Molluscum contagiosum medical therapy
|
Molluscum contagiosum Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment is often unnecessary[1][2]. Individual molluscum lesions may go away on their own and are reported as lasting generally from 6 to 8 weeks,[3] to 2 or 3 months.[4] However via autoinoculation, the disease may propagate and so an outbreak generally lasts longer with mean durations variously reported as 8 months,[3] to about 18 months,[5][6] and with a range of durations from 6 months to 5 years.[4][6] depending on the location and number of lesions, with no single approach shown to be convincingly effective.
Medical Therapy
Nonetheless, treatment may be sought after for the following reasons:
- Medical issues including:
- Bleeding
- Secondary infections
- Itching and discomfort
- Potential scarring
- Chronic keratoconjunctivitis
- Social reasons
- Cosmetic
- Embarrassment
- Fear of transmission to others
- Social exclusion
Many health professionals recommend treating bumps located in the genital area to prevent them from spreading.[6] It is important to realize that treating the bumps does not cure the disease. The virus is in the skin and new bumps will often appear even after all the visible ones are surgically treated. Any surgical option of treatment may therefore have to be repeated each time new bumps occur. The body eventually mounts an effective immune response and rids itself of the virus, but until then, new bumps may occur over the course of a year or more.
Betadine
There are a few treatment options that can be done at home. Betadine surgical scrub can be gently scrubbed on the infected area for 5 minutes daily until the lesions resolve (this is not recommended for those allergic to iodine or betadine). However, the ability of iodine to penetrate intact skin is poor, and without a pin prick or needle stick into each molluscum lesion this method does not work well. Do not use on broken skin.
Astringents
Astringent chemicals applied to the surface of molluscum lesions to destroy successive layers of the skin include trichloroacetic acid, podophyllin resin, potassium hydroxide, and cantharidin.[7]
Australian lemon myrtle
A 2004 study demonstrated over 90% reduction in the number of lesions in 9 out of 16 children treated with 10% strength solution of essential oil of Australian lemon myrtle (Backhousia citriodora).[8] However the oil may irritate normal skin at concentrations of 1%.[9][10]
Over-the-counter substances
For mild cases, over-the-counter wart medicines, such as salicylic acid may shorten infection duration. Daily topical application of tretinoin cream ("Retin-A 0.025%") may also trigger resolution.[11][12] These treatments require several months for the infection to clear, and are often associated with intense inflammation and possibly discomfort.
Imiquimod
Doctors occasionally prescribe Imiquimod, the optimum schedule for its use has yet to be established.[13]Imiquimod, a form of immunotherapy. Immunotherapy triggers your immune system to fight the virus causing the skin growth. Imiquimod is applied 3 times per week, left on the skin for 6 to 10 hours, and washed off. A course may last from 4 to 16 weeks. Small studies have indicated that it is successful about 80% of the time
Non-medicine treatment
The infection can also be cleared without medicine if there are only a few lesions. First, the affected skin area should be cleaned with an alcohol swab. Next, a sterile needle is used to cut across the head of the lesion, through the central dimple. The contents of the papule are removed with another alcohol swab. This procedure is repeated for each lesion (and is therefore unreasonable for a large infection). With this method, the lesions will heal in two to three days.
References
- ↑ Prodigy knowledgebase (2003). "Molluscum Contagiosum". National Health Service. Retrieved 2006-07-06. Unknown parameter
|month=ignored (help) - UK NHS guidelines on Molluscum Contagiosum - ↑ van der Wouden JC, Menke J, Gajadin S; et al. (2006). "Interventions for cutaneous molluscum contagiosum". Cochrane Database Syst Rev (2): CD004767. doi:10.1002/14651858.CD004767.pub2. PMID 16625612.
- ↑ 3.0 3.1 Weller R, O'Callaghan CJ, MacSween RM, White MI (1999). "Scarring in Molluscum contagiosum: comparison of physical expression and phenol ablation". BMJ. 319 (7224): 1540. PMID 10591712.
- ↑ 4.0 4.1 derm/270 at eMedicine
- ↑ MedlinePlus Encyclopedia 000826
- ↑ 6.0 6.1 6.2 Tyring SK (2003). "Molluscum contagiosum: the importance of early diagnosis and treatment". Am. J. Obstet. Gynecol. 189 (3 Suppl): S12–6. PMID 14532898.
- ↑ "Molluscum Contagiosum - Treatment Overview". WebMD. January 12, 2007. Retrieved 2007-10-21.
- ↑ Burke BE, Baillie JE, Olson RD (2004). "Essential oil of Australian lemon myrtle (Backhousia citriodora) in the treatment of molluscum contagiosum in children". Biomed. Pharmacother. 58 (4): 245–7. doi:10.1016/j.biopha.2003.11.006. PMID 15183850.
- ↑ Hayes AJ, Markovic B (2002). "Toxicity of Australian essential oil Backhousia citriodora (Lemon myrtle). Part 1. Antimicrobial activity and in vitro cytotoxicity". Food Chem. Toxicol. 40 (4): 535–43. PMID 11893412.
- ↑ Hayes AJ, Markovic B (2003). "Toxicity of Australian essential oil Backhousia citriodora (lemon myrtle). Part 2. Absorption and histopathology following application to human skin". Food Chem. Toxicol. 41 (10): 1409–16. PMID 12909275.
- ↑ Papa C, Berger R (1976). "Venereal herpes-like molluscum contagiosum: treatment with tretinoin". Cutis. 18 (4): 537–40. PMID 1037097.
- ↑ "Molluscum Contagiosum". Adolesc Med. 7 (1): 57–62. 1996. PMID 10359957.
- ↑ Hanna D, Hatami A, Powell J; et al. (2006). "A prospective randomized trial comparing the efficacy and adverse effects of four recognized treatments of molluscum contagiosum in children". Pediatric dermatology. 23 (6): 574–9. doi:10.1111/j.1525-1470.2006.00313.x. PMID 17156002.