Types of Molluscum

There are 2 types of the molluscum contagiosum virus (MCV) -

MCV type 1:

This is the most common version of the virus. Usually, it attacks children under the age of 15 years.

MCV type 2:

This type is sexually transmitted. It is common among adults.

Complications

Usually, this disease has minimal to no complications. However, a few complications may occur. These include:

• Bacterial infections
  Antibiotic treatment is necessary for bacterial infections.
• Scarring
  Sometimes, pale patches of skin or tiny scars are formed as a result of the lesions.
• Eye problems
  There is a possibility that derivative eye infections like conjunctivitis or keratitis could develop. Your eyes may become sensitive to light and sore. Therefore you should contact your doctor if you see boils or bumps around your eyes.

Causes of Molluscum

The molluscum contagiosum virus (MCV) causes Molluscum contagiosum. However, most people who do come in contact with the virus have immunity against it. Hence, they do not develop any growth. So people with a weakened immune system are more susceptible to molluscum contagiosum. The transmission of the virus is through direct contact. Therefore, it is ideal to wash your hands regularly, keep the infected area covered and not share personal items.

Risk factors:

• Direct contact with contaminated objects like infected towels and handkerchiefs.
• Having a weak immune system. For example, an HIV infected patient or someone who has undergone radiation or chemotherapy.
• Sexual contact with an infected person.
• Playing contact sports like basketball, wrestling and football.
• Taking certain medications to treat autoimmune disorders.
• Crowded work, play and living conditions.
• Having atopic dermatitis (eczema).
• Taking corticosteroids that suppress the immune system.
• Taking medicines to aid organ transplants.

Genital lesions:

Molluscum contagiosum on the penis is not very different from MC of some other zones.

Appearance: Small, white-pink or skin colored bumps with a dimple. In certain cases, they may become red, risen and chafed.

Texture: Smooth and firm

Location: Ordinarily found on the pole of the penis

Size: Usually, the bumps are small, around 2-5 millimeters

If the bumps grow very large, do not have dimples and suddenly increase in number, one should get tested for HIV.

Recurrence:

The molluscum contagiosum virus does not lie dormant in your body like the herpes virus.

Since this infection goes away without treatment within a few months, most people tend to ignore it or take it lightly. However, if you get infected more than once, it should be a priority to meet a doctor. It could highlight underlying problems. In addition, this persistence can help you become aware of any concerns regarding your immune system.

Moreover, there is a possibility that you do not have molluscum contagiosum but another skin infection that looks like it. So, it is definitely worth a closer look if you notice a recurrence.

Diagnosis:

It can be diagnosed by its appearance itself. However, it is not only the lesion that decides the condition. The underlying cause is a contributory factor that provides the basis of doctors’ consultations and recommendations for investigations. Above all, molluscum contagiosum may be a reflection of immune disorders like HIV.
Moreover, molluscum contagiosum may be mistaken as other lesions, such as:

• Epidermal cysts
• Nevocellular nevi
• Sebaceous hyperplasias
• Kaposi sarcoma.

The other types are pseudocystic molluscum contagiosum, giant molluscum contagiosum, and molluscum contagiosum. The similarity between the other lesions is what results into frequent medical misdiagnosis.

In some cases, your doctor may recommend histologic or microscopic confirmation of molluscum contagiosum. In conclusion, due to the uncertain nature of the diagnosis, it is extremely important to get diagnosed by an expert for the right treatment.

Treatments

Generally, molluscum contagiosum lesions disappear without treatment.

However, you should get treated if, 

• The lesions are larger than 5 millimeters
• They are located on your face and neck
• You have a skin condition like atopic dermatitis 
• You have serious concerns about spreading the virus.

The following treatments are the most effective for molluscum contagiosum -

• Topical treatments:

Topicals are widely available in the form of creams, lotions, and ointments, however, their efficacy is subjective to the individual. Your dermatologist will probably prescribe you one based on your skin type and the way the infection presents. 

Your doctor applies these creams containing acids or chemicals to the bumps. They induce the top layer of skin that the virus infects to peel off. However, these need to be applied individually onto each lesion as their effect is therapeutic locally. 

Some of the topical treatments are:

• Tretinoin in the form of cream or lotion
• Trichloroacetic or bichloroacetic acid
• Acne medications that contain 5% benzoyl peroxide 
• Podophyllotoxin cream (0.5%) 
• Iodine and salicylic acid, potassium hydroxide, cantharidin, and imiquimod. 
• Medication used to remove warts may be helpful.

• Oral treatments:

Oral treatments are painless and easy. These facilitate the gradual removal of lesions. Furthermore, doctors prefer to treat children with oral medicines. This is because they find the topical or physical methods of treatment uncomfortable or upsetting. However, the facial mollusca lesions do not respond as well as the rest of the body’s lesions do. 

• Physical removal:

Physical removal is ideal for those individuals for whom the spots are affecting their self-esteem and quality of life. People with weakened immune defenses need to physically remove this condition. This is because it may take them years to clear it out otherwise. 

Some of the treatment methods are:

1. Cryotherapy: Your doctor freezes the bumps with liquid nitrogen. This kills the virus inside the spots and removes them. Cryotherapy requires several sessions before each spot clears completely. However, this does not work on bumps that are widespread or very big due to the pain and risk of spreading the virus to other parts of the body.
2. Curettage: In this treatment, your doctor uses a small tool to scrape the bump off the skin. Some doctors prefer removing the lesions, especially if they are fast-spreading. Once the bumps are gone, the virus cannot spread. However, this may cause scarring.
3. Laser therapy: Your doctor uses a laser to destroy the cells that make up each spot. However, this treatment requires multiple sessions for satisfactory results.

These treatments cannot guarantee that you will not get new lesions. This is because most treatments focus on individual spots. That is why it is best to get the treatment conducted regularly and under qualified supervision.