Molluscum contagiosum is a pox virus that can be transmitted through:

• Close direct contact, including touching the skin of an infected person, which is particularly relevant in activities such as contact sports.
• Contact with contaminated objects belonging to the infected person, such as towels, flannels, and clothing.
• Sexual contact, including sexual intercourse.

Once infected, the virus can be spread to other areas of your own body. Engaging in activities like picking, scratching, or squeezing the lesions increases the risk of transmission, as the substance inside the spots is highly infectious and spreads easily.

It is important to note that Molluscum is not transmitted through sneezing or coughing, as the virus primarily resides on the skin rather than in respiratory secretions like common cold viruses.

Children often get infected due to sharing contaminated items of personal hygiene such as towels, whilst adults tend to get these lesions around the genitals due to intimate or sexual contact.

Some instances of transmission are suspected to occur in the settings of social activity such as swimming pools, sports venues and gymnasium.

However, it is difficult to be sure how and when the infection occurs in most cases.

• People with a partner who has Molluscum contagiosum
• Children between the ages of 1–10
• Those who live in a tropical climate
• People with weakened immune systems (such as those with HIV or cancer)
• Those with atopic dermatitis (eczema)
• People who participate in contact sports or swimming

Molluscum contagiosum is a contagious virus transmitted from person to person through close social contact, intimate sexual contact, and by sharing personal items such as towels that may be contaminated.

The virus spreads within the community through a combination of these mechanisms. For instance, an individual may contract the infection through intimate sexual contact and later inadvertently contaminate a towel that a family member then uses.

The infection can be transmitted to your partner through skin-to-skin contact or sexual activity. It is essential to refrain from picking or squeezing lesions on the body, as this can release a highly infectious substance that may easily transfer to a partner.

When Molluscum contagiosum lesions occur on the genitals, there is a risk of spreading the infection to sexual partners. While using a condom can help in preventing transmission, it may not entirely eliminate the risk if lesions are not completely covered.

Although Molluscum contagiosum can be transmitted through sexual contact, it is not generally considered a sexually transmitted infection due to its ability to spread via simple skin-to-skin contact with an infected individual.

Molluscum contagiosum can be diagnosed clinically in over 99% of cases. Your clinician will take a history, examine your skin, and will be able to provide a diagnosis without needing any additional investigations or tests.

It is important to know the history of the lesions, you may be asked if you remember how they started, how long they have been there, and if their appearance has changed over time. You may also be asked if you recall being in contact with anyone with similar skin changes. Your clinician might also ask you other questions about your lifestyle and habits to help assess your risk of having Molluscum contagiosum.

Please note, everything you share with us is confidential and will not be shared with the NHS or anyone else unless you wish for us to do so.

In certain situations, your clinician might diagnose your condition based solely on your medical history without a physical examination. In such instances, the clinician may request you to submit photographs of the lesions to facilitate the diagnosis.

Furthermore, magnification tools like a magnifying glass or dermatoscope may be employed for a more detailed view of the lesions. Examination after freezing can also enhance contrast, making it easier to identify the characteristic central punctum.

If there is uncertainty in diagnosis or concern about potential precancerous or cancerous changes in the skin, a skin biopsy may be recommended. This involves taking a sample of the abnormal skin under anesthesia, which is then sent to a laboratory for microscopic examination.

Molecular testing, specifically polymerase chain reaction (PCR), can also be utilised to identify the genetic material of the Molluscum contagiosum virus. While rarely employed in practice, it may be beneficial in cases where the diagnosis is unclear, and lesions could be caused by another infective agent such as Herpes simplex virus (HSV) or Human papillomavirus (HPV).

PCR testing can also help identify the specific type of molluscum virus present. MCV-1 is the most common type, responsible for the majority of cases in children. MCV-2 is primarily associated with skin lesions in individuals living with HIV. MCV-3 and MCV-4 are extremely rare. Some patients may have multiple virus types detectable in their lesions.

When someone gets infected with the Molluscum contagiosum virus (MCV), their body produces antibodies against the virus. Antibodies generally develop whether an individual gets any symptoms or not, and this antibody remains detectable in the blood for a long time.

MCV antibody testing is not routinely available.

Genital warts and Molluscum contagiosum stem from two very distinct viruses.

Genital warts are skin outgrowths triggered by specific strains of the human papillomavirus (HPV), particularly types 6 and 11, whereas Molluscum contagiosum is caused by the Molluscum contagiosum virus (MCV).

The appearance of genital warts is typically more 'cauliflower-like', exhibiting an irregular shape, and tends to be softer and more fleshy. In contrast, MCV lesions are rounder, flatter, and firmer, featuring a distinctive central spot.

In the process of diagnosing Molluscum contagiosum, it is crucial to eliminate the possibility of other conditions that might present similar symptoms, including:

• Genital warts
• Skin tags
• Seborrhoeic keratosis
• Lichen sclerosus
• Chronic herpetic lesions in individuals with underlying immunosuppression
• Blocked sebaceous glands
• Localised cysts
• Scarring - including keloid scarring

In some cases, patients may exhibit lesions caused by multiple factors, leading to the possibility of receiving more than one diagnosis simultaneously.

Yes.

Everything you share with us is confidential and will not be shared with the NHS or anyone else unless you wish for us to do so.

Most cases of Molluscum contagiosum clear spontaneously within 6–18 months and do not cause any ill effects. There is no association between Molluscum contagiosum and skin cancer and it does not predispose you to any other skin conditions.

It is not necessary to tell your partners if you have, or have had, Molluscum contagiosum as it is a very common skin condition.

However it may be sensible to share this information with a partner, particularly if the lesions are on or near the genitals as there is a high chance of spreading the virus to your partner.

To prevent getting Molluscum contagiousum, we recommend that you:

• Do not share personal items belonging to anyone with Molluscum contagiosum, including towels, clothes, bars of soap, sports gear or hairbrushes
• Avoid skin to skin contact with infected people
• Using a condom can help prevent the spread during sexual contact and intercourse
• Avoid sharing baths
• Practice effective hand washing

Many patients are worried about how their diagnosis affects their future, in terms of relationships and social situations. Skin lesions can be perceived as a marker of poor hygiene and can carry significant stigma. It is important to remember that the Molluscum contagiosum virus is very common and is easily passed from person to person, and infection does not reflect poor hygiene, or sexual practices.

Having Molluscum contagiosum can be thought of as a common cold of the skin, and does not cause any ill effects or need any specific treatment.