Molluscum contagiosum (MC) is a viral infection of the skin or occasionally of the mucous membranes. It is caused by a DNA poxvirus called the molluscum contagiosum virus (MCV). MCV has no animal reservoir, infecting only humans. There are four types of MCV, MCV-1 to -4; MCV-1 is the most prevalent and MCV-2 is seen usually in adults and often sexually transmitted. This common viral disease has a higher incidence in children, sexually active adults, and those who are immunodeficient,[1] and the infection is most common in children aged one to ten years old.[2] MC can affect any area of the skin but is most common on the trunk of the body, arms, and legs. It is spread through direct contact or shared items such as clothing or towels.

The virus commonly spreads through skin-to-skin contact. This includes sexual contact or touching or scratching the bumps and then touching the skin. Handling objects that have the virus on them (fomites), such as a towel, can also result in infection. The virus can spread from one part of the body to another or to other people. The virus can be spread among children at day care or at school. Molluscum contagiosum is contagious until the bumps are gone (which, if untreated, may last up to 6 months or longer).

The time from infection to the appearance of lesions can range up to 6 months, with an average incubation period between 2 and 7 weeks.

Individual molluscum lesions may go away on their own and are reported as lasting generally from 6 to 8 weeks,[4] to 2 or 3 months.[5] However via autoinoculation, the disease may propagate and so an outbreak generally lasts longer with mean durations variously reported as 8 months, to about 18 months,[6][7] and with a range of durations from 6 months to 5 years.

Treatment is unnecessary in kids depending on the location and number of lesions, and no single approach has been convincingly shown to be effective. It should also be noted that treatments causing the skin on or near the lesions to rupture may spread the infection further, much the same as scratching does

It is helpful for toddlers to treat irritated areas with neosporin, and also helps to put a long shirt over the area, so keep the child from scratching the warts. There are medical treatments for molluscum, but we generally don't recommend them as they are painful and can cause permanent scarring, whereas molluscum that run their natural course resolve with no scars.

It seems bizarre for a viral wart rash to last for so long but the best outcome with the least pain and suffereing ( for both the child and the parent) is watchful waiting!

Natalie Hodge MD FAAP