It is among the most common skin infections, especially in the 0-6 age group, when the immune system is still maturing. Let’s find out how to recognize the symptoms and how to treat it
«Doctor, Alice has had these pustules under her right armpit for a few weeks», asks Alessandra, during a visit to the pediatrician. “They don’t seem to bother her, but every now and then a new one pops up and they don’t go away. What can we do?”.
Molluscum contagiosum is a viral skin infection, quite common in children but also present in adults. It manifests itself with the appearance of small skin lesions, commonly called “skin molluscs”. These lesions can worry parents, who often contact the pediatrician to understand what they are and how to make them go away. In this article we will delve into the causes, symptoms and therapeutic possibilities to deal with the problem.
Molluscum contagiosum: the causes
The poxvirus is responsible for molluscum contagiosum. This virus can be transmitted through direct contact (skin-to-skin) with an infected person, or, more rarely, through contaminated objects, such as towels, combs or toys.
Among young children, who share hugs, cuddles, contact games and objects, this infection is quite widespread.
Even small wounds or abrasions favor the entry of the virus into the skin. Some studies indicate atopic dermatitis as a possible risk factor, as it alters the skin barrier. However, the poxvirus follows a life cycle that ends with a response from the immune system.
Molluscum contagiosum in children
In children, molluscum contagiosum is among the most common skin infections, especially in the 0-6 age group, when the immune system is still maturing and, as we have seen, due to frequent physical contact between peers.
Lesions often appear on the face, limbs, or trunk, especially in areas not covered by clothing (but not on the palms of the hands or soles of the feet). They appear as small, rounded, smooth, pink or whitish papules, often with a small central dimple.
There is usually no itching, but it can appear if the skin becomes irritated due to scratching. It is very important to avoid scratching the lesions, because this increases the risk of superinfections, as well as the possibility of contagion to other parts of the body and to other children.
Molluscum contagiosum and adults
Although less frequent, the poxvirus can affect adults. In this age group the infection often presents in a different way: molluscum contagiosum frequently affects (but not only) the genital area, such as the groin and pubic area, and is often transmitted through contact during sexual intercourse.
In adults, genital itching can be the main symptom, and a medical examination is important to differentiate molluscum from other pathologies with similar symptoms and to prevent transmission of the infection to a partner.
Molluscum contagiosum symptoms
The skin manifestations are typical and quite easy to recognise: small raised nodules, shiny, smooth, pearly, white or light pink in colour. In the center you can often notice a dimple, also called navel.
As we have seen, in children molluscum contagiosum often appears on the face, trunk and limbs, while in adults it mainly affects the genital area.
Molluscum contagiosum can cause itching, especially if there is irritation or bacterial infection.
Molluscum contagiosum: therapy
The good news is that molluscum contagiosum is a benign pathology, which resolves spontaneously over time, although not always quickly: it can take months, up to 2 years. For this reason, following the indications of pediatric societies, when asked “what can I do?” usually the solution indicated is to wait.
However, parents often require therapeutic intervention, sometimes because the lesions are increasing or because impetigo or atopic eczema overlap. In some cases, local therapy may be suggested, which seeks to eliminate the virus and/or stimulate the immune response against it. Other times we opt for removal, which can be mechanical (with a kind of tweezers) or with liquid nitrogen (cryotherapy). However, various studies show that treatments for molluscum contagiosum have a success rate only slightly higher than therapeutic abstention. In children, we also try to avoid painful or invasive treatments, preferring a more conservative and waiting strategy, with attention to avoiding scratching and maintaining good hygiene.
