DGRefHelp - NHS Dumfries & Galloway
- Characteristic discrete pearly smooth lesions, often with an umbilicated centre.
- No need for laboratory confirmation.
- It can be associated with eczema.
Molluscum
Warning
What’s new
There are no changes to this guideline.
Introduction
- Molluscum contagiosum is a benign viral skin infection that is caused by the DNA pox virus.
- It affects both children and adults and spreads through close direct contact or contact with contaminated objects, e.g. towels.
- The incubation period can vary between 7 days and 6 months. Molluscum infection in immunocompromised states can be significantly more aggressive and widespread, presenting with 100 or more lesions in one individual and progressing as confluent, coalescing plaques.
- Offer STI testing if appropriate.
- Most lesions spontaneously regress/crust over in 3 to 9 months, although secondary bacterial infection can occur if lesions are scratched.
- Clients should be advised to avoid shaving/waxing or squeezing lesions as this increases the likelihood of autoinoculation and/or super-infection.
- Treatment is offered for cosmetic reasons only.
- In adults with facial lesions, consider HIV testing.
- In clients with immunodeficiency due to HIV infection, anti-retroviral therapy may assist in resolution of lesions.
Clients should not be offered treatment routinely, expectant management is recommended for immunocompetent.
Treatment options include:
- Podophyllotoxin cream 0.5% for men and non-pregnant women, or Imiquimod cream 5% for men and non-pregnant women.
- Cryotherapy with liquid nitrogen. The aim is tissue (viral) destruction. This is also suitable for pregnant women. Apply for 5 to 10 seconds. Repeat at weekly intervals as necessary (no evidence for this from trials).
Treatments for molluscum used elsewhere on the body (e.g., 5% potassium hydroxide) are not recommended for genital skin.
- No need for partner notification.
- No specific follow-up.
- Fernando I, K Edwards S, Grover D. British Association for Sexual Health and HIV national guideline for the management of Genital Molluscum in adults (2021). Int J STD AIDS. 2022 Apr 1;33(5):422–32. Available from: British Association for Sexual Health and HIV national guideline for the management of Genital Molluscum in adults (2021) (bashhguidelines.org)