Health Insights · Dermatology
Molluscum contagiosum: small firm spots that spread
Molluscum is a common viral skin infection of childhood causing small firm bumps with a dimple in the centre. It clears completely by itself, leaves no scar if untreated, and requires no exclusion from anything. The difficulty is that it takes a year or more, and it spreads in the meantime.
Seek assessment if the spots
- are on or very close to the eyelid, with a red or irritated eye
- become hot, spreading red, painful or weeping, with fever
- are very widespread or unusually large, particularly over 1cm
- occur in someone immunosuppressed or with severe eczema
- appear in an adult in the genital area — this is sexually transmitted and warrants screening
Molluscum near the eye can cause conjunctivitis and occasionally more serious eye inflammation. Extensive or atypical molluscum in an adult can be a marker of immune suppression and warrants assessment.
What it looks like
- small, firm, dome-shaped bumps, 1 to 5mm, pearly, pink or skin-coloured
- a central dimple or plug — the characteristic feature
- commonly in clusters in warm moist areas: armpits, behind the knees, groin, trunk, face
- often surrounded by patches of eczema, which is a reaction to the virus
- usually 10 to 30 spots, though children with eczema often have many more
- spread by direct contact, shared towels, baths and by scratching
The red, angry phase is a good sign
At some point spots typically become red, swollen and inflamed, sometimes with pus, and parents understandably assume they have become infected. In most cases this is the immune system finally recognising and clearing the virus — the so-called beginning-of-the-end sign, usually followed by resolution within weeks. Genuine bacterial infection spreads beyond the spot, with surrounding warmth, spreading redness and often fever. If in doubt have it looked at, but do not assume the angry phase means treatment failure.
Why doing nothing is usually right
There is no treatment that reliably shortens it, and most active treatments — freezing, curettage, caustic preparations — are painful for a child and can cause scarring, which the illness itself does not. Treating is therefore reserved for particular situations rather than being the default.
What to do meanwhile
Do
- Keep any eczema well treated with emollients — this reduces spread more than anything else
- Cover spots with clothing or a plaster during contact sports and swimming
- Use separate towels and flannels within the household
- Keep nails short, and discourage scratching and picking
- Bathe siblings separately, or the affected child last
Do not
- Do not squeeze or pick the spots — this spreads them and causes scarring
- Do not shave over affected skin
- Do not use over-the-counter wart treatments unless advised
- Do not keep a child off school or nursery — no exclusion is needed
- Do not stop swimming lessons; covering the spots is sufficient
When treatment is considered
- spots near the eye, or in a site causing genuine problems
- widespread or persistent disease, particularly with severe eczema
- significant distress or bullying in an older child
- genital molluscum in adults, where treatment and sexual health screening are appropriate
- immunosuppression, where the illness behaves differently
- Options include topical preparations, cryotherapy and curettage, chosen against the child's age and tolerance.
Why come to us. Most families need the diagnosis confirmed, the eczema treated and honest reassurance about the timescale — which is one appointment, and prevents months of trying things that do not help. Our paediatric and dermatology teams can confirm it is molluscum rather than warts or something else, prescribe proper emollient and eczema treatment, and treat the small number of cases that warrant it. 7 days a week, no referral needed.
Private assessment for molluscum contagiosum in London
Molluscum contagiosum causes small, firm, pearly spots and usually clears on its own over months, so treatment is often not needed. A private GP in East London can confirm the diagnosis and advise, and our private dermatology clinic in London can treat troublesome or widespread cases. Molluscum contagiosum is assessed at our private hospital in Whitechapel, East London, within reach of Canary Wharf, the City and Aldgate.
Molluscum contagiosum: a common viral skin infection
Does molluscum need treatment?
Often not — it usually clears by itself. Treatment is considered if spots are troublesome, spreading or in sensitive areas.
Is molluscum contagious?
Yes — it spreads by contact, so avoid scratching, sharing towels, and close skin contact until it clears.
When should I see a doctor?
If the diagnosis is unclear, spots are widespread or in the genital area, or you have a weakened immune system.
Can I be seen quickly?
Yes — same-day private GP appointments are available most days.
Is there a private doctor near me for molluscum?
Yes — a same-day private GP or our private dermatology clinic in London at Whitechapel, near Canary Wharf, can confirm the diagnosis and advise.
Does molluscum need treatment?
Often it clears on its own, but troublesome or widespread cases can be treated; our dermatology team can advise on options.
Diagnosis confirmed, eczema treated, timescale explained
Paediatrics and dermatology on site, 7 days a week.