May 6, 2013

What’s The Best Treatment For Molluscum Contagiosum?

I was recently diagnosed with molluscum contagiosum. The doctor said that this is not normally sexually transmitted, which was my big worry at first. She also told me that the body will destroy the virus naturally but could take up to six months to do it! She didn’t prescribe anything for me, and now I would like to get medication for this. What hope do I have of getting medicine, and what would be the best for this virus that is interrupting my love life?

Molluscum contagiosum (MC) is a viral infection of the skin and occasionally of the conjunctiva of the eyes. The lesions are small raised bumps, usually about 1/16 to 1/8 of an inch in diameter. They have flat or slightly dimpled tops, and therefore are usually not confused with pimple-like bumps. They do not have the coarse or rough surface of a wart. They are usually flesh-colored or slightly yellow, but can become red if inflamed. Unless inflamed, they do not hurt or itch. They can occur on any part of the body, though I have most often seen them on the abdomen or upper thighs.

The way by which one catches MC is not known. Our writer’s doctor is correct that they are not a sexually transmitted disease, and I see no reason for her to allow this to interfere with her love life. They are spread by autoinoculation — that is, by picking at one and then scratching the skin elsewhere, but obvious transmission between two people is unusual. They commonly appear in children, and often will not be spread to other members of the household. One old dermatology text that I have calls them “not particularly contagious.”

MC is often not treated, and will disappear spontaneously over a period of months. However, many people, like today’s writer, are unwilling to wait, and because the bumps may be cosmetically unattractive, I can understand. Treatment consists of traumatizing the lesions, and it can be done in a number of ways. The bumps have a core, which can often be picked out by a small curette. The tip of a small knife blade could be used. It need not be sharp, since one wants to pop or pry out the core of the lesion, not cut it out. I have often treated them by lightly freezing the bumps with liquid nitrogen, and I know many dermatologists will lightly cauterize the lesions. They should heal without leaving a scar, unless cautery has been used too vigorously.

If our writer wants to try treating them herself, she can try popping out the core with a small blunt knife. She should try it on one in a spot that she can easily see and reach. I would suggest then waiting for a week or so to make sure that it is healing before attacking the rest of them. An alternative would be to get some dry ice, and freeze the bump, trying to avoid freezing the surrounding skin. Dry ice should be handled with gloves to prevent freezing the fingers. If she would rather have them treated by a doctor, I would suggest seeing a dermatologist, since her regular doctor, who I presume is not a dermatologist, doesn’t want to do it. Many general doctors do not keep cautery units or liquid nitrogen in their offices, and she may be unfamiliar with the popping method.


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