Before I go all science geek on you with this topic, I wanted to mention why I am trying to make an effort to write about this. First, my kid has Molluscum Contagiosum so I know some information about it and want to educated my fellow EczeMOMs. Second, when I started to research about the condition online, I came across only a few journal articles and blogs that grazed over the topic. I was that panicking mother who realized my child had this and I needed answers on how to manage it. The blogs were informative, however, there was too much scientific verbiage about what it is and not enough on how to manage it. My goal is to educate you on what Molluscum Contagiosum is and how to manage it in kids with Eczema and Atopic Dermatitis.
Disclaimer: I am not a doctor and this information should not be used to diagnose a medical condition. This is collective information from my experience, extensive research, and what I learnt from my pediatric dermatologist.If you feel that your child who has eczema, now has Molluscum Contagiosum- I would recommend you find and speak to a dermatologist as general pediatricians are limited in their knowledge and specialization on how to treat it.
WHAT IS MOLLUSCUM CONTAGIOSUM?
“Moll-uscum Cont-agiosum!” It sounds like it could be a spell right out of a Harry Potter movie. But in reality, it is a viral infection commonly found in kids 1-10 years of age. It causes benign and painless lesions (pimple-like growths) on different parts of the body. These lesions can last up to 6-12 months and in some cases as long as 4 years. They are small and raised with a pit or dimple in the center. They are usually flesh-colored, pink, or white with a firm and pearly appearance. They range in size and are usually found in clusters around face, arms, legs, abdomen, neck, and genital area[1].
TRANSMISSION
This virus is very contagious and can spread from direct physical contact or contaminated items like toys, towels, bath sponges, and cloths. A child that has a localized lesion can spread it to other parts of their body by just scratching the area[1]. My oldest daughter was the first one to get this on her forehead and we had no idea what it was. It looked like a harmless little pimple with a dot in the middle and would go away eventually. But then we decided to seek medical help when we noticed it was growing and was starting to bother her. In normal kids, this virus is self-limiting (meaning it resolves naturally after a period of time), however this is not the case in kids with eczema. Since scratching is one of the ways it spreads throughout the body you can imagine that this would spread like wild fire in kids with eczema[1]. Finding this out from my dermatologist came as a shock and all I could think about was my kid’s entire body covered with these lesions.
PREVENTATION
- If your child has these lesions do not share their cloths and towels with their siblings.
- Have your child do frequent hand hygiene[2].
- Frequently clean shared toys with disinfectant wipes.
- Siblings should not be sharing bath water and bath sponge.
- It is important that your child doesn’t scratch or pick on the lesion[2]. So
- Address eczema flair-ups quickly and regularly moisturize the skin. This is important to avoid further spread of the virus[2].
- Do not put a Band-Aid on the lesion, as per my dermatologist the adhesive from the Band-Aid can spread the lesion further.
- Avoid getting into swimming pools with other kids as you can easily spread it around[2].
TREATMENT
Molluscum Contagiosum in healthy individuals are self-limiting. These harmless lesions are not considered a threat by the body which is why they can grow silently. The idea behind all the treatments is to cause the body to create an immune response against these lesions causing them to fall off. As per the CDC if you chose to treat it talk to your doctor before buying anything online or at a store as it can be harmful[2]
Treatment is recommended for:
– Kids with chronic skin condition (such as eczema)
– Immunocompromised kids
– Molluscum is bothersome/irritating
– Molluscum in the genital area
– Kids with several molluscum bumps throughout their body.
Over-the-counter (OTC)treatment
Molluscum Contagiosum can be treated at home using Salicylic acid that is found in OTC Wart removal cream. Follow your doctor’s instructions on how to apply the cream and continue using it until you see a reaction[2]. The reaction that is expected is an irritated lesion that is redder and more inflamed. This is a sign that the body is fighting the virus.
Cons:
– Although effective, these creams work very slowly and can take up to several months to see results.
Pros:
– Inexpensive and easy to find.
– Do not need a prescription
Cryotherapy
Cryotherapy is the use of extreme cold temperature (liquid nitrogen) on the lesion which causes the bumps to temporarily freeze causing an irritation on the lesion and forcing the body to create an immune response towards the lesion[1]. Our Pediatric dermatologist recommended this for my kids as one of them had it on her face and cryotherapy does not cause scaring and the second one has eczema and use of other creams can cause more irritation making the eczema worse.
Method: Majority of the time after one round of treatment the lesion starts scabbing off the next day. During the procedure the kids will feel like they are being touched with ice. The doctor will use a Q-tip dipped in liquid nitrogen and touch the lesion several times. As liquid nitrogen is ~ –320°F kids don’t feel the pain until after the procedure is done and the pain usually lasts for few minutes. My oldest has a very low threshold for pain, so when the doctors touched her forehead with the Q-tip she was just irritated by the sensation but didn’t feel much pain at first. Following that she started crying complaining of a headache, within 30 seconds she stated that the headache magically disappeared.
Pros:
– It gets rid of the lesion very quickly.
– Will not cause any scaring.
– Will take care of the lesion in one session.
– No irritation to the surrounding skin.
Cons:
– This treatment is considered a procedure, so it comes with a hefty price tag if you have a deductible.
– It causes temporary discomfort and pain.
Oral therapy
Cimetidine is an anti-reflux medication also used as an antihistamine that is prescribed by the doctors to get rid of Mollusca.
Pros:
– This treatment is more commonly offered to pediatric patients as its painless, safe, and well tolerated.
Cons:
– It is not always effective especially on facial mollusca[1].
Pulsed Dye Laser (PDL)
PDL is recommended for patients that are immunocompromised and have several molluscum bumps on their body that are difficult to treat[2].
Pros:
– An effective strategy to treat several bumps in one visit.
– Leaves no Scar.
– Bumps clear out within a month.
– Very effective on kids as young as 8 years of age[2].
Cons:
– Rarely covered by insurance so not many dermatologists offer this treatment.
– Very expensive.
– Can cause temporary discoloration in people who have skin of color[2].
Cantharidin (Beetle Juice)
This treatment is done in the dermatologist’s office where they will apply the solution on each bump, usually requires 2 office visits. Results should be visible in 24-48 hours of treatment.
Pros:
– This is a painless procedure when applied using the correct methods by a medical professional[2]. Talk to your doctor to see if this is an appropriate option for a child with eczema.
Cons:
– This is a very serious treatment that if used incorrectly will cause damage to skin
– Once applied in the area kids cannot touch it and have to stay still which becomes a challenge depending on the area of the lesions.
WARNING: Using this treatment at home without the proper guidance will cause serious injuries such as chemical burn, scaring, and pain[2].
Topical therapy
Tretinoin is a Vitamin A derivative commercially used for Acne treatment which is also used to treat molluscum bumps. This is a prescription medication that is inexpensive and it irritates the surface of the lesion causing the body to create an immune response against the virus[2].
Cons:
– A drawback to using this on kids with eczema is that it further irritates their already inflamed skin causing them more discomfort.
– Will take a while to be effective.
Pros:
– It’s inexpensive.
– Can be done at home.
OUTCOME
In healthy individuals the lesions will eventually clear up without treatment, however treatment will help to clear out the bumps faster. Assess your child’s body (skin, scalp, & genital area) frequently as these bumps can return. Following the proper precautions and your dermatologists’ recommendations will help you prevent new lesions[1]. It is not easy when you go to a doctor with an unknown condition and they throw tons of names at you that are hard to pronounce making it difficult to focus on what needs to be done. My goal through this post was to educate and present a variety of treatment options before you make a visit to your dermatologist. You are the expert on your child, so how or if you choose to treat will be completely up to you and your circumstances. I hope this information helps and if you have other treatments or would like to share your own experiences, drop a comment below.
REFERENCE IMAGES
[1] Molluscum contagiosum: Diagnosis and treatment. (n.d.). Retrieved February 24, 2021, from https://www.aad.org/public/diseases/a-z/molluscum-contagiosum-treatment. American Academy of Dermatology Association
[2] Molluscum contagiosum. (2015, May 11). Retrieved February 23, 2021, from https://www.cdc.gov/poxvirus/molluscum-contagiosum/index.html. Center of Diseases Control
