7 Key Molluscum Contagiosum Symptoms You Should Know

Molluscum contagiosum is a common viral skin infection that primarily affects children, though it can occur in adults as well. Caused by the molluscum contagiosum virus (MCV), this condition is characterized by distinctive skin lesions that appear on various parts of the body. While generally harmless and self-limiting, understanding the symptoms of molluscum contagiosum is crucial for early identification and proper management. This comprehensive guide will walk you through the key symptoms, causes, and preventive measures to help you recognize and deal with this contagious condition.

1. Small, Raised Bumps on the Skin

The hallmark symptom of molluscum contagiosum is the appearance of small, raised bumps on the skin surface. These lesions typically measure between 2-5 millimeters in diameter, though they can occasionally grow larger.

Characteristics of these bumps include:

• Dome-shaped or rounded appearance
• Firm to the touch
• Flesh-colored, white, pink, or pearly in appearance
• Smooth, shiny surface
• Can appear individually or in clusters

In the beginning stages of molluscum contagiosum, these bumps may be very small and easily overlooked. They gradually increase in size over several weeks. The bumps are painless in most cases, which is why many people don’t notice them immediately. The number of bumps can vary significantly from person to person, with some individuals developing just a few lesions while others may have dozens or even hundreds scattered across their body.

2. Central Dimple or Indentation

One of the most distinctive and diagnostic features of molluscum contagiosum lesions is the presence of a small dimple or indentation in the center of each bump. This central depression is called an “umbilication” and is a key identifying characteristic that helps distinguish molluscum from other skin conditions.

Important details about the central dimple:

• Appears as a tiny pit or crater in the middle of the bump
• May not be visible in very early or very small lesions
• Becomes more apparent as the bump matures
• Can sometimes contain a white, waxy, or cheesy core material

This umbilicated appearance is so characteristic of molluscum contagiosum that healthcare providers often use it as a primary diagnostic criterion. When examining suspicious skin lesions, the presence of this central dimple strongly suggests molluscum contagiosum rather than warts, acne, or other skin conditions. In some cases, gentle pressure on the lesion may cause a small amount of white, cottage cheese-like material to be expressed from the central core.

3. Specific Distribution Patterns on the Body

Molluscum contagiosum bumps tend to appear in specific areas of the body, and the distribution pattern often varies depending on the age of the affected person and how the infection was transmitted.

Common locations in children:

• Face (especially around the eyelids and cheeks)
• Neck
• Arms and hands
• Trunk (chest and abdomen)
• Legs

Common locations in adults:

• Genital area
• Inner thighs
• Lower abdomen
• Buttocks

In children, the infection typically spreads through casual contact during play, sports, or shared items like towels. Therefore, lesions often appear on exposed skin areas that come into contact with other children or contaminated surfaces. In adults, molluscum contagiosum can be transmitted through sexual contact, which explains why the bumps frequently appear in the genital region and surrounding areas. However, it’s important to note that lesions can appear anywhere on the body except the palms of the hands and soles of the feet, which seem to be resistant to this infection.

4. Itching and Irritation

While molluscum contagiosum lesions are typically painless, itching and irritation are common symptoms that many patients experience. The degree of itchiness can vary considerably from person to person.

Key points about itching:

• Not everyone with molluscum experiences itching
• Itchiness may be mild to moderate
• Scratching can spread the virus to other parts of the body
• May worsen if the area becomes irritated or inflamed
• Children are more likely to scratch, increasing spread

The itching sensation associated with molluscum contagiosum can be problematic because scratching the lesions can cause several complications. First, it can lead to autoinoculation, where the virus spreads from one area of the body to another through contaminated fingers. Second, scratching can damage the skin barrier, potentially leading to secondary bacterial infections. Third, it can cause inflammation and redness around the lesions, making them more noticeable and uncomfortable. For these reasons, it’s important to avoid scratching the bumps, though this can be particularly challenging for young children who may not understand the importance of leaving the lesions alone.

5. Inflammation and Redness Around Lesions

As the body’s immune system recognizes and begins to fight the molluscum contagiosum virus, inflammation can develop around the lesions. This inflammatory response is actually a positive sign that the body is working to clear the infection.

Signs of inflammation include:

• Redness surrounding the bumps
• Swelling of the affected area
• Warmth to the touch
• Increased tenderness
• Formation of a red halo or ring around each lesion

This inflammatory phase, sometimes called “BOTE” (Beginning of the End), often occurs before the lesions resolve and disappear. The development of redness and inflammation typically indicates that the immune system has mounted an effective response against the virus, and the bumps may clear within a few weeks after these signs appear. However, it’s important to distinguish between normal inflammation as part of the healing process and secondary bacterial infection. If the area becomes extremely painful, develops pus, or if you notice spreading redness, fever, or other signs of infection, medical evaluation is necessary to rule out bacterial superinfection that may require specific treatment.

6. Clustering or Linear Arrangement of Bumps

Molluscum contagiosum lesions often appear in distinctive patterns that can help with diagnosis and provide clues about how the infection spread.

Common patterns include:

• Clusters of bumps grouped closely together
• Linear arrangements following scratch lines (Koebner phenomenon)
• Multiple bumps in a localized area
• New bumps appearing near existing ones

The clustering pattern occurs because the virus spreads easily through direct contact. When an infected lesion is touched or scratched, the virus can be transferred to nearby skin, causing new bumps to form in the surrounding area. The linear pattern, known as the Koebner phenomenon, happens when the skin is traumatized through scratching, and the virus seeds along the scratch line, creating a row of lesions. This is particularly common in children who scratch itchy lesions or in areas where skin rubs against clothing or other skin surfaces. Understanding these distribution patterns can help you identify potential spread and take measures to prevent further autoinoculation. It also helps healthcare providers confirm the diagnosis, as this clustering pattern is quite characteristic of molluscum contagiosum.

7. Prolonged Presence Without Symptoms

One notable characteristic of molluscum contagiosum is that the lesions can persist for an extended period, often without causing significant discomfort or other symptoms beyond their visible appearance.

Timeline characteristics:

• Individual lesions typically last 2-4 months
• Complete resolution usually occurs within 6-12 months
• Some cases can persist for 2-4 years
• New lesions may continue to appear as old ones resolve
• No systemic symptoms (fever, fatigue) typically occur

Unlike many viral infections that cause fever, fatigue, or other systemic symptoms, molluscum contagiosum is usually confined to the skin. Most people feel completely well and healthy despite having visible bumps. The infection runs its course as the immune system gradually recognizes and eliminates the virus. During this time, the total number of lesions may wax and wane, with new bumps appearing even as older ones fade. This prolonged, asymptomatic nature of the infection means that many people, especially children, can participate in normal activities without feeling sick. However, the visible nature of the lesions and their contagious potential can cause social concerns and may require lifestyle modifications to prevent spread to others.

Main Causes of Molluscum Contagiosum

Understanding what causes molluscum contagiosum can help you take appropriate preventive measures and reduce the risk of transmission.

The molluscum contagiosum virus (MCV):

Molluscum contagiosum is caused by a virus belonging to the poxvirus family. There are four types of MCV, with MCV-1 being the most common. The virus infects only humans and spreads through various routes.

Primary transmission methods:

• Direct skin-to-skin contact: The most common way the virus spreads, particularly among children during play, sports, or physical contact
• Contact with contaminated objects: Towels, clothing, toys, sports equipment, and other items can harbor the virus and transmit it to new hosts
• Sexual transmission: In adults, the infection can spread through intimate contact, making it sometimes classified as a sexually transmitted infection when it affects the genital area
• Autoinoculation: Scratching or touching existing lesions and then touching other parts of the body can spread the virus to new areas
• Water-related transmission: Sharing swimming pools, baths, or water sports equipment can facilitate spread, though chlorinated pool water itself doesn’t efficiently transmit the virus

Risk factors that increase susceptibility:

• Age: Children between 1-10 years old are most commonly affected
• Weakened immune system: People with HIV/AIDS, cancer, or taking immunosuppressive medications are more vulnerable
• Atopic dermatitis or eczema: Compromised skin barrier increases infection risk
• Warm, humid climates: The virus thrives in these conditions
• Crowded living conditions: Increased person-to-person contact facilitates spread
• Participation in contact sports: Wrestling, swimming, and other sports increase exposure risk

Prevention Strategies

While molluscum contagiosum is highly contagious, there are several effective strategies to reduce the risk of infection and prevent its spread to others.

Personal hygiene measures:

• Wash hands frequently and thoroughly with soap and water
• Avoid touching, scratching, or picking at existing lesions
• Keep fingernails short and clean to minimize trauma if scratching occurs
• Cover lesions with waterproof bandages, especially before swimming or sports activities
• Avoid sharing personal items like towels, washcloths, clothing, or razors
• Take showers instead of baths to reduce the risk of spreading the virus to other body areas

Environmental and social precautions:

• Clean and disinfect toys, sports equipment, and surfaces that may be contaminated
• Avoid sharing exercise equipment or use protective barriers
• Use individual towels and ensure they are washed in hot water after each use
• Consider avoiding public swimming pools or communal bathing areas until lesions have resolved
• If participating in contact sports, cover lesions adequately and inform coaches about the condition

For those already infected:

• Avoid scratching or shaving over affected areas, as this can spread the virus
• Keep the skin clean and dry
• Consider covering lesions with clothing or bandages in social situations
• Inform close contacts, especially in household or childcare settings
• Avoid sexual contact if lesions are in the genital area until they have been evaluated by a healthcare provider

Special considerations for children:

• Teach children not to pick or scratch bumps
• Monitor playmates and siblings for signs of infection
• Inform daycare or school personnel about the condition
• Keep affected children’s personal items separate from those of siblings
• Consider keeping affected skin covered during play dates or group activities

For immunocompromised individuals:

People with weakened immune systems should take extra precautions, as they may develop more extensive or persistent infections. Close monitoring and early consultation with healthcare providers is recommended if exposure occurs or symptoms develop.

Frequently Asked Questions

Is molluscum contagiosum dangerous?

No, molluscum contagiosum is generally not dangerous. It’s a benign, self-limiting viral infection that typically resolves on its own without causing serious complications. However, it can be more persistent and widespread in people with weakened immune systems.

How long is molluscum contagiosum contagious?

Molluscum contagiosum remains contagious as long as the bumps are present on the skin. The virus can spread from the time lesions first appear until they completely resolve, which may take anywhere from several months to a few years. Once all lesions have cleared, the infection is no longer contagious.

Can adults get molluscum contagiosum?

Yes, adults can get molluscum contagiosum, though it’s less common than in children. In adults, the infection is often transmitted through sexual contact and may appear in the genital area. Adults with weakened immune systems are also at increased risk.

How can I tell the difference between molluscum and warts?

The key distinguishing feature is the central dimple or umbilication that molluscum bumps have, which warts typically lack. Molluscum lesions are usually dome-shaped and smooth, while warts tend to have a rougher, cauliflower-like surface. A healthcare provider can definitively diagnose the condition.

Should I pop or squeeze molluscum bumps?

No, you should not pop or squeeze molluscum bumps. This can spread the virus to other parts of your body or to other people, cause scarring, lead to secondary bacterial infection, and result in inflammation. Let the lesions resolve naturally or consult a healthcare provider for appropriate management options.

Can I go swimming with molluscum contagiosum?

While the chlorine in pools doesn’t efficiently transmit the virus, molluscum can spread through shared towels, kickboards, and other pool equipment, or through skin-to-skin contact. It’s advisable to cover lesions with waterproof bandages and avoid sharing equipment. Some public pools may have policies about skin infections, so check beforehand.

Do I need to see a doctor for molluscum contagiosum?

While molluscum contagiosum often resolves without treatment, you should consult a healthcare provider if you’re unsure about the diagnosis, if lesions appear on the face or genital area, if you have a weakened immune system, if signs of secondary infection develop, or if the condition causes significant cosmetic concerns or emotional distress.

Will molluscum contagiosum leave scars?

When left alone to heal naturally, molluscum contagiosum typically doesn’t cause scarring. However, picking, scratching, or squeezing the lesions can lead to scarring. Some treatment methods may also have a higher risk of scarring. Protecting lesions from trauma gives the best cosmetic outcome.

Can you get molluscum contagiosum more than once?

Yes, it’s possible to get molluscum contagiosum more than once. While infection may provide some immunity, it’s not complete or permanent. Reinfection can occur, especially with exposure to different strains of the virus or in individuals with compromised immune systems.

Is molluscum contagiosum related to mollusk animals?

No, despite the similar name, molluscum contagiosum has no connection to mollusks (shellfish, snails, etc.). The name comes from the Latin word “molluscus,” meaning soft, which refers to the soft appearance of the skin lesions, not to the marine animals.

References:

• Mayo Clinic – Molluscum Contagiosum
• Centers for Disease Control and Prevention – Molluscum Contagiosum
• American Academy of Dermatology – Molluscum Contagiosum
• NHS – Molluscum Contagiosum
• DermNet NZ – Molluscum Contagiosum