ConditionSkin, hair & nails
Molluscum Contagiosum
Molluscum contagiosum is a common viral skin infection that causes small, firm, pearly or flesh-colored bumps with a tiny dimple in the center. It mostly affects children aged 1 to 10, and in adults it can be sexually transmitted to the genital area. It spreads by skin contact and shared towels, and by scratching to other areas of the body. It is harmless and clears on its own, usually within 6 to 18 months, though treatment can speed clearance.
Also called: Water warts, MC, molluscum
At a glance
- What it is
- A poxvirus skin infection causing small, dome-shaped bumps with a central dimple.
- Who gets it
- Mainly children 1 to 10. Adults through sexual contact. People with eczema or weak immunity get more lesions.
- Spread
- Skin-to-skin contact, shared towels, baths, swimming, and scratching.
- How long
- Each bump lasts weeks to months. The infection usually clears in 6 to 18 months, sometimes longer.
- Treatment
- Often none. Options include cantharidin, berdazimer gel, freezing, curettage and treating eczema.
When to get help
See a doctor within a day or two
- Bumps on the eyelid edge with a red, sore eye (molluscum can cause conjunctivitis)
- Widespread or large bumps in someone with HIV, on chemotherapy or other immune suppression
- Bumps that are very red, hot, swollen and painful with fever (possible bacterial infection)
Book a routine appointment
- Genital bumps in an adult: get checked and consider STI testing
- Bumps that are spreading rapidly, especially with eczema
- Uncertain diagnosis, or bumps lasting longer than 18 months
Usually safe to manage at home
- A few typical bumps in a healthy child, left to clear on their own while avoiding scratching and sharing towels
- A bump that becomes red and inflamed just before it clears (the "beginning of the end" sign)
What molluscum looks like
- small, firm, smooth, dome-shaped bumps, usually 2 to 5 mm across
- pearly, pink or flesh-colored
- a small dimple (umbilication) in the center, which may contain a white, cheesy core
- often in groups or lines, from scratching
- usually painless, sometimes itchy
- in children: commonly on the trunk, armpits, elbow and knee creases, and face
- in adults: often on the lower abdomen, inner thighs and genitals
An eczema-like itchy rash often develops around the bumps (molluscum dermatitis). As the immune system recognizes the virus, bumps may become red, swollen and crusted before clearing. This is usually a good sign, not an infection.
How it spreads
The molluscum contagiosum virus is a poxvirus that lives only in the top layer of the skin. It spreads by:
- direct skin contact
- sharing towels, sponges, bath water, clothes and toys
- swimming pools (likely via shared towels and equipment)
- scratching or shaving, which spreads it to new areas of your own skin (autoinoculation)
- sexual contact in adults
The incubation period is typically 2 to 6 weeks, sometimes longer.
Who is at higher risk
- children, especially those who swim or share baths
- children with atopic dermatitis, whose damaged skin barrier allows more spread
- people with weakened immunity, including HIV, who may develop large or numerous bumps
- sexually active adults
- contact sports participants
Molluscum vs similar conditions
| Condition | Key differences |
|---|---|
| Warts | Rough surface, no central dimple |
| Acne or folliculitis | Pustules, often around hair follicles, come and go faster |
| Chickenpox | Itchy blisters in crops, with fever, clear in 1 to 2 weeks |
| Genital warts | Cauliflower-like, no central dimple |
| Milia | Tiny hard white cysts, no dimple |
Diagnosis
A doctor or dermatologist diagnoses molluscum by its appearance, sometimes with a magnifier (dermatoscope). Rarely, a scraping or biopsy confirms it. Adults with genital molluscum should be offered testing for other STIs.
Treatment
Treatment is optional for healthy children, because molluscum clears on its own and treatments can be uncomfortable. Reasons to treat include:
- many or spreading lesions
- itching, discomfort or secondary infection
- lesions on the face or genitals
- eczema that is flaring
- social or cosmetic concerns
- adults with genital lesions, to reduce spread
Treatment options
- cantharidin (a blistering agent) applied in a clinic. A standardized topical version is FDA-approved for molluscum
- berdazimer gel, a home-applied topical medicine approved for molluscum
- cryotherapy: freezing with liquid nitrogen, mainly for older children and adults
- curettage: scraping lesions off, usually with numbing cream
- other topical treatments: podophyllotoxin (adults, not in pregnancy), potassium hydroxide or tretinoin in some cases
- treating surrounding eczema with moisturizers and mild steroid creams reduces spread
Treatment can cause pain, blistering, scarring or color change. Imiquimod is no longer recommended for children because trials showed no benefit.
Preventing spread
- avoid scratching or picking bumps
- cover visible bumps with clothing or waterproof bandages for swimming and contact sports
- do not share towels, bath water or clothing
- wash hands after touching bumps
- adults: avoid sexual contact while lesions are present, and avoid shaving over affected areas
Children do not need to stay home from school or childcare.
Outlook
Molluscum always clears eventually, usually within 6 to 18 months, though it can last up to 4 years in some children. It usually leaves no scar unless scratched, picked or treated aggressively. Once it clears, recurrences are uncommon, though reinfection is possible.
Frequently asked questions
What causes molluscum contagiosum?
It is caused by the molluscum contagiosum virus, a type of poxvirus. It infects only the top layer of the skin and spreads through skin contact, shared towels or bath water, scratching, and sexual contact in adults.
Is molluscum contagiosum contagious?
Yes, while bumps are present. It spreads by direct contact and shared items. Covering bumps, not sharing towels and avoiding scratching reduce spread. Children can still attend school and childcare.
How long does molluscum last?
Individual bumps last weeks to a few months. The infection as a whole usually clears within 6 to 18 months, though it can take up to several years, especially in children with eczema.
Should molluscum be treated?
Treatment is optional for healthy children because it clears on its own. Treatment may be considered for many lesions, discomfort, eczema flares, genital lesions or cosmetic concerns. Options include cantharidin, berdazimer gel, freezing and curettage.
Why are my child's molluscum bumps turning red?
Redness and swelling often mean the immune system has recognized the virus and the bump is about to clear. This "beginning of the end" sign is common. See a doctor if the redness spreads, becomes very painful or comes with fever.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology (AAD): Molluscum contagiosum: Diagnosis and treatment
- CDC: Molluscum contagiosum
- NHS: Molluscum contagiosum
- American Academy of Pediatrics (AAP): Red Book: Molluscum contagiosum
- MedlinePlus: Molluscum contagiosum