Molluscum contagiosum virus (MCV) is a poxvirus that causes a chronic (long-lasting), localized (limited to certain areas of skin) infection, consisting of skin-colored, dome-shaped papules (bumps) on the skin of an infected individual, usually children ages 2 to 8.
Molluscum contagiosum progresses through several stages that individuals should be aware of for a better understanding of the infection. Keep reading to explore the different stages and gain valuable insights into this common viral skin condition.
What does Molluscum look like in early stages?
Molluscum bumps usually form about 1-2 months after contact with an infected person or object, such as towels. An individual bump can last up to 12-18 months and can occur on any area of the skin except the palms of the hands and soles of the feet.
The most common areas on the skin for bumps to appear are on the sides of the neck, arms (especially on the inside of the elbow joint), chest, thighs and abdomen. Clustered bumps, where a group of bumps form in a small area, are common.
Facial bumps can occur as well. Molluscum bumps on a child look different in their early stages than it does in its later stages.
The natural history of molluscum bumps usually follows a pattern. At first, within the first month or two, the bumps are shiny, dome-shaped (not flat), pink or skin colored, and small . The size of them is about the size of a pin head or slightly larger. Most of the bumps have a central depression or indentation, this is called umbilication and is an early feature of molluscum bumps.
Sometimes, bumps can be in a “linear” pattern (see figure). A linear pattern is where multiple molluscum bumps (for example 5 or 6) form in a line-like distribution. This is usually caused by a person scratching the skin area containing the virus in a line-like manner, spreading the virus in the process.
What does Molluscum look like in mid stages?
Over time, they may become larger and inflamed. Inflamed molluscum contagiosum is characterized by redness and swelling of individual bumps.
Sometimes the redness and inflammation means a higher likelihood of impending improvement. For example, in a study of 696 children with molluscum contagiosum, children with inflamed bumps were less likely to develop an increase in the number of bumps over the course of three months than patients who didn’t have inflamed bumps. Inflamed molluscum should not be mistaken for a bacterial infection, as antibiotic treatment is not required or needed.
The next stage of molluscum bumps is the “core stage”. In this stage, the white, virus packed core of the molluscum bump tends to get pushed out.
This core forms within the upper layer of the skin called the epidermis. This pasty, white core is full of virus, so it is best not to touch it with bare hands (gloves are better). The core is not pus or a bacterial infection, so antibiotics are not necessary.
It is also important not to pick or manipulate these bumps because any disturbance of them (such as using tweezers, scratching, squeezing, or rubbing them) can result in spread of the virus to other areas of skin, including to other areas of normal (unaffected) skin surrounding the bumps.
Scratching the areas can result in a phenomena called autoinoculation. This means that a person who is infected with molluscum transfers and infects a different area of skin than the site of the original infection (bumps).
This is very common in molluscum infection and prolongs the length of the infection in children. Children with molluscum who do this frequently can have bumps popping up on different areas of the body for up to 5 years!
What does The Final Stage of Molluscum look like?
The last and final stage is the healing stage.
During this stage, the bumps are relatively flat, but there is some mild redness in the area where the bumps used to be. It is recommended to continue using Skin Bump Gone hydrogel patches for another 1-2 weeks after this stage is reached. This is important because there may be microscopic virus particles in the area where the bumps used to be and discontinuing the hydrogel patches too early may cause them to recur (come back).
Frequently Asked Questions about Molluscum Contagiosum Symptoms and Stages
What stage of molluscum is pus?
About 10% of molluscum bumps have pus in them at some point, usually in the later stages of the infection after a few months of being on the skin. The pus is not caused by a bacterial infection and is in fact sterile.
The pus is actually white blood cells fighting the virus and is a normal reaction to the virus from the child’s immune system. Kids with eczema typically have molluscum bumps that have more pus in them.
What does infected molluscum look like?
Molluscum bumps almost never become “infected” with a bacteria and therefore don’t need to be treated with oral or topical antibiotics. It is common for molluscum bumps to get inflamed, with areas becoming red, itchy, scabbed or “angry” looking. They can even develop pus in them, which forms from the white blood cells in the skin attacking the virus.
What can molluscum be confused with?
Molluscum can be confused with other common viral skin infections, such as warts and chicken pox. Warts are usually on the hands, feet, elbows and knees and are less shiny than molluscum bumps. Chicken pox is very itchy and is less common than molluscum, given that most kids get the vaccine nowadays.
Is molluscum scabies?
No, molluscum is not scabies. Molluscum is caused by a virus and is very common in children. Scabies is caused by a mite (which is a microscopic bug that is similar to a tick) and is much less common in children than molluscum.
Scabies in kids typically occurs when they are infants after being exposed by the mother during nursing. A scabies infestation causes intense itching and doesn’t form bumps on the skin like molluscum does. In general, molluscum bumps don’t itch or hurt.
What does the start of molluscum look like?
Molluscum bumps typically start out small, about 1/8 inch in diameter and gradually get slightly bigger over time. From the start, molluscum bumps are usually skin colored, smooth, shiny bumps on the arms, legs, face and underarms areas, although the chest, abdomen and back areas (ie: trunk) are most common. They can form in groups or clusters commonly or even with multiple bumps in a straight line. At the start, they are usually not red or have pus in them.
How do you know if molluscum is healing?
Molluscum bumps typically last at least a few months, but sometimes can remain for years. A healing molluscum bump can become tender, inflamed, crusted, red, or be purulent (pus). Sometimes (but not always), an itchy rash can form around the molluscum bump that can mean the infection is healing.
This is the body’s natural immune system finishing off the virus infection and usually means the bump is on track to go away. After the phase of being red or having pus, the bump flattens and becomes less visible. Sometimes a scar can form as well, especially in kids with more than 30 bumps total.
How long does the average molluscum infection last?
The average infection lasts about 6-9 months, but sometimes it can take up to 5 years for all the bumps to go away. This happens because the virus can spread from one area to another area of skin; this is called autoinoculation and is very common with molluscum. Treating the molluscum bump as soon as possible, before it starts spreading, is very important to minimize the overall duration of the infection.
What can be mistaken for molluscum contagiosum?
Molluscum bumps are harmless and easy to identify. In children, warts are the most common type of bump that is confused with molluscum bumps. Warts are typically dry and rough, not smooth and dome shaped. Warts are typically at different locations of the body than molluscum bumps. Molluscum typically occur on the neck, face, chest, abdomen and the inside parts of the elbows and knees. Warts are most common on the fingers (figure below), hands, feet and on the outside parts of the elbows and knees.
What is the longest molluscum can last?
Although individual bumps of molluscum can last up to 6-12 months, it can take up to 5 years for all the bumps to go away. This is because the bumps (and virus in the bumps) are continuously spreading to different areas of the skin by touching and rubbing the areas.
This virus is extremely contagious and just a minor scratch at a bump can result in millions of virus particles attaching to the fingers (and especially under the fingernails). If the hands are not thoroughly washed and the fingers touch another area of skin, new bumps will form within 2 months and the cycle starts all over again.
What do molluscum bumps look like?
Molluscum bumps are small, dome shaped or raised bumps on the skin of infected children. They are typically skin colored or light pink and about the size of a pin head up to the size of a pencil eraser.
They tend to grow on the skin of the neck, arms, legs, and trunk. They can also occur in groups or clusters on the skin where 6-12 bumps are in the same area and very close to each other.
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