Molluscum contagiosum is a contagious skin infection caused by a DNA virus belonging to the Poxviridae family, characterised by small, dome-shaped papules with a central dimple (umbilication). While it can affect any age group, it is more common and widespread particularly in children and in individuals with weakened immune systems. In 2026, minimally invasive approaches that prioritise patient comfort have gained increasing importance in the management of this infection.
Clinical Features and Diagnosis
Molluscum lesions typically appear as 2–5 mm diameter, shiny, skin-coloured or slightly pink papules. A characteristic central depression (umbilication) is present in each lesion, from which a whitish, cheese-like material (molluscum body) can be expressed. Diagnosis is most often made by clinical examination; dermoscopy or biopsy may be required in atypical cases.
In children, lesions are usually located on the trunk, arms, and legs, whereas in adults they appear more commonly on the genital area and inner thighs. In children with atopic dermatitis, lesions may be more widespread and treatment-resistant.
Transmission Routes and Prevention
The virus spreads through direct skin-to-skin contact, shared use of contaminated objects, and auto-inoculation (self-spreading of lesions). In adults, sexual contact is an important route of transmission. The following precautions are recommended for prevention:
- Avoid touching or scratching lesions
- Do not share personal items such as towels and clothing
- Keep affected areas clean and dry
- Exercise caution in shared facilities such as swimming pools
Treatment Approaches in Children
Pain and anxiety management are of great importance when planning treatment in children. The methods preferred for paediatric patients in 2026 updated protocols are as follows:
- Topical treatments: Potassium hydroxide (5–10% KOH) solution is one of the first-line treatments in children. The ability to apply it at home and its painless nature are important advantages. Cantharidin solution applied in a clinical setting also provides effective results.
- Curettage: Mechanical removal of lesions with a small curette following application of a topical anaesthetic cream. In experienced hands it is a quick and effective method.
- Watchful waiting: In immunocompetent children, lesions may resolve spontaneously within 6–18 months. A watch-and-wait approach may be adopted for a small number of asymptomatic lesions.
Treatment Options in Adults
In adult patients, treatment options can be evaluated across a broader spectrum:
- Cryotherapy: Freezing lesions with liquid nitrogen is a frequently preferred and effective method in adults. Generally 1–3 sessions are sufficient.
- Laser treatment: Pulsed dye laser and CO2 laser produce successful results, particularly for numerous or resistant lesions. The risk of scarring is minimal.
- Topical retinoids: Retinoid-containing creams such as tretinoin can be used as supportive treatment, especially for genital area lesions.
- Immunomodulatory treatments: Imiquimod cream contributes to viral elimination by enhancing the local immune response.
Special Approach in Immunocompromised Patients
In HIV-positive individuals and patients receiving immunosuppressive therapy, molluscum lesions can be atypical, widespread, and resistant to treatment. In this patient group, correction of the underlying immune deficiency forms the basis of treatment. Strengthening the immune system with antiretroviral therapy may lead to spontaneous regression of molluscum lesions.
Molluscum Contagiosum Treatment at Virtuana Clinic
At Virtuana Clinic, we create personalised treatment plans for molluscum contagiosum taking into account the patient's age, number of lesions, localisation, and immune status. While we prioritise pain-free and non-traumatic methods for our younger patients, we offer advanced treatment options that deliver fast and lasting results for adult patients. Please contact us for pricing and to receive a detailed dermatological assessment for your molluscum lesions.
References
This article is for informational purposes only. Please consult a qualified physician for treatment decisions.