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Small pearls on children's skin
Molluscum contagiosum: shiny papules with a central dimple, frequent in children.
They are small rounded papules, shiny, skin-coloured or pearly, a few millimetres across, with a detail that makes them recognisable: a dimple in the centre, a kind of umbilication. They appear most often in children, on the trunk, armpits, folds and face, and tend to increase in number over time.
They are caused by a virus and spread by direct contact, through shared objects and — this explains the typical arrangement in lines or groups — by autoinoculation: the child scratches one lesion and seeds others in the same area. Swimming pools and contact sports are settings where they circulate more easily.
The important thing to know is that they are benign and tend to resolve spontaneously, although it can take months. This changes the conversation: the question at the visit is not «how do I remove them at once» but «is it worth intervening in this case». We intervene when lesions are very numerous, when they become inflamed, when they sit in troublesome places, or when there is associated eczema favouring their spread.
They resolve on their own: the question is whether waiting is worthwhile
This is what reassures parents and at the same time must be said in full. Molluscum is benign and tends to resolve on its own, but it can take a long time and meanwhile lesions increase, spread between siblings and may become inflamed. The decision is therefore not between «treating» and «not treating», but between two reasonable strategies, chosen by looking at number, sites, the child's age and the presence of eczema. Neither is wrong in principle: what is wrong is deciding without having looked.
How it shows
- Rounded, shiny papules a few millimetres across
- A dimple or umbilication at the centre of the lesion
- Arrangement in groups or lines, where the child has scratched
- Frequent sites: trunk, armpits, folds, face, limbs
- Progressive increase in number over time
- Sometimes redness and inflammation of individual lesions
How we proceed
- 1Visit: confirmation of the picture and counting of lesions
- 2Assessment of any associated eczema, which favours spread
- 3Shared decision with the parents between observation and treatment
- 4Advice to limit autoinoculation and spread within the family
- 5Later review to follow the course
Available treatments
- Dermatology visit
- Assessment of associated eczema
- Outpatient treatment where indicated
- Scheduled follow-up
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Frequently asked questions
Can my child go swimming and to school?+
Yes: exclusion from school is not required and swimming is not forbidden. The sensible measures are to cover the lesions where possible, not to share towels and sponges, and to stop the child scratching, since scratching multiplies them more than anything else. Specific advice depends on how many there are and where.
One lesion has become red and swollen: is it infected?+
Not necessarily. Many lesions become inflamed just before resolving, an expected phenomenon sometimes mistaken for worsening. That said, marked or painful inflammation, or inflammation with pus, deserves to be examined, because bacterial superinfection is possible and is treated differently.
Can I catch it as an adult?+
It is possible, although far more frequent in children. In adults its appearance still deserves assessment, because the context in which it presents and the distribution of lesions can have different meanings than in a child. It is not a cause for alarm, but nor is it the identical situation.
Related reading
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