Molluscum: What is it and how is it treated?
My 20-month-old daughter has been diagnosed with molluscum. Her daycare insists that it be gone before they will let her into the new center. She has had this for a whole year.Question:
Molluscum contagiosum commonly shortened to simply molluscum is a viral infection of the skin. It causes small bumps which crop up usually in the areas of the arms, legs, abdomen, and face. These bumps do not itch, and if you look carefully, there is often a dimple in the middle of each bump. It is a quite common infection in children.
Because it is a virus which causes these bumps, it can be transmitted much the same as other viruses, namely by touch as well as sharing of certain objects such as towels. However, the infectivity of this virus is relatively low. In other words, the likelihood of picking up this infection by touching the skin of someone who has it is not very high. It is quite similar to how common hand and foot warts are transmitted. We get warts on our hands by being infected with the virus from someone else. However, there are a good number of people with these warts with whom we shake hands on a daily basis, and yet, not everyone gets warts on their hands.
This skin infection is a more of a nuisance than anything, and does not cause any serious side effects. Most of the time, molluscum will go away on its own, but it may take a very long time. It is not uncommon for these bumps to stick around for months if not years before fading away. And because it is a virus, it is quite common for the skin adjacent to the infected area to also develop bumps. Therefore, more bumps usually crop up before it gets better.
There are a couple of strategies for treatment. Probably the most common one is simple watchful waiting. Because these bumps do not cause any future side effects, and they usually go away on their own, many doctors encourage non-intervention. However, there is a way to get rid of them. The most common method is to have the doctor remove them with an instrument called a curette. This is a small loop with a sharp edge to it. These bumps are embedded in the skin much like a rock is embedded in the dirt. Much like using a shovel to pop the rock out of the dirt, a curette can pop these bumps out of the skin. However, it is painful without something to numb the skin. Fortunately, there is a topical medication called EMLA cream that can be applied two hours before coming to the doctor which makes this procedure virtually painless.
It is my opinion the daycare is being completely unreasonable about not letting your child in. With careful cleaning of toys, changing tables, and washing hands (which they should be doing anyway) the risk of transmitting this virus to someone else is rather small. On the other hand, if you child has a lot of bumps particularly around the forearms and hands, this might make it a little more difficult to minimize transmitting the infection. I suggest you make a decision with your doctor as to what is best for your child when it comes to removal of these molluscum bumps. Many pediatricians will remove these, but if there are none near you, a dermatologist should be able to do this. If you decide not to have them removed, ask your doctor to discuss this issue with the daycare. A word from the doctor may be able to give you some leverage into having your child admitted. If you do decide to have them removed, keep in mind this is a virus that can transmit the infection to surrounding skin, so your child may need to have the procedure done a few times to remove any additional ones that come up after the initial removal.Answer: