See also

Eczema

Key points

1. Molluscum contagiosum virus (molluscum) is a common, self-limiting, viral infection of the skin
2. Investigations are not required, and most children do not require treatment
3. Most cases resolve spontaneously within 6-9 months, but lesions can persist for more than a year. Exclusion from day care or school is not required
4. Eczema increases the risk of molluscum infection which in turn can exacerbate eczema in the surrounding skin. Optimise eczema management

Background

• Molluscum is a common viral infection of childhood
• Lesions can occur anywhere on the body except the palms and soles, and a child may develop a few or many lesions
• Molluscum is spread by direct skin-to-skin contact, fomites (eg towel) or auto-inoculation by scratching or touching a lesion
• Children with pre-existing eczema may have more extensive and longer lasting molluscum

Assessment

The diagnosis of molluscum is made clinically by characteristic appearance of the lesions

• Firm, pearly, dome-shaped papules with central umbilication (pit)
• Lesions are usually 1-3mm in diameter, but can grow to 1-2cm
• Lesions can occur anywhere on the body. The most common areas include the trunk, axillae, antecubital and popliteal fossae and groin. Autoinoculation is responsible for most anogenital lesions in children

Complications

• Eczema may develop in the surrounding skin. Recognition of molluscum can be difficult as eczema can obliterate the primary lesions, however a carefully taken history about the appearance of the initial lesions is usually diagnostic

        Images of typical molluscum*

Management

• Exclusion from day care or school is not required
  • Children with molluscum should not be isolated or restricted in their activities
• Avoid sharing towels and bathing together to reduce the risk of spread to siblings
• Complete resolution will happen when an immune response develops, which may take from 3 months to 3 years
• Treat associated eczema
• Lesions can become inflamed but antibiotic treatment is often not needed (consider antibiotics if purulent exudate, abscess or extending erythema)

Treatment of lesions

• Most children do not require treatment
• Treatment is considered if affecting quality of life or immunocompromised
  • Physical treatments such as cryotherapy or curettage are not routinely recommended for children and may cause scarring
  • Refer to specialist dermatology services for consideration of cantharidin treatment, a topical blistering agent which when used appropriately should not cause scarring

Consider consultation with local paediatric team when

• the diagnosis is uncertain
• severe eczema

Parent information sheet

Molluscum

Image sources*

Wikimedia Commons. Mollusca1klein. Retrieved from https://commons.wikimedia.org/wiki/File:Mollusca1klein.jpg (11 April 2025)

Wikimedia Commons. Molluscum contagiosum. Retrieved from https://commons.wikimedia.org/wiki/Category:Molluscum_contagiosum#/media/File:Molluscum_contagiosum.jpg (11 April 2025) 

Last updated March 2026