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What Happens If Molluscum Contagiosum Is Left Untreated

Many ask what happens if molluscum contagiosum is left untreated, especially given its potential to spread and resolve on its own.  Because the growths are easily spread from one area of the skin to another, some growths may appear as others are going away.  It may take from 6 months up to 5 years for all of the molluscum to go away on their own.  


It is always possible for a child’s skin to get infected again with the molluscum virus.  The condition may be easier to control if treatment is started when there are only a few growths.  The fewer the growths, the better the chance for stopping the spread. 

The self-limited nature of molluscum contagiosum and the paucity of evidence that definitively supports therapeutic intervention have led to debate over the need for treatment.


Decision to treat — Potential advantages of successful treatment include limitation of lesion spread to other sites, reduction of the risk of transmission to others, resolution of itching when present, and the prevention of scarring that can result from lesions that become inflamed, traumatized, or secondarily infected. Treatment may also reduce patient or parental psychologic stress over the appearance of lesions. However, depending on the chosen therapy, treatment can be time consuming or can result in adverse effects such as pain, irritation, dyspigmentation (skin darkening or lightening), or scarring.


For healthy children with molluscum contagiosum, treatment is optional. One retrospective study utilizing a telephone survey and medical chart review found similar rates of molluscum contagiosum resolution among 46 treated and 124 untreated children; approximately 50 percent of children in both groups had complete resolution within 12 months.


It should be noted that with periocular lesions (bumps around the eye), the destructive methods and topical agents commonly used should not be utilized on lesions involving the ocular (eye) mucosa or eyelids. Patients with symptomatic ocular lesions should be referred to an ophthalmologist for management.


Strong evidence for the efficacy of any treatment for molluscum contagiosum is lacking. A systematic review of randomized trials that investigated the efficacy of treatments for non-genital molluscum contagiosum in healthy individuals found insufficient evidence to conclude that any one treatment was definitively effective."Exploring what happens if molluscum contagiosum is left untreated reveals that while many cases resolve spontaneously, untreated molluscum can spread and cause psychosocial discomfort.


In general, how are Molluscum treated?


Molluscum are treated in similar ways that warts are treated. They can be frozen with liquid nitrogen, destroyed with various acids or blistering solutions, treated with an electric needle (electrocautery), scraped off with a sharp instrument (curette), treated daily with a home application of retinoid cream or gel, treated with a topical immune modifier, or treated with a topical anti-viral medication.  Laser therapy has also been found to be effective in treating molluscum.  Discomfort is associated with freezing, scraping, the electric needle, and laser therapy.  Often these procedures are reserved for older children and adults and not for young children due to the pain.  If there are many growths, multiple treatment sessions may be needed every three to six weeks until the growths are gone.  It should be noted that if most bumps are treated, but not all, the child is still contagious.  It is also an option, especially with young children, not to treat, and to wait for the growths to go away on their own. However, the child will be contagious for as long as the bumps remain (up to 5 years).  High-quality data on the efficacy of treatments for molluscum contagiosum are limited and treatment for molluscum in children is optional since the molluscum will eventually heal on their own.  Reasons why molluscum may be treated include cosmetic concerns or to try to prevent the spread of infection to other body areas, siblings, or playmates.  No one treatment for molluscum has proven to be the "best." Therefore, treatment usually depends on where the growths are located, your preferences, and the preferences of your health care provider. Side effects of treatment can include pain, skin irritation, skin discoloration, and scarring. 


In conclusion, understanding what happens if molluscum contagiosum is left untreated helps parents and patients make informed decisions about whether to pursue treatment


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