What is Molloscum Contagiosum? Symptoms, Treatment, and Prevention

What is Molloscum Contagious?

If you’re anything like the majority of patients at The Pomegranate Institute, you’ve been blissfully unaware of molluscum contagiosum - even if you’ve had a comprehensive sexual health education.

Molloscum contagiosum is a temporary, pesky but not painful, very contagious skin disease caused by a double-stranded DNA poxvirus.

So why is a sex therapist in Massachusetts talking about these tiny little bumps? Because molloscum contagiosum can spread through sexual activity.

How is Molloscum Contagiosum Spread?

Molloscum contagiosum spreads through skin-to-skin contact with the affected area of another individual, or through touching contaminated objects like clothing, towels, razors, or toys. While transmission can be through sexual contact, non-sexual contact is much more common.   

In 2010 there were approximately 122 million diagnosed cases, mostly in children ages two to five. Sexually active teenagers and adults can also be impacted, and folks that are immuno-compromised are at greater risk. 

Since most people are unfamiliar with molloscum contagiosum, they may have it and not know it. Symptoms are not painful and generally go unnoticed or are mistaken for another skin condition. It can easily be mistaken for conditions like acne, ingrown hairs, keratosis pilaris (aka “strawberry skin”) or HSV. This means someone infected may be at risk of unwittingly spreading it to other people. 

In our practice, we often see the virus jump from children to adult members of their household (often by sharing towels) and then between adults during sex.

How is Molloscum Contagiosum Diagnosed

Molloscum contagiosum is not something that would show up in a regular STI panel. It’s diagnosed through physical exam, not through urine or blood tests. This is why it’s important to make sure that your routine screening includes a physical exam, and to be familiar with what your own genitals look like, so you are more likely to notice changes like small bumps that look slightly different from your normal bumps.

A provider evaluating for molloscum contagiosum will be looking for firm, white or flesh-colored, dome-shaped papules, a characteristic divot or dimple in the center may be visible. We’ll go ahead and let you google up close photos yourself, but most people with the condition are incredibly surprised to hear they have it, that’s how subtle the symptoms are.

A provider might use a technique called “dermoscopy” which involves looking at the skin with a special light and magnifying lens to help differentiate between suspected molloscum and other skin conditions.

How is Molloscum Contagiosum Treated?

Molloscum contagiosum generally resolves on its own in about six months, so sometimes treatment isn’t even recommended. But it is possible to “autoinoculate”, meaning spread the virus from an infected spot on your body to a non-infected spot on your body, especially if you’re having a hard time leaving the bumps alone. Sometimes covering the bumps with a waterproof bandage is enough to sufficiently reduce the risk of the bumps spreading.

There’s also a bunch of questionable home remedies out there, like applying apple cider vinegar or tea tree oil to the bumps, covering them with duct tape, “frosting” (applying a thick layer of lotion like cake frosting) the bumps, or applying retinol and a hydrocolloid patch. We don’t recommend any of these strategies because you risk irritating the skin and making it easier for the virus to spread.

If the bumps are located on or near the genitals, or somewhere a partner is likely to come in contact with during sex, your provider might recommend treating them with cryotherapy, which involves applying liquid nitrogen to the bumps for about 8 seconds. If you’re worried about hearing “liquid nitrogen” and “your vulva” in the same sentence, don’t worry, the sensation is a really localized to the bumps themselves and feels like the tips of your fingers or ears getting cold on a winter walk. It’s uncomfortable but not painful. Several rounds of treatment may be necessary to ensure all the bumps have been addressed, and new ones are not forming, so your provider will likely recommend several visits to check the progress of your treatment.

The molluscum contagiosum virus infects only the outermost cells in your epidermis (called keratinocytes). This means, that unlike other viruses, the molloscum contagiosum virus no longer exists within your body after your symptoms resolve.

When To See A Healthcare Provider?

If you think the virus was spread from sexual activity, your next steps are to get treatment and do what you can to stop the spread, just like you would with any other STI.  It’s important to notify current and recent partners, and make them aware that the virus can spread through non-sexual contact to other household members. Try not to turn it into a “whodunit”. With some very rare exceptions, it’s unlikely someone knowingly transmitted the virus to you. 

For most of our patients, the hardest part of having molloscum contagiosum is making changes to their sexual practices until everyone has received treatment and the virus has completely cleared.  This usually takes around 6 months, but cases can last longer due to the risk of auto-inoculation.

If you're feeling frustrated in the wake of a recent infection, or getting worried about the risk of one, reach out!  A sex therapist can help you navigate the stress. We love talking to the health-conscious and health-anxious folks of Massachusetts about their sexual health!