Molluscum Contagiosum: Those Little Pearly Bumps on Your Child's Skin

As you dry your child after a bath, you spot a cluster of small, round, smooth, almost shiny bumps under their arm, each with a tiny dimple in the middle. They don't bother your child and they don't itch, but there are more of them than two weeks ago. This is most likely molluscum contagiosum, a common and harmless viral skin infection in children.

Harmless, yes, but long and a little stubborn. That is what worries parents: the bumps can stay for months. Here is how to recognise them, how they spread, what you can do (and what is better left alone), and the question that comes back every summer: what about the swimming pool?

What does molluscum contagiosum look like?

The bumps are smooth little domes of 1 to 5 mm, flesh-coloured, pinkish or pearly white, with a characteristic small dimple in the centre (doctors call this umbilication). They often appear in groups and are usually painless, with little or no itching.

In children they like the trunk and the skin folds: armpits, backs of the knees, groin. The NHS notes that bumps on the face or around the eyes, or very many or larger ones, are mostly seen in people with a weakened immune system.

The virus belongs to the poxvirus family. According to the French Society of Dermatology (SFD), it mostly affects children aged 2 to 12.

How did my child catch it?

Through contact. The virus passes from skin to skin, but also through shared towels, washcloths, clothes and toys. Nursery, school and bath time with brothers and sisters are ideal places for it to travel, as with many common childcare infections.

Children also re-infect themselves: by scratching, rubbing or picking at a bump, they leave the virus a little further along their skin. That is why "colonies" grow around the first bumps.

How long does molluscum last?

This is the real difficulty: you need patience. The US CDC says the bumps usually disappear within six months to a year, sometimes longer. The SFD speaks of several months, sometimes one to two years, and the NHS of usual healing in under 18 months, without treatment. In the meantime, new bumps can appear while others fade.

Healing most often happens without scarring. One misleading sign is worth knowing about: a bump that turns red, swollen and a little tender is not necessarily infected. According to the SFD, it is often the body's defence reaction, which comes just before the bump disappears.

Does molluscum need treatment?

Not systematically. All the sources we consulted agree: in an otherwise healthy child, watching and waiting is often enough, since the infection heals by itself. Treatment can be discussed case by case, for example:

• when the bumps are numerous or bothersome;
• when they are surrounded by eczema;
• when they become infected (rare);
• when they affect the eyelids or the genital area;
• when the child has a weakened immune system.

The techniques available, carried out by a doctor or dermatologist, are curettage (removal with a small scoop, after a numbing cream), certain local treatments and, more rarely, cryotherapy (freezing). None of them prevents new bumps from appearing, and they can be unpleasant for a young child, which is why waiting is often the option chosen.

Two myths to forget. Antibiotics do not cure molluscum, because it is a virus; they are only used if a bacterial infection sets in. And as for the "remedies" you find online: the CDC warns that some are ineffective, even harmful. Never remove a bump yourself.

Molluscum and eczema: a frequent pair

Children with atopic eczema are more exposed to molluscum, and their bumps are often more numerous. Their dry, itchy skin makes self-infection easier. A red, rough patch can also appear around the bumps: this is a reactive eczema.

The SFD is clear on two points. This eczema must be treated, with the prescribed creams, including topical corticosteroids, which do not spread the virus or prolong the infection. And the skin must be moisturised every day. Against dryness and itching, the NHS advises cool baths and a fragrance-free moisturiser applied regularly; a simple emollient such as a cold cream will do. For the everyday care of atopic skin, see our article on infant eczema.

Swimming pool, beach, hammam: can my child go in the water?

Yes. The CDC specify that a child with molluscum does not need to stay at home or miss nursery or school, and can swim as long as there is no open sore. According to the SFD, the risk at the pool comes mainly from close contact and shared towels rather than from the water itself.

A few habits are enough, at the club pool as at the beach:

• a towel or a personal bath cape, never lent to anyone;
• exposed bumps covered with a waterproof plaster or a lycra swimsuit;
• a moisturiser after swimming, as the SFD advises.

For the youngest children's swimming lessons, our guide to baby swimming and the pool covers the other precautions. At the hammam (Moroccan steam bath), the same rules apply: personal mitt, towel and stool, and no shared bath with siblings while the infection heals.