Molluscum Contagiosum ICD-10: B08.1

Viral skin infection

Often searched as: small bumps with dimple in center, water warts on kids, flesh colored bumps on skin, contagious skin bumps children, small round bumps that spread, bumps from swimming pool, dome shaped skin bumps, viral bumps on skin…

Clinical urgency level

lowmediumhigh

Systems Affected

skin

Severity Levels

mild

A few isolated papules in a child or immunocompetent adult, self-resolving over months — no treatment required unless desired.

moderate

Numerous papules spreading across multiple areas, causing cosmetic distress or itching, or affecting the genital area in adults — treatment recommended.

severe

Extensive, treatment-resistant molluscum in immunocompromised individuals (HIV, organ transplant) with hundreds of lesions or unusually large ('giant') molluscum — requires specialist management.

Red Flags

Hundreds of lesions spreading rapidly, especially in an immunocompromised person
Large or 'giant' molluscum papules (>1cm) — suggests immune suppression
Genital molluscum in an adult not previously diagnosed — consider STI evaluation
Molluscum on or near the eyelid affecting the eye (molluscum conjunctivitis)
Secondary infection: a papule becoming very red, painful, and swollen beyond a normal inflammatory response

Clinical Presentation

Molluscum contagiosum — dome-shaped papules with central umbilication on the trunk

Source: Wikimedia Commons (CC BY-SA 3.0 )

Molluscum contagiosum image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a doctor if your child has many spreading bumps that are being scratched or getting infected, if molluscum appears in the genital area (adults), if lesions are near the eyes, or if they persist beyond 18 months without sign of resolution. Immunocompromised individuals with molluscum should always be evaluated.

Differential Diagnosis

Warts (verruca vulgaris or flat warts — no central dimple)
Milia (tiny white cysts — no dimple, smaller)
Basal cell carcinoma (pearly nodule — in adults, rare)
Keratoacanthoma (rapidly growing nodule with central keratin plug)
Cryptococcus (disseminated — molluscum-like lesions in HIV patients)
Syringoma (flesh-colored papules near eyes)

Comorbidities

Atopic dermatitis (skin barrier disruption greatly increases spread)
HIV/AIDS (extensive, giant, or treatment-resistant molluscum)
Other primary immunodeficiencies
Secondary bacterial skin infection from scratching

Prognosis

In immunocompetent children, molluscum contagiosum resolves spontaneously within 6–18 months in the vast majority of cases as the immune system develops a response to the virus. In adults with normal immunity, it also resolves but may take longer. Treatment (cryotherapy, curettage, topical agents) speeds resolution and reduces spread. In immunocompromised individuals, spontaneous resolution is unlikely without immune reconstitution, and molluscum can be extensive and persistent.

Detailed Overview

Causes, Symptoms, and When to Take Action Molluscum contagiosum (also called 'water warts') is a benign viral skin condition characterized by raised papules. It most often affects children, sexually active adults, and individuals with weakened immunity. How It Looks Texture: Smooth, dome-shaped papules with a central dimple (umbilication) Color: Flesh-coloured, pinkish or slightly purple Shape: Round or oval; papules may cluster or appear singly Location: Common on trunk, limbs, face; in adults can appear in genital area Why Does It Appear? Caused by molluscum contagiosum virus (a DNA poxvirus) infecting skin's epidermal cells. Transmitted through direct skin-to-skin contact, sexual contact, or by touching contaminated items (towels, clothing, toys). Autoinoculation (spreading by scratching or touching existing lesions) increases number of lesions. Warm, humid environments, skin barrier disruption (e.g. due to atopic dermatitis), and immune suppression increase risk. Should You Be Concerned? Molluscum contagiosum is harmless in most cases. However, concern may be warranted if: Lesions are numerous, persist for long periods, or worsen There is itching, inflammation, or secondary infection The condition occurs in immunocompromised individuals or in genital area Cosmetic appearance is distressing Can You Prevent It? Avoid sharing personal items like towels, clothes, or razors Keep hands clean and avoid scratching lesions Maintain skin barrier health, especially in those with eczema or other skin conditions Minimize exposure in warm, humid settings 👉 How Piel AI Can Help Piel AI enables tracking of lesion appearance and number over time. While not a diagnostic tool, it helps notice changes, flare ups, or spread and supports discussions with a healthcare professional. Summary Molluscum contagiosum is a benign viral skin infection causing smooth dome-shaped papules. Transmitted by contact or contaminated items; worsened by scratching and weakened immunity. Usually resolves without serious harm, but long duration, inflammation, or infection may occur. Good hygiene, barrier care, and monitoring are key.

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