DermHelpCentral

Needling Technique for Molluscum

The is a a good technique for molluscum that patients can use at home.

"Needling means introduction of needle in the lesion.
Molluscum contagiosum is an infection caused by a poxvirus
that gives rise to small, benign, white, pink, or flesh-coloured,
umbilicated, raised papules or nodules located in the
epidermal layer of the skin.

There are many ways molluscum can be treated,  However, this is  a safe, cheap nonpharmacologic intervention (NPI).

Retinoic acid (tretinoin) is a form of chemical ablation that can be self-administered and has been used topically to remove molluscum lesions. However, application of retinoic acid may cause skin drying, peeling, irritation, and soreness.

After application of tretinoin (0.05%) 26 no. needle is introduced in the lesion, which causes little bleeding that can be controlled by pressure. The lesion turns erythematous and oedematous and soon disappears. Needling can be performed twice a week and daily application of tretinoinis to be continued. With inflammation molluscum lesion disappears within 7 to 10 days. For larger lesions tretinoin 0 .1% and 21 no. needle can be used. Needling is useful in
children who are afraid of office procedures. Mothers can be taught this procedure to perform at home. Weeks or months of treatment can be converted into days by this procedure.

 

Molluscum in Kids

Your Child’s Molluscum

1. What is molluscum contagiosum?

Molluscum contagiosum is a harmless viral infection of the skin. It is very common in children and is contagious. It is caught by direct contact with other children. For most kids, no treatment is necessary. The bumps themselves are usually painless.

2.What to expect

Like most virus infections, this will go away on its own without treatment within 6 months to 2 years. The bumps themselves often become red and inflamed or “pop” just as they are about to go away. This is a sign that the virus is going away, but can be itchy. If there is some pain, you may treat it with warm compresses, ibuprofen, or Tylenol. Most times, the bumps do not become infected with bacteria, but this can sometimes happen.

If your child has a rash around molluscum, we call this molluscum dermatitis. Controlling the associated itch with Benadryl can the spread of these lesions.

3.Treatment for Molluscum Contagiosum

If you or your child want to treat these bumps, medicines applied to the skin can be used. Many of these treatments can be irritating to the skin and are not very helpful. Be careful not to cause too much irritation to the surrounding healthy skin. These treatments do not make people sick so although molluscum are contagious, you do not need to limit your child’s activities.

• Zymaderm This is an over-the-counter homeopathic ointment that can be dotted on individual bumps one to two times daily for up to 2 months.
• Tretinoin Cream (Retin A) This is a cream your doctor can prescribe, to dot on the individual bumps at bedtime until scabbed or peeling.
• Cantharidin (beetle juice) Your pediatrician applies this medicine to the individual bumps in the office. This is left on for 4-6 hours then you must wash this off soap and water. Within 24-48 hours blisters will form, and the individual bump may go away. If blisters develop sooner than 6 hours after application, wash off the medicine immediately. Blisters can be small and not bothersome or large and uncomfortable and the reaction is often unpredictable.
• There is one case report of the use of Duct Tape for molluscum.

4. General Recommendations

• To prevent spreading, we recommend switching from baths to showers.
• Infected children should avoid bathing with non-infected children, and your kid should use their own towel.
• A good daily moisturizer applied over the entire body will treat your child’s skin if it is dry, and may cut back on scratching and spreading.

Molluscum: The Case for Watching

Molluscum contagiosum: to treat or not to treat?
Experience with 170 children in an outpatient clinic in Baltimore.
Basdag H, Rainer BM, Cohen BA.
Pediatr Dermatol. 2015 May-Jun;32(3):353-7.

Abstract: Despite the high prevalence of molluscum contagiosum (MC) in children, epidemiologic data on this common self-limited viral infection is limited. In this report we review our experience with the demographic characteristics, clinical characteristics, management, and time to resolution of MC in 170 children. A retrospective medical chart review and telephone survey were conducted on children younger than 16 years of age evaluated for MC in the Division of Pediatric Dermatology at the Johns Hopkins Children's Center, Baltimore, Maryland, from January 1, 2008, to December 31, 2011. Of 170 children with MC, 51.8% were female and 77.1% were Caucasian. The median age at diagnosis was 5 years and 46.5% had a history of atopic dermatitis (AD). Children with AD had significantly more MC lesions than those without (p < 0.05); 72.9% of children did not receive any treatment. MC lesions completely cleared within 12 months in 45.6% of treated and 48.4% of untreated children and within 18 months in 69.5% of treated and 72.6% of untreated children. Treatment (if any), sex, race, diagnosing physician, number of lesions at diagnosis, number of anatomic locations, or history of AD did not predict time to resolution of MC lesions. MC lesions completely resolved in approximately 50% of children within 12 months and in 70% within 18 months. Treatment did not shorten the time to resolution.

This is an important article and should be read by any parent before subjecting a child to treatment.