Molluscum contagiosum is a common viral skin infection that causes small, firm, painless bumps on the skin. It affects roughly 5% of the general U.S. population, with children under 14 being the most commonly affected group. The infection is caused by a poxvirus that spreads through skin-to-skin contact, and while it looks alarming, it resolves on its own in most cases within 6 to 18 months.
What the Bumps Look and Feel Like
The bumps from molluscum contagiosum are small, round, flesh-colored or pinkish papules with a smooth, waxy surface. Their most distinctive feature is a tiny dimple or pit in the center, which doctors call umbilication. If you squeeze one (which you shouldn’t), a thick, white, waxy core comes out. This core is packed with virus particles.
Most people develop anywhere from a handful to a few dozen bumps, though immunocompromised individuals can develop hundreds. The bumps are usually painless, though they can become itchy or irritated. They tend to cluster in areas where skin touches skin or where someone has scratched, and they commonly appear on the trunk, arms, legs, and face in children. In adults who contract it through sexual contact, the bumps typically show up on the lower abdomen, inner thighs, and genital area.
How It Spreads
The virus spreads in three main ways. The most common is direct skin-to-skin contact with someone who has active bumps. It also spreads through contaminated objects like towels, clothing, toys, and pool equipment. And it spreads through sexual contact, which is the primary route for adult infections.
One of the trickiest aspects of molluscum is something called autoinoculation, which is when you spread the virus to new areas of your own body. This happens when you scratch or pick at the bumps, shave over them, or have hair removal procedures on an affected area. That single act of scratching can turn a few bumps into dozens within weeks.
Who Gets It
Children are disproportionately affected. Studies from the U.K. and the Netherlands found a cumulative incidence of about 17% in children under 15. In the U.S., the point prevalence in children ages 0 to 16 ranges from about 5% to nearly 12%, depending on the study. Molluscum accounts for roughly 1% of all skin diagnoses worldwide.
Adults with healthy immune systems can get it too, though it’s less common outside of sexual transmission. People with weakened immune systems, including those with HIV, are at higher risk for more severe and longer-lasting outbreaks.
How Long It Lasts
In healthy children, about half of cases clear within 12 months and 70% clear within 18 months without any treatment. The average duration runs 13 to 18 months, but some cases drag on for 2 to 5 years. In adults with healthy immune systems, bumps typically resolve within 12 months, though occasional cases take 2 to 3 years. The CDC puts the overall range at 6 to 12 months, with outliers lasting up to 4 years.
The frustrating part is that even as old bumps disappear, new ones can pop up from autoinoculation, which extends the total duration of the infection. This is why the virus sometimes feels like it’s never going away, even though each individual bump has a limited lifespan.
How It’s Diagnosed
Most of the time, a doctor can diagnose molluscum contagiosum just by looking at it. The combination of small, dome-shaped bumps with a central dimple is distinctive enough that lab tests aren’t usually needed. When the diagnosis is uncertain, a biopsy can confirm it. Under a microscope, molluscum-infected skin cells contain large, characteristic inclusion bodies that are unmistakable to a pathologist.
Treatment Options
Because molluscum resolves on its own, one completely valid approach is simply waiting it out. This “active non-intervention” approach is commonly used, especially in young children who may find treatment procedures distressing. The infection carries an excellent prognosis in people with healthy immune systems.
When treatment is preferred, options fall into a few categories. Destructive methods physically remove or destroy the bumps. These include freezing with liquid nitrogen, scraping the bumps off with a small instrument, and applying topical blistering agents. One commonly used blistering agent is derived from blister beetles and works by creating a small blister within the top layer of skin. The blister lifts the infected tissue away and typically heals without scarring. Other topical options include solutions containing salicylic acid, potassium hydroxide, or silver nitrate.
Immune-boosting treatments work by stimulating your skin’s local immune response to fight the virus. Antiviral medications are generally reserved for severe cases in immunocompromised patients.
The Eczema-Like Reaction
Some people, especially children, develop a red, eczema-like rash around their molluscum bumps. This reaction can also appear at sites away from the bumps themselves. It looks concerning, but it’s actually a sign that the immune system is mounting a response against the virus. It often signals that the bumps are about to start clearing.
This rash is usually mild and either asymptomatic or only slightly itchy. In most cases, a simple moisturizer is all that’s needed. Interestingly, using steroid creams or other immune-suppressing treatments on this rash can actually backfire, potentially suppressing the very immune response that’s fighting the virus and allowing molluscum to spread further. For kids with significant itching, a short course of a mild steroid cream can be used, but it’s generally best to let the immune reaction do its job.
Preventing Spread at Home and School
Children with molluscum do not need to stay home from school or daycare. The key is covering visible bumps that aren’t already covered by clothing with a simple bandage, changed when it gets dirty. For younger children who need diaper changes or bathroom help, bumps in the underwear or diaper area should be bandaged when possible.
At home, avoid sharing towels, washcloths, or clothing with the affected person. The virus can survive on surfaces, and while there’s no disinfectant specifically approved to kill it, household bleach solutions and standard EPA-registered surface disinfectants are effective for cleaning shared surfaces.
Swimming pools present a common concern for parents. A child with molluscum can still swim, but all visible bumps should be covered with watertight bandages. They shouldn’t share towels, kickboards, or pool toys. Used bandages should be disposed of at home, not at the pool. Pool equipment that might contact skin should be thoroughly disinfected and dried between uses.
Perhaps the most important prevention measure is discouraging scratching and picking. Every time a bump is scratched open, the virus-laden core can transfer to fingers and then to new skin, creating fresh bumps and extending the infection by months.