One of the most delightful things about having children is their propensity to develop wonderful skin conditions. Of these, molluscum contagiosum, or “water warts”, is one of the more challenging and frustrating conditions parents have to deal with.
What Is Molluscum Contagiosum?
Molluscum contagiosum, or “water warts”, as it is sometimes called, is caused by a virus from the pox family. The most common feature of this viral infection is the small round nodule that appears on the skin- usually 1-2 mm in diameter. There is usually a central dimple, called an umbilication. Inside the wart is a seed made of a waxy shiny material.
Natural History Of Molluscum Contagiosum:
Molluscum contagiosum is extremely contagious (the clue is in the name!). Your child can pick it up via direct contact with a friend’s warts. He can also become infected via “fomites”- the viral particles that cling to solid surfaces for several hours after an infected person has come into contact with them.
KIds often become infected by sharing towels and body boards in the swimming pool, leading to the nickname “water warts”, although the virus is not actually spread via water at all.
Left to itself, molluscum is self- limiting in the majority of cases; it will resolve without treatment within approximately 9-18 months. For this reason, many doctors recommend no treatment, and adopt a “watch and wait” policy.
When to Treat Molluscum:
Although molluscum is regarded as generally benign, some children may experience complications such as:
- Eczema around the site of the molluscum. (Click here for further information about treating Childhood Eczema)
- Rapid spread of warts due to excessive scratching and reseeding
- Bacterial infection due to scratching
- Irritation and chafing, especially if molluscum occur in the groin or armpit area
Children with complications may require active intervention to prevent further spreading, and reduce discomfort.
How to Treat Molluscum:
We’ve already discussed the “do nothing” approach. If your child has no discomfort, and there are relatively few spots, this may be your best approach.
However, if your child is experiencing complications, your doctor may discuss certain interventions:
Topical Creams and Paints:
- Wart paints such as Salicylic Acid have been found to be very helpful on plantar warts, or verrucas. However, molluscum are less thickened, so this treatment may be painful and may blister normal skin nearby.
- Imiquimod, or “Aldara”, is an immune modifier which supposedly encourages the immune system to “wake up” and fight the molluscum, clearing it up faster. However, several studies have shown no improvement following this treatment, so it is no longer recommended for treatment of molluscum.
- Cantharidine: a paint derived from a beetle, and dating back to ancient Chinese medical traditions. This paint causes a blister to form on top of the molluscum, which should peel off after 3-4 days, taking the molluscum with it. In the majority of cases it is relatively painless and causes little to no scarring. Occasionally, it may be painful, and there is a small chance of bacterial contamination of the blisters.
- Curettage: removing the roof of the wart to remove the contagious “seed” from the centre. This is usually done after applying local anaesthetic cream, but may still cause some discomfort. If there are multiple warts to treat, a young child may become very distressed. There is a small risk of scarring.
- Cryotherapy: using liquid nitrogen to freeze the warts off. Again, this is best done after applying local anaesthetic creams to the area. It may also cause scarring.
So we have “do nothing” and we have various quite invasive, or painful, options. Is there a middle of the road approach? Although rarely recommended by medical professionals, there is growing evidence that several other, more innocuous, therapies may be beneficial:
- Tea Tree Oil: dabbing a drop of tea tree oil on each of the molluscum once or twice a day may help prevent them spreading, and may actually reduce the number of molluscum. It appears to work by causing the immune system to “wake up” and get started on removing the molluscum. It is a good idea to try this before going for a more invasive option. At the very least, your doctor may have to treat less warts!
- Wheat Grass Spray : this is a similar idea to Tea Tree Oil, but it is a little harder to come by. Unless you already have some at home, in which case, have a go!
- Tape Stripping: this rather bizarre treatment may work for you. Apply duct tape or Elastoplast onto the molluscum, with the adhesive part in contact with the warts. Keep it on for a couple of days and then take it off. I must admit though- I haven’t had any personal experience with this one!
My favourite of the above home remedies is the tea tree oil. It is readily available and easy to apply. And it really works! Among all the parents I have recommended it to, the majority find that the warts either disappear or reduce greatly. This is fantastic for your child and your doctor, as any further wart removal will be quicker and less traumatic for all concerned!
What molluscum therapies have you tried? Which worked for you? Have you any advice or stories you would like to share? Leave your comments below.
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