Molluscum Contagiosum Pediatric Skin Rash

Pediatric Dermatology Basics

A photo of a child with molluscum contagiosum.
Grouped molluscum contagiosum lesions on a child's arm.. Photo by Vincent Iannelli, MD

Molluscum contagiosum is probably one of the more common skin rashes in children that parents rarely seem to know about.

In fact, a diagnosis of molluscum contagiosum is often met with surprise, as most have never even heard of molluscum.

That's despite the fact that they likely have heard of eczema, ringworm, and impetigo, etc, other common pediatric rashes.

Like warts, molluscum is a viral infection that is common in school-age children.

Molluscum Symptoms

Molluscum contagiosum lesions are typically small, dome-shaped, and can have a small dimple in their center. Although often flesh-colored, they can also be pink. They are usually found alone or grouped on a child's trunk, axilla, or skin folds of their elbow and knees.

For many children, molluscum don't cause any symptoms and the rash is simply a cosmetic problem. Others can get redness and scaling on the skin around the molluscum rash, which may be itchy.

Another characteristic is that molluscum will sometimes have a plug of cheesy material coming out of the central part of the lesion.

Molluscum Diagnosis

The diagnosis of molluscum is usually made by the classic appearance of the molluscum lesions.

The diagnosis can be confusing at first, though, when the molluscum are still very small. It may take a few weeks for the lesions to grow before they look like more typical molluscum lesions.

Molluscum Treatments

Since molluscum usually goes away in about six to nine months on its own, some pediatricians advocate not treating it. Keep in mind that it can sometimes last for two to four years and may spread aggressively, which is why others do recommend treating molluscum with:

  • Direct removal with a curette
  • Cryosurgery - freezing
  • Cantharidin - a blistering agent
  • Aldara (Imiquimod) - also used for genital warts, although they are not related to molluscum
  • Retin A (Tretinoin) - also used for acne

All of these treatments have their shortcomings, though. Direct removal and cryosurgery are painful. Cantharidin can cause large blisters. Aldara is expensive. And Retin A doesn't always work well when used by itself.

So what should you do about your child's molluscum?

Talk with your pediatrician or a pediatric dermatologist about your options, which might include:

  • Leaving the molluscum alone, especially if your child has already had them for several months and they are not spreading.
  • Direct removal with a curette or cryosurgery if your child only has a few lesions. Although it can be painful, your pediatrician can consider using a topical anesthetic.
  • Cantharidin is another option if your child doesn't have a lot of lesions. It is not FDA approved in the United States, so not all doctors have it.
  • Either using Aldara cream and Retin A cream aloneĀ or using them together on alternate days.

    Most importantly, if you do treat your child's molluscum, watch for new lesions during treatment. They are contagious and start spreading the infection again, even if the initial treatment was successful.

    What To Know About Molluscum Contagiosum

    Other things to know about kids with molluscum contagiosum include that:

    • Molluscum contagiosum is caused by a double-stranded DNA poxvirus.
    • Molluscum can be spread by direct contact with an infected person (most common), touching contaminated objects (such as towels, toys, or clothing), and on a child when they scratch a lesion and then scratch other areas of their skin (autoinoculation).
    • It is not uncommon for kids to get at least 10 to 20 molluscum lesions. Some get many more.
    • Molluscum can grow aggressively in children who have a weakened immune system, causing them to have 100s of lesions.
    • Molluscum may get misdiagnosed when they get irritated, becoming red, swollen, and crusted, and they may look infected. It is more likely just a sign that they are going away, though.
    • The incubation period of molluscum is very long - up to 2 months - which means that your child may get new bumps or lesions long after others have gone away. This doesn't necessarily mean that he was reinfected, though. The molluscum virus was likely already on his skin and it just took that long for the new bump to appear.

    A pediatric dermatologist can be helpful if your child has molluscum that isn't responding to standard treatments.


    Dohil MA. The epidemiology of molluscum contagiosum in children. J Am Acad Dermatol. 01-JAN-2006; 54(1): 47-54.

    Habif: Clinical Dermatology, 4th ed.

    Long: Principles and Practice of Pediatric Infectious Diseases, 3rd ed.

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