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Warts & Molluscum

Warts and Molluscum Contagiosum are common viral infections of the skin that result in benign (non-cancerous) growths. While they are medically harmless, they can be unsightly, painful, and socially distressing, particularly for children and young adults. Because they are contagious, they can spread easily through families or schools. At Smooth Skin Clinic, we offer medical-grade treatments to clear these lesions efficiently when over-the-counter remedies have failed.

Key Points

  • Both conditions are caused by viral infections (HPV for warts, Poxvirus for molluscum).
  • They are highly contagious and spread via direct skin contact or contaminated surfaces.
  • Warts are typically rough and hard; Molluscum are smooth, pearly, and dimpled.
  • Most cases eventually resolve on their own, but this can take months to years.
  • Treatment is recommended if they are painful, spreading, or causing embarrassment.

What are Warts & Molluscum?

Viral Warts are caused by the Human Papillomavirus (HPV). They trigger rapid growth of the top layer of skin, creating a rough, thickened texture. Molluscum Contagiosum is caused by a poxvirus. It presents as clusters of small, painless bumps that often have a cheesy white core.

Who gets them?

These infections are most common in children and adolescents due to their developing immune systems and close contact in schools or pools. However, adults can also contract them, particularly if they are immunosuppressed or through gym/pool environments.

Contact Smooth Skin Clinic for effective removal of persistent warts or molluscum.

Clinical features

1. Viral Warts

- Appearance: Rough, scaly, cauliflower-like lumps.

- Location: Common on hands (Common Warts), feet (Plantar Warts/Verrucas), and face (Plane Warts).

- Symptoms: Often painless, but plantar warts on the soles of the feet can be very painful when walking.

 

2. Molluscum Contagiosum

- Appearance: Small (2-5mm), shiny, pearly-white or pink bumps with a central "dimple" (umbilication).

- Location: Clusters often appear on the trunk, armpits, behind knees, or groin.

- Symptoms: Usually painless but can become red, inflamed, and itchy as the body fights the virus.

Diagnosis and differential diagnosis

Diagnosis is typically straightforward based on visual examination.

  • Dermoscopy: We use a dermatoscope to look for "red dots" (blood vessels) typical of warts or the central white core of molluscum.

  • Biopsy: Rarely needed, but may be performed if a lesion looks atypical or is not responding to treatment, to rule out skin cancer.

Impact and complications

While physically benign, the psychological impact can be significant. Visible lesions can lead to teasing or self-consciousness. Complications:

  • Spread: Scratching can spread the virus to other parts of the body (autoinoculation).

  • Infection: Broken skin from scratching can lead to secondary bacterial infections (impetigo).

  • Pain: Plantar warts can alter gait and cause foot/knee pain.

Causes and triggers

    • Infection: Direct contact with the virus from another person or surface (e.g., swimming pool decks, shared towels).

    • Skin Barrier: The virus enters through tiny cuts or abrasions in the skin (e.g., eczema patches or bitten nails).

    • Immunity: People with weakened immune systems take longer to clear the virus.

Treatment Options

  • Cryotherapy (Freezing) Liquid nitrogen is applied to freeze and kill the infected cells. Multiple sessions are usually required.
  • Cantharidin ("Beetle Juice") A painless liquid applied in the clinic that causes a blister to form under the wart/molluscum, lifting it off. Excellent for children.
  • Topical Acids Prescription-strength Salicylic or Lactic acid paints.
  • Curettage Physical removal (scraping) of molluscum lesions under local anaesthetic.
  • Immunotherapy Treatments like Diphencyprone (DCP) or Candida antigen injections to trigger an immune response for stubborn, multiple warts.
  • Vascular Laser To cut off the blood supply to resistant warts.

Expectations and Outcomes: Warts can be stubborn. “Cure” often requires persistence with multiple treatments every 2-3 weeks. There is no single “magic bullet,” but combination therapy usually yields the best results.

Frequently Asked Questions

Have questions about scheduling or what to expect? Here are answers to common inquiries to help you feel fully prepared.

The virus lives in the basal layer of the epidermis. Even if the visible "lump" is removed, microscopic viral particles may remain in the surrounding skin, causing a recurrence. This is why we often treat a margin around the visible wart.

No. In healthy children, it is a self-limiting condition that will eventually go away without a trace, though it can take 12-18 months. Treatment is offered mainly to stop the spread and improve appearance.

It is difficult to prevent entirely as these viruses are everywhere. However, avoiding sharing towels, wearing thongs/flip-flops in public showers, and keeping skin moisturized (to prevent micro-cracks) can reduce the risk.