Molluscum Contagiosum
What are molluscum contagiosum?
Molluscum contagiosum is a large name for an essentially benign viral infection of the skin that causes small skin-colored lumps or bumps. While there are many different causes for lumps and bumps of the skin, molluscum also tend to have a small indentation or crater in their center - not always obvious to the untrained eye!! Molluscum are caused by a DNA poxvirus, of which there are three types (MCV I, MCV II, MCV III). While the presence of molluscum is a frequent aesthetic concern, they are harmless and painless. To sum up, molluscum are a variety of wart that may spread and multiply rapidly.
What is the incubation period?
The classical skin rash typically appears in the 2 to 7 weeks after exposure or contact.
How is a diagnosis of molluscum made?
Molluscum are caused by a virus called a poxvirus. The presence of this virus in the skin causes previously normal skin to grow into bumps. These painless small bumps typically possess a central divot or crater (umbilication). A molluscum, left alone, will not present with discharge or bleeding. The presence of discharge or bleeding may indicate another diagnosis - consult one of our specialists. A diagnosis is made by visual examination. At times your physician may send a tissue sample (biopsy) for confirmation by a trained pathologist.
How are they transmitted?
Molluscum are warts that are easily transmitted via direct skin to skin contact (do not require unprotected penetration). They are not necessarily sexually-transmitted, and can be found on the hands, buttocks, abdomen and face - in addition to the obvious genital regions. Avoid manipulating or toying with these lesions, as they can become infected - or worse, may multiply from auto-contamination (you spread them from one place to another on yourself). As your physician will inform you - do not shave infected skin! Shaving infected areas increases your risk of spread and auto-contamination, in addition to increasing your risk of the lesions becoming infected.
Why should I consult if they are benign or harmless?
It is important for one to confirm the diagnosis. Some forms of skin cancer may resemble molluscum, so it is important to allow us to examine you if you find any abnormal lumps or bumps. In addition, it is prudent to treat molluscum when they are few in number...they can multiply quite quickly if left unchecked!!
How do I prevent the transmission of molluscum?
Abstinence or correct condom use may help to prevent the transmission of this viral infection from one person to the next if the lesion is on the penis alone(this is rarely the case). The problem is that molluscum are rarely limited to the genital area alone and this disease is not necessarily sexually transmitted, so direct contact with anybody who has it can lead to infection. Our typical advice is; when practical avoid skin to skin contact until all lesions are treated and resolved. This can often be accomplished by the use of clothing - wear clothes that strategically cover affected sites until there are none left. For example, wear a t-shirt and underwear during sexual relations if your molluscum are in the pubic, groin or buttock region. This helps!
How are molluscum treated?
The elimination of molluscum is accomplished by the destruction of locally infected skin... this sounds frightening!? The destruction of infected skin sites can be done by freezing the growths with liquid nitrogen (cryotherapy). Liquid nitrogen burns the wart lesion and is quite successful in erradicating the molluscum. Another, very effective method of removing molluscum is the technique of "curettage". Curettage involves the use of a small sterile scalpel that is extremely precise in its ability (in trained hands) to remove just the infected skin. Curettage is quick and relatively well-tolerated. Other techniques include destroying the tissue with laser surgery, using a toxic blistering agent (such as podophyllin - made from rain forest beetles), or burning them off with a potent acid (trichloracetic acid). Our physicians are particularly adept at removing the bad and leaving intact the normal tissue . If you believe you might be infected with molluscum, give us a call and book an appointment.
And like all forms of warts, molluscum will disappear spontaneously. Most of these warts will clear spontaneously in 6 to 8 months; however, they may last much longer...and this is a long time to be infectious!
A recent study compared two different methods used in the removal of molluscum contagiosum
The conclusion was that physical expression methods similar to curettage were as effective as caustic methods (phenol), yet resulted in less scarring
Reference
Weller R, O'Callaghan CJ, MacSween RM, White MI. Scarring in molluscum contagiosum: comparison of physical expression and phenol ablation. BMJ 1999;319:1540.
"Your sexual health is important to us at the clinic l' Actuel!"
Text by Dr. Robert O'Brien
