| Treatment action | Topical/behavioral | Testing/Notes |
|---|---|---|
| Comfort measures, general care | Sitz bath, gentle cleansing, topical petrolatum, avoidance of irritants or tight clothing, application of cool gel packs | Molluscum is transmitted skin to skin or by auto-innoculation. Incubation averages 2-6 weeks. Diagnosis is usually made clinically. Immunocompetent patients may have spontaneous resolution (without treatment) within three months. Genital molluscum should be treated in sexually active women. Link to Molluscum Contagiosum in Atlas. |
| Reduction of pain | Topical xylocaine 5%, applied as needed, usually 4-6 times a day (no more than 15 grams a day) | |
| Mechanical removal of lesions | Curettage: Manually remove the lesions with a curette, pre-treating with EMLA (Lidocaine/Prilocaine) to numb the areas if necessary | Some feel this is the most effective, though time consuming, method. Clinician-only treatment. |
| Freezing of lesions | Cryotherapy: Liquid nitrogen applied to each lesion for 6-10 seconds to achieve a white frosted 1 mm border, every 1 to 2 weeks till lesions are gone, is usually effective. Pre-treat with EMLA (Lidocaine/Prilocaine) to numb the areas if necessary. | Most common treatment used in clinician offices. Pain associated with the procedure can be a problem, as can scarring afterward, including hypopigmentation in those with dark skin. The procedure is well tolerated by adults but may not be by children. Clinician-only treatment. |
| Medical treatment of lesions | Blistering agent: Topical cantharidin 0.7% (Cantharone, a blistering agent that must be compounded) is applied in a thin film to the lesions and dried. The lesions are taped for two to four hours, and then washed off. This is repeated as needed every 2 to 3 weeks.
Anti-mitotic podophyllotoxin: Podofilox 0.5% in a solution, gel or cream applied twice a day on three consecutive days in a week for up to four weeks. |
Using one drop can make a nasty blister. Erythema, burning pain, and pruritus may occur after treatment although the liquid is painless when first applied. Scarring may also occur. Clinician-only treatment.
May be self-applied by older adolescents or adults. Safety in children is not established. Erythema, burning pain and pruritus may occur after treatment. |
| Electrodesiccation of lesions | Light electrodesiccation with or without local anesthesia pre-treatment. | Clinician-only treatment. |
Updated 7/11/14 Link to Molluscum Contagiosum in Atlas.