Molluscum Guide

Here’s what you need to know about these annoying, quickly spreading bumps that are taking over your child’s skin—and possibly your life. As a dermatology prescriber, I’ll walk you through the evidence-based options available, from at-home remedies to in-office treatments, so you can understand what works, what doesn’t, and what’s safe for your child.

Below, we’ll talk:

• Why Molluscum Spreads so Easily + How To Prevent Spread
• Which Treatments can Actually Speed Up Clearance
• At-Home Treatments You Can Start Now
• How to keep the rest of the family from catching it
• When to Schedule a Dermatology Appointment and What to Expect

What is Molluscum Contagiosum?

Molluscum contagiosum is a contagious skin infection, much like warts yet caused by a different virus, called the poxvirus. It leads to small, dome-shaped bumps that often have a central dimple. (To me, they look like little belly buttons)

• Molluscum spreads easily, especially in children or people with eczema
• Adults are less affected due to stronger immune responses
• Pediatricians often recommend a “wait and see” approach although the virus can take 6 to 18 months to resolve on its own
• There is currently no antiviral cream or pill that kills the molluscum virus. Treatments work by irritating the bump and triggering your body to attack the virus

Scheduling a dermatology appointment for professional treatment can help you get ahead of the spreading lesions if you feel like you’re being outnumbered!

Seek Dermatology Treatment if:

• Bumps are spreading or multiplying
• Bumps are in sensitive areas like around the lips, eyes, genital area
• Lesions are red, swollen, or draining
• You want to speed up healing or reduce the chance of scarring

How to Prevent Spread

Covering the lesions is one of the most important ways to prevent spreading.

The fluid inside the bump is contagious—if it opens or is scratched, it can spread to others or new areas on your own skin.

Pro tip from Sydney: Use a pimple patch medicated with retinol or salicylic acid to treat while you cover. The hydrocolloid bandage part do a pimple patch alone also helps heal these pesky bumps. There are pimple patches that cover a large cluster too- check out pimple patch options I use here.

DON'T

• Share bath water (or hot tubs)
• Share or reuse towels, razors, or clothing
• Pop the bumps
• Rewear a bathing suit before washing it in hot water
• Shave over, pick, or scratch the bumps
• Participate in skin-to-skin sports with uncovered lesions

DO

• Keep bumps covered to prevent spread by containing the virus-filled liquid core
• Cover with anything that works to prevent spread from scratching: tape, pimple patches, band-aids, gauze and paper tape, and whatever works!
• Use hydrocolloid waterproof bandages, especially during sports or swimming. Plus, some bandages can stay on skin for 1 week which is usually great to prevent spread.
• Wash hands after touching affected areas
• Use aquaphor (or thick emollient moisturizer), especially for those who have underlying dry skin or eczema. I prefer aqupahor spray to moisturize and soothe without touching bumps.
• Consider long pajamas and often onesies to protect spread from scratching the skin directly while sleeping (because if the liquid inside is drug across the skin, then voila, we have more molluscum babies)
• For adults with genital lesions, avoid sexual activity until they are completely resolved.
• Schedule a dermatology appointment to discuss treating lesions in sensitive areas like lips and eyelid skin

If you’re dealing with an infestation…

You’re thinking I can’t treat these individually- no worries! Here’s what to do- treat a few topcially at a time. Little by little you can conquer them. Both of these options- duct tape and pimple patches- work for large patches. I would also step up treatment with topical irritants (what we’ll talk about next) that can be applied at home or in-office or as a combination. Never hesitate to schedule a dermatology appointment.

Topical Treatment Options

If you’re doing all of the above and waving a white flag here’s how to step up treatment with topical irritants.

While results are variable and none are FDA-approved for molluscum specifically, many parents try OTC options like these in addition to keeping covered and preventing spread.

Therapies to treat molluscum operate on this same principle: controlled irritation to affected skin → trigger immune response → resolution.

Next up, I’ll walk you through some ways to treat with products you have around the house.

Pro Tip: Lesions often become red and peel (and might look worse) before clearing. The lesions are usually not as uncomfortable as they look.

At‑Home Treatments

Caution: these are worth a try but can cause irritation or rash on surround skin, which can lead to more itching and spreading of lesions and rash around those treated.

Topical retinoids (like adapalene or prescription tretinoin)

- Mildly irritate the skin to stimulate the immune system
- Use carefully on sensitive areas.
-Apply precisely with a toothpick (because retinoids treat a 2-3 mm beyond where applied so a dry ring around the lesion is common.)

Pimple Patches

- choose one medicated with retinol or any pimple patch since the hydrocolloid bandage alone will help cover and heal
- Compound W salicylic acid band-aid is marketed for warts but works well for molluscum too

Duct Tape Therapy

- Duct tape therapy is a simple at-home option that can trigger resolution.
- Covering just a few bumps can sometimes lead to the entire rash clearing in 2–3 months by activating the immune system (seattlechildrens.org).

Salicyic Acid Brush Products

- Salicylic acid brush products and even freezing spray can tackle molluscum with patience and consistency.

Zymaderm

- Iodine: Has antiseptic and potentially antiviral properties; may help dry out lesions.
- Silver nitrate: A caustic agent used in medical settings to chemically destroy tissue. Can irritate and desiccate lesions.
- Thuja occidentalis (arborvitae): A homeopathic ingredient sometimes included for its proposed immune-modulating effects, although evidence is limited.

MolluscumRx

- Contains botanical extracts (e.g., thuja, echinacea)
- Similar in philosophy to ZymaDerm, targeting immune activation through irritation

EmuaidMAX

- Claims broad-spectrum antimicrobial and anti-inflammatory action
- Contains colloidal silver, tea tree oil, and emu oil
- Evidence is anecdotal, but some use it for skin barrier repair while treating bumps

Tea Tree Oil (diluted) and other essential oils

- Has natural antiviral and anti-inflammatory properties
- May be too irritating for some; should be diluted with a carrier oil
- Evidence in molluscum is mixed but promising in small studies
- CAUTION: this is where I see the most reactions, especially with those in underlying eczema.

Apple Cider Vinegar

- DIY home remedy applied via cotton swab or bandage
- Acts as a mild acid to irritate bumps
- Can be too harsh for young children or sensitive areas

Heating Pad

Lastly, I want to mention an integrative treatment using a heating pad that I learned about at a dermatology conference from dermatologist, Ted Rosen, MD.

Though off-label, this heating pad treatment represents a non-invasive and evidence-based at-home treatment option from a small, Chinese research study.

• Apply a heating pad (111°F) for 30 minutes once a week, for 12 weeks. Based on the study, it can achieve complete clearance in both adults and children by the end of 12 weeks. 
• Make sure there's a thin layer of cloth or gauze between the pad and molluscum bumps or make sure it has a removable, washable cloth on the pad.
• Check that the maximum temperature on a heating pad before purchasing to guarantee it reaches the necessary 111°F. This sunbeam pad is the one I recommend.

In-Office Treatments

Expectation is everything- I explain that it will take at least 3 treatments every ~2 weeks. In-office treatments are still in the realm of irritating the lesions but are stronger than over-the-counter treatments.

Cantharidin (a painless blistering agent applied in-office) AKA Beetlejuice

- Must be rinsed off in a few hours and covered with a band-aid. A water blister can occur overnight that will pop on its own while covered by the band-aid.
- Children prefer this treatment although it’s more work on parents.

Cryotherapy (freezing)

- In my opinion this is the easiest and most effective but children don’t tolerate it well.
- For marketing purposes I call it the “Elsa” or “Mr. Freeze treatment” and sometimes let the patient pour out a little liquid nitrogen after to see the magic of it, but it’s not often that they’ll agree to it a second time.

Pro Tip: I especially recommend freezing with liquid nitrogen AKA cryotherapy for lesions in sensitive areas where we can apply with a cotton-tip applicator.

Wartpeel (Salicylic Acid and 5-FU in Remedium Vehicle) Prescription Topical

This is how I treated my son’s as an experiment to guide other parents. A MD-PA team in Iowa created this amazing topical that I offer for treatment if copays are high, it’s difficult to get into office every 2-3 weeks, or many others in the house are affected. (It’s techinically for warts and seborrheic keratoses)

-These ingredients are available to prescribe not as wartpeel but need to be applied ~4 nights weekly and are still not that effective so after becoming a mom I avoid giving parents homework!

Curettage (scooping out the bumps)

I don’t do this treatment because kids are wiggly, and it can easily lead to more spreading.

Zelsuvmi (berdazimer sodium)

Not widely used, but it is an FDA-approved (in 2024) prescription topical, especially for children 1 year of age and older with multiple lesions.

In the dermatology office we also treat underlying eczema aggressively to reduce viral spread through broken skin (I like to use non-steroid prescriptions to decrease itching). Plus, we can manage rashes and superficial infections, like impetigo, that can erupt from topical irritants. If this benign, contagious rash is affecting your mental health please know you are not alone- call your local dermatology office for support!

Key Takeaways:

• Molluscum is contagious and spreads through skin contact or shared items.
• The core of each bump contains the virus—avoid popping or scratching.
• There is no single cure; treatment works by irritating the lesion to prompt immune clearance.
• Covering the bumps is critical to stop the spread.
• Seek dermatology care if it’s spreading, persistent, in sensitive areas, or affecting quality of life.
• A combination of in-office treatments every 2-3 weeks and at-home treatments can help large clusters resolve best.

References:
1. Rosen T. Off-label therapeutics in adult and pediatric patients for the experienced and daring clinician. Presented at the 2022 Society of Dermatology Physician Assistants Conference; November 17-20, 2022; Miami, Florida.