Molluscum contagiosum is a benign viral skin infection caused by the DNA virus called the Moluscum Contagiosum Virus (MCV). Four viral subtypes have been identified, MCV-1, 2, 3, 4; MCV-1 is the most prevalent followed by MCV-2.
The virus is transmitted by skin contact as well as by contact of the skin with objects infected by the virus, such as towels, clothes and linens. It is a very common skin infection in children and also a sexually transmitted disease in adults
The lesions caused by the virus Molluscum contagiosum are solitary or clusters of round nodules (papules) with pink or white color. They have a shiny look and they are often 2‑5 mm in diameter. They resemble a pimple but they are often slightly larger in size, their color is close to skin color and they have a dimple in the center containing a keratinized plug. They appear in almost all areas of the body. In younger ages they can be found in areas such as the face, the trunk and upper and lower extremities. In adults they mainly arise in the genital area and the folds of the thigh-groin area. Molluscum contagiosum lesions are painless but can cause itching or intense discomfort in cases of transfection and inflammation.
The diagnosis is based on clinical examination. Sometimes, in cases of doubt, the diagnosis is made on skin biopsy, if required.
The aim of the treatment of Molluscum contagiosum includes both the improvement of possible symptoms (relief from pain or itching), and the removal of lesions for cosmetic reasons. If left untreated for a long period of time, they may disappear (self-healing following several months in immunocompetent patients), remain in the same status or most often grow in size and number.
There is a good chance of propagation to other parts of the body through autoinoculation that can occur by touching, scratching or the attempt to break a lesion. Unlike other skin viruses that may remain in the patient’s body in latency and reappear following a period of time, such as HPV and herpes simplex virus, the Molluscum contagiosum virus does not remain in the body if the lesions that it develops are treated effectively. Thus, the necessity of their treatment is highlighted.
The treatment regimens are divided into self-applied treatments and treatment administration at the doctor’s office. The former includes topical application of pharmaceutical substances directly on the lesion by the patient himself/herself at home. Factors influencing the choice of treatment include the size, the number, the anatomical area the lesions are found, the patient’s preference and the side effects of each case.
Home treatment includes the administration of irritants, such as salicylic acid, retinoids, potassium hydroxide and cantharidine with dubious results. Moreover, podophyllotoxin (0.5% cream) can be applied; this, however, cannot be used on pregnant women as it is a quite caustic substance. Imiquimod cream can also be applied at the sites where lesions appear for enhancing the response of the immune system.
The treatments applied in the clinic are the following:
, i.e., application of liquid nitrogen using a spray device that freezes the lesion as well as a perimeter of healthy skin surrounding the lesion. It is a quite painful method and can leave undesirable scars on the application sites.
that consists of crushing the lesions with the use of forceps and the immediate application of iodine tincture at the sites. It is also a painful method and thus, it is difficult to implement on children.
or diathermy coagulation which is done under local anesthesia which is also effective in larger sized lesions, but may also leave small scars.
which is the most modern and effective method of removal at an office basis. The laser causes ablation of the lesions and their complete and prompt removal. For larger lesions, local anesthesia is usually required. Laser treatment is a completely accurate method that leaves the surrounding healthy tissue intact, which means that it reduces the probability of creating unsightly scars.
The cost of laser treatment for Molluscum contagiosum removal starts from 50 € for solitary small lesions.
In Cosmetic Derma Medicine clinic we offer all methods for the treatment of Molluscum contagiosum. However, the treatment of choice is laser treatment as it achieves the highest rates of viral eradication.