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Molluscum vs Warts: What’s The Difference?


Dr Ryan Goerig





The main difference between molluscum and warts is that they are caused by completely different viruses that cause very different skin bumps.

Molluscum contagiosum and warts are both common skin infections in children, but they are caused by distinct viruses and have different clinical features and natural histories. There are many other key differences that people should know, and you should keep reading if you want to know more in-depth information.


This is what a wart looks like:


wart on skin

This is what molluscum bumps on skin look like:



Keep in mind molluscum bumps may look slightly different depending on the stage of molluscum you are currently in.

Infection similarities and differences:


There are many similarities and differences in how people get infected with warts and molluscum.


Here is a consolidated list of key differences and similarities:


  • Both warts and molluscum are viral infections.

  • Warts are caused by HPV (human papillomavirus), while molluscum is caused by Pox viruses.

  • Molluscum primarily affects children aged 1 to 7, while HPV usually infects children from 4 to 16.

  • Both infections can be transmitted through direct skin-to-skin contact.

  • Molluscum is highly contagious and spreads easily between individuals, especially siblings and classmates.

  • Warts tend to be less contagious than molluscum and don't spread well in water or baths.

  • Molluscum can live on inanimate objects (fomites) like bath loofas, soap, towels, clothing, and sporting equipment.

  • Molluscum can also spread in swimming pools and baths, while warts typically don't.

  • Both infections can cause itching and sometimes a rash around the affected area.

  • Molluscum bumps can come and go for many years, while individual wart bumps can last for years or even decades.

  • Molluscum bumps usually don't scar unless scratched, while warts rarely go away on their own but may sometimes disappear.

  • Once the molluscum bumps are cleared, the person is no longer contagious, but re-infection is possible. Latent HPV can also exist without producing a visible wart.

  • Molluscum can cause autoinoculation, where scratching can transfer the virus to other areas of the skin.


Here is additional info for further education:

Molluscum contagiosum is caused by a group of viruses called Pox viruses. Molluscum primarily infects younger children (ages 1 to 7) and is highly contagious. Molluscum bumps usually show up a month or two after contact with an infected person.

The typical course of infection are bumps coming and going, often for many years (up to 5 years in some cases). The bumps usually don’t scar unless they are scratched or manipulated in some way, although it’s possible for them to scar on their own (similar to acne).

In some cases, a red rash can form around the bumps and cause the person to scratch the areas, which then can transfer the virus to other areas of the skin. This is called autoinoculation. It is very common with kids that contract molluscum. Molluscum notoriously spreads “like wildfire” between people, especially siblings and classmates.

It is not uncommon for a child to show up with molluscum at school or day-care and, within about a month or two, the entire class will be infected. Molluscum is well known to live outside of humans for days to weeks on end. The inanimate objects, called fomites, that molluscum likes are bath loofas, bars of soap, towels, clothing, and sporting equipment.

Molluscum is also known to spread in swimming pools and baths. Itching is common in the areas of the molluscum bumps and sometimes even a rash can form around the bumps.

For molluscum, once the bumps are cleared from the skin, the person is no longer contagious. In some cases, people can get re-infected if contact from an infected person is made. The molluscum virus does not live in the body or bloodstream after the bumps are gone and will not re-activate unless a person contacts another infected person or object.

Warts are caused by a virus called HPV (human papillomavirus). There are over 70 different strains of HPV that infect humans. HPV usually infects children from the ages of 4 to 16. HPV is not as contagious as molluscum, although a person can transmit the virus to another person through skin to skin contact. Children who bite or chew the warts on their fingers can get wart bumps around the mouth.


Typically, the HPV virus does not live on inanimate objects, such as towels, bath loofas and sporting equipment. The time between touching someone with a wart to the time a wart appears on the skin is 2-6 months, which is longer than in molluscum.

Warts tend to be less contagious than molluscum and don’t spread very well in water or baths. It takes direct skin to skin contact to spread a wart from one person to another. Sometimes warts can live on the skin without producing a bump. This is called “latent HPV” and is common with HPV infections.

Individual wart bumps can last for years and even decades, especially on the palms and soles. They rarely go away on their own, but it can happen.

Physical appearance similarities and differences:


Molluscum bumps look much different than warts. Molluscum bumps are pink and dome-shaped, often with a central indentation. They are between the size of a pinhead to the size of a pencil eraser (1/4 inch).


The bumps are usually clustered together on the neck, chest, abdomen, arms, legs, and underarm areas. They can even form in lines due to scratching.

This happens because a person scratches a bump and the molluscum virus gets under the fingernails. The person then scratches the unaffected skin in a linear pattern, spreading the virus in the process. That is why the bumps form in a line pattern.

Wart bumps usually show up on the fingers, hands, knees and elbows. The bumps are dry and crusty. They can form in clusters and can form one large wart. This is called a mosaic wart.

Flat warts are a type of wart that are typically quite small (1/16 inch in diameter). They tend to be skin colored or pink and can be numerous (10-30 little bumps). They are very common, especially on the cheeks and forehead of children. Sometimes they can be hard to see on the faces of children because they are so flat and small.


Treatment:


Warts and molluscum are sometimes treated similarly. Cryosurgery (also called cryotherapy or liquid nitrogen treatment) is a very common in-office treatment for both warts and molluscum.


Multiple treatments are required at an interval of 2-4 weeks between treatments.

Cryotherapy is painful, can cause scarring, and is only about 60% effective. Over-the-counter treatment for warts exists and is very popular. The products usually contain salicylic acid in them (for example, Compound W). This chemical exfoliates the skin and stimulates the local immune system, which causes the wart to fall off sometimes.

This treatment is very “hit or miss” in terms of clearing warts. Some studies have shown a 10-20% clearance rate while others show higher. Importantly, salicylic acid does not work on molluscum virus, only warts.

Treatment for molluscum involves cryotherapy or cutting the molluscum bumps in a doctor’s office, but this is usually not advised for small children because of the pain involved. Topical prescription creams usually are ineffective as well and they are not FDA approved. Most of the creams recommended are FDA approved for acne or genital warts and are used “off-label” to treat molluscum.


Frequently asked questions about treatment molluscum contagiosum at home:


How can you tell the difference between molluscum and warts?

Warts are typically on the fingers (especially around the fingernails), feet (especially the soles), elbows, and knees. Flat warts are a unique kind of wart that look pink and have a flat top appearance to each bump. They are very small and are hard to even see sometimes unless you look really hard for them.


Molluscum bumps are round and dome-shaped and have a center dimple in them. They are usually located on the chest, abdomen, crease of the arms and legs, and neck areas. They can also be irritated and reddish with a rash around them.

Know the stages of molluscum to know what the affected area should look like.

Does wart remover work on molluscum?


Wart remover contains high concentrations of salicylic acid which can cause a lot of irritation on children’s skin. This can result in a red, flaky rash that can be itchy and problematic for kids.

Wart remover barely works on warts and is, therefore, not effective in the treatment of molluscum bumps. In conclusion, wart remover is not recommended as a topical at-home treatment for molluscum contagiosum.

Is molluscum a form of warts?

Molluscum is not a form of wart. They are completely different viruses. In fact, molluscum is more closely related to chickenpox than to warts. Molluscum is caused by a virus called a Pox virus, whereas warts are caused by human papillomavirus (HPV).

Molluscum virus does not “turn into” a wart virus, and vice versa. However, it is possible to have both molluscum bumps and wart bumps on the skin at the same time in the same child. The bumps in these cases are typically in different locations on the body.

Does duct tape get rid of molluscum?

Duct tape has been attempted in the treatment of many skin conditions, including warts and molluscum bumps. Some people think it works, while others don’t think it makes a difference.


It’s hard to say. There are currently no high quality clinical studies addressing this, so it is impossible to make firm conclusions regarding the effectiveness of duct tape on molluscum bumps.

There are more effective home remedies for molluscum to use besides duct tape.


Why is molluscum called “water warts”?

Molluscum’s colloquial name is “water wart”. This moniker was given to it because molluscum bumps sort of look like warts on the skin and molluscum is spread easily in water (swimming pools and baths). When you put the two observations together the name “water wart” was born.

Is molluscum a form of HPV?

No. Molluscum contagiosum is caused by a virus called a Pox virus. Human papillomavirus, or HPV, is a distinct type of virus that causes warts on the skin as well as certain types of cancer (such as throat and uterine cancer). They are not related in any way. The only similarity is that both viruses, Pox and HPV, cause bumps to form on the skin in children.









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