Genital Molluscum Contagiosum
Molluscum contagiosum is a common and generally harmless skin infection caused by a pox virus that gives rise to spots on skin. It is most common in children and young adults. The pox virus is spread by direct skin-to-skin contact with someone else or by shared items such as bedding or towels.
The spots usually appear a few weeks after infection and occur in people generally in good health. They may be more extensive in people with eczema or in people whose immune system is suppressed, such as immunosuppressant therapy or HIV.
The spots are usually asymptomatic but they can sometimes be itchy, bleed or become sore if scratched or traumatised. They vary in size from small (2-6 mm diameter) to large 10-20mm and, although they vary in number, are usually fewer than 20. They are skin coloured, raised and hemispherical with a central dimple. They commonly affect the face, chest, armpit, upper legs and genital area.
Molluscum contagiosum are usually diagnosed by clinical examination although a skin biopsy under local anaesthetic may be needed if there is uncertainty
The condition usually clears by itself within 6 to 18 months. However, during this time new spots may appear as the old spots are clearing.
Molluscum do not always need to be treated but, whilst spots are present, the pox virus can be spread to sexual partners. Most treatments are painful and can increase the risk of scarring the skin; factors that should be taken into account when deciding on treatment.
Topical therapies for non genital skin include salicyclic acid and potassium hydroxide. These work by irritating the spots and causing them to become inflamed. The immune system then detects the virus and is able to clear the spots. The medication needs to be applied carefully to prevent unnecessary skin irritation. Sometimes a small scar / pallor of the skin can occur after resolution.
Genital Molluscum can be individually frozen with liquid nitrogen (cryotherapy) without anaesthetic or removed with a sharp instrument (curettage) under local anaesthetic.
Squeezing or cutting the tops off Molluscum is not recommended as it can result in scarring and spreads the virus to others part of the skin.
To prevent infection to others, use your own towel, flannel, clothing and bedding.
Links:
https://www.nhs.uk/conditions/molluscum-contagiosum/
http://www.pcds.org.uk/clinical-guidance/molluscum-contagiosum