What to expect on this page?
Like many other conditions, molluscum contagiosum causes skin lesions. In this article, we show you photos and summarize information that you might like to know if you have, or your child has, skin lesions you’re trying to identify.
You will learn what molluscum contagiosum is, how it is transmitted, what its signs and symptoms are, and what other problems it can cause.
You will also learn what molluscum contagiosum lesions looks like (size, color, and shape), where on the body they tend to appear, and how they compares to several lesions caused by other conditions:
- Herpes
- Syphilis
- Warts
- Folliculitis
- Sebaceous cyst
Finally, information about treatment is provided.
Facts about Molluscum Contagiosum
Molluscum contagiosum is a widespread skin condition that affects up to 8% of the world’s population. It is a viral infection commonly found in people from tropical and/or low-income countries. It is caused by the pox virus.1, 2
How molluscum contagiosum is transmitted
The pox virus can be transmitted in the following ways:3, 4
- Skin-to-skin contact (touching the skin or molluscum contagiosum lesion of an infected person)
- Autoinoculation (touching your own molluscum contagiosum lesion and then touching another part of your body, including the face, spreading the disease)
- Sexual contact (one of the most common routes in adults)
- Infected objects (toy, towel, sponge, clothes)
- Swimming pools, baths, and saunas (more research is needed to prove that transmission is possible this way)
Who is at risk of getting molluscum contagiosum
Anyone can get molluscum contagiosum. However, some people are at higher risk:5
- Children ages 1–10 (up to 17% of children are infected)
- People who are immunosuppressed, such as people with HIV (up to 18% of people with HIV are infected); these people have a more severe manifestation of the disease and it is harder to treat
- Residents of regions where the climate is warm and humid
- People with a skin condition called atopic dermatitis
The incubation period
Molluscum contagiosum’s incubation period (the time between being infected and developing the first disease-related symptoms) is usually between two weeks and six months.
The health consequences of molluscum contagiosum
Fortunately, molluscum contagiosum is a benign condition. It usually does not cause any serious complications. However, when treated inappropriately (by scraping it yourself, for example), scars and post-lesion marks may develop (see photo below). Also, molluscum contagiosum lesions may cause stress and social adaptation problems.2, 6
Image source: https://dermnetnz.org/topics/molluscum-contagiosum/
Recognizing molluscum contagiosum
Molluscum contagiosum leads to the development of a local infection characterized by the appearance of superficial lesions (mollusca). Details about these lesions are discussed below.
What molluscum contagiosum lesions look like
The characteristics of molluscum contagiosum lesions (growths) are summarized in the table below. 7, 8, 9, 10
| Characteristic | Description |
|---|---|
| Size | 2-5 mm (may grow up to 6 mm) |
| Color | Flesh-colored, whitish or pink |
| Shape |
|
Where the lesions appear
Molluscum contagiosum lesions can appear almost anywhere. However, they are more common on certain parts of the body:7
- Trunk (torso)
- Underarm region
- Behind the knee
- Skin of genitals
- Inner thighs
- Lower abdomen
- Neck
- Face
- Legs
The lesions may also appear on the palms of the hands and the feet. However, the likelihood of their appearing on the feet is extremely low.10
In most cases, the lesions are located near each other.9
The number of lesions that commonly appear
Most infected people have fewer than 20 molluscum contagiosum lesions. However, immunosuppressed people may have hundreds.9
What molluscum contagiosum lesions feel like and look like
The lesions may be:10
- Itchy
- Inflamed
- Swollen
Also, an infected person may notice a wax-like substance coming out of the lesion when it is squeezed.9
Comparison of Molluscum Contagiosum with other conditions
Several conditions lead to the development of superficial lesions and similar skin disorders. The information in the table below will help you distinguish molluscum contagiosum from similar conditions.
Image source: Bray, D., 2011
Molluscus Contagiosum
- Flesh-colored, whitish or pink
- Pearly dome-shaped growth
- Dimpled center
- Looks like a tiny pimple
- Smooth surface
- Usually patients do not experience any other symptoms
Image source: Herpes Zoster.MedicineNet
Herpes Simplex Virus
- Unlike with molluscum contagiosum, the lesions are located next to each other (there is scaling of the lesions)
- The lesions are painful and itchy (this may not be true of molluscum contagiosum lesions)
- Unlike molluscum contagiosum, the new lesions continuously develop over 3–5 days
- Unlike with molluscum contagiosum, patients may experience overall weakness and have fever and enlarged lymph nodes
- There is no dimple in the center of the lesion as there is with molluscum contagiosum
- Unlike with molluscum contagiosum, there is local redness and swelling around herpes lesions
Image source: Molluscum contagiosum. Source: Healthline
Molluscus Contagiosum
- Flesh-colored, whitish or pink
- Pearly dome-shaped growth
- Dimpled center
- Looks like a tiny pimple
- Smooth surface
- Usually patients do not experience any other symptoms
Image source: Lamb CA, Lamb EIM, Mansfield JC, Sankar KN. Sexually transmitted infections manifesting as proctitis.
Syphilis
- Unlike molluscum contagiosum lesions, syphilis lesions have a rough surface
- Unlike molluscum contagiosum lesions, syphilis lesions are red or brownish
- Unlike molluscum contagiosum lesions, syphilis lesions commonly occur on the palms of the hands and the feet
- Syphilis lesions are painless (molluscum contagiosum lesions may be painful)
- Syphilis patients usually have other symptoms, such as overall weakness, enlarged lymph nodes, headache, and weight loss (with molluscum contagiosum, other symptoms are usually absent)
Image source: https://www.triage.com/health/en/patient/molluscum-contagiosum/photos
Molluscus Contagiosum
- Flesh-colored, whitish or pink
- Pearly dome-shaped growth
- Dimpled center
- Looks like a tiny pimple
- Smooth surface
- Usually patients do not experience any other symptoms
Image source: Molluscum Contagiosum and Warts | American Family Physician
Warts
- Unlike molluscum contagiosum lesions, warts do not have a smooth surface
- Unlike molluscum contagiosum lesions, warts may have black dots on their surface (these are blood vessels)
- Unlike molluscum contagiosum lesions, there is no dimple in the center of a wart
- Like molluscum contagiosum lesions, warts are flesh-colored, whitish, or pink
Image source: https://www.triage.com/health/en/patient/molluscum-contagiosum/photos
Molluscus Contagiosum
- Flesh-colored, whitish or pink
- Pearly dome-shaped growth
- Dimpled center
- Looks like a tiny pimple
- Smooth surface
- Usually patients do not experience any other symptoms
Image source: Da pacem Domine, 2017
Folliculitis
- As with molluscum contagiosum, there may be multiple pimples
- Unlike molluscum contagiosum lesions, folliculitis pimples are filled with pus
- Folliculitis pimples are painful and swollen (this may not be true of molluscum contagiosum lesions)
- Unlike with molluscum contagiosum, the surrounding skin is red and inflamed
- Unlike with molluscum contagiosum, patients may have mild fever
- Unlike with molluscum contagiosum, there is local tenderness and burning
- Unlike molluscum contagiosum lesions, there is no dimple in on the center of a folliculitis lesion
Image source: How is molluscum contagiosum infection transmitted?- Medscape.
Molluscus Contagiosum
- Flesh-colored, whitish or pink
- Pearly dome-shaped growth
- Dimpled center
- Looks like a tiny pimple
- Smooth surface
- Usually patients do not experience any other symptoms
Image source: Sebaceous Cyst Images, Stock Photos & Vectors | Shutterstock
Sebaceous cyst
- Unlike a molluscum contagiosum lesion (which is smaller than 6 mm), the diameter of a sebaceous cyst exceeds 5 cm
- Unlike with molluscum contagiosum lesions, the area is inflamed (the cyst is red and painful)
- Unlike a molluscum contagiosum lesion, there is pus inside a cyst
- Unlike a molluscum contagiosum lesion, a cyst is movable
- Like a molluscum contagiosum lesion, a cyst has a smooth surface
- Unlike a molluscum contagiosum lesion, there is no dimple in the center of a cyst
Treating molluscum contagiosum
When you should see a doctor
If you find an unexpected lesion, you need to see a doctor to be diagnosed and treated. 9
Why treatment of molluscum contagiosum is recommended
Molluscum contagiosum lesions usually disappear without any treatment. However, this process takes 6–12 months (and sometimes up to four years). So, patients who want prompt recovery should get treatment. Treatment is also recommended for people who have molluscum contagiosum lesions in the genital area.11
Treatment options for molluscum contagiosum
There are two main treatment strategies for molluscum contagiosum. They’re listed below with their advantages and disadvantages.7, 11
| Treatment option | Description | Advantages | Disadvantages |
|---|---|---|---|
Physical removal |
|
|
|
Topical therapy |
|
|
|
Patients with suppressed immunity will not benefit from these treatment options. The optimal treatment strategy for them is known to be an immunity-boosting therapy.11
Conclusion
Even though molluscum contagiosum does not cause serious complications, infected persons may suffer from psychosocial and aesthetic (appearance) issues. And people with molluscum contagiosum lesions can transmit the infection to other people through sexual contact or other direct skin-to-skin contact. Therefore, it is recommended that anyone who notices an unusual lesion promptly see their doctor to prevent further transmission and unpleasant aesthetic complications.
References
1. Evidence and recommendations on molluscum contagiosum - Guidelines on the Treatment of Skin and Oral HIV-Associated Conditions in Children and Adults - NCBI
2. Molluscum contagiosum. NCBI
3. Transmission | Molluscum Contagiosum | Pox viruses | CDC.
4. Molluscum contagiosum - NHS..
5. Risk Factors| Molluscum Contagiosum | Pox viruses | CDC.
6. Long Term Effects | Molluscum Contagiosum | Pox viruses | CDC.
7. Molluscum contagiosum - UpToDate.
8. Patient education: Molluscum contagiosum (Beyond the Basics) - UpToDate.
9. Molluscum Contagiosum - Harvard Health.
10. Molluscum Contagiosum | Poxvirus | CDC.
11. Treatment Options | Molluscum Contagiosum | Pox viruses | CDC.
