions. One product had potassium hydroxide at 20% - far above the safe 5-10% range. That’s dangerous for kids.

Also avoid aggressive procedures like laser removal or curettage (scraping) for young children. The pain, trauma, and risk of scarring outweigh the benefits.

What’s New in 2025?

The field is slowly changing. A new topical immunomodulator showed 82% clearance in a 2023 clinical trial. It’s not on the market yet, but it’s the most promising development in years.

The CDC’s 2023 update was a big win: schools and pools can’t exclude kids with molluscum anymore. That’s helping reduce stigma.

Global trends suggest cases may rise 22% over the next decade due to warmer, more humid climates - especially in tropical regions where prevalence already hits 18% in kids.

When to See a Doctor

You don’t need to rush to the dermatologist for every bump. But call if:

• The bumps are growing rapidly or spreading beyond a few areas
• They become red, swollen, or ooze pus (sign of bacterial infection)
• Your child has eczema, HIV, or another immune condition
• Bumps appear on the eyelids or genitals and cause discomfort
• You’re unsure if it’s molluscum or something else

Most family doctors can diagnose it. Dermatologists are only needed for complex cases or if treatment is being considered.

Final Thoughts: Patience Is the Best Medicine

Molluscum contagiosum is not a crisis. It’s a temporary skin glitch. It doesn’t mean your child is dirty. It doesn’t mean you failed as a parent. It’s just a virus - one that millions of kids get every year and outgrow without a trace.

Focus on keeping the skin clean, avoiding scratching, and not sharing personal items. Give it time. Most bumps will vanish without a scar, without a procedure, and without drama.

If you’re stressed, use the American Academy of Dermatology’s free “Molluscum Manager” app. It tracks bumps, sends reminders for hygiene, and gives you science-backed answers - not fear.