Molluscum contagiosum (water warts) in children ages one to five

What is molluscum contagiosum?

Molluscum contagiosum, sometimes known as water warts, is a mild infection that causes raised spots to appear on your child's skin. It often affects young children, particularly between the ages of one and four (NICE 2017). It's usually harmless, and will probably get better on its own within about 18 months (NICE 2017).

The spots are caused by a virus known as molloscum contagiosum virus (MCV) (NICE 2017). The virus can be passed from person to person, but your little one should still be able to go to nursery or preschool as normal while he has it (NICE 2017).

What are the symptoms of molluscum contagiosum?

The main – and usually only – symptom of molloscum contagiosum is small, raised, dome-shaped spots (NICE 2017). They're typically pink or red on white skin or a beige colour on darker skin (NHS 2020).

You're most likely to notice these on your child's chest, tummy, back, armpits, behind his knees or nappy area, though they can appear anywhere on the body (NICE 2017).

There are usually about 20 to 30 spots at any one time (NHS 2017). Each spot is quite small (usually about 3-5mm across). One way to tell if it's molluscum contagiosum is to look for a tell-tale dimple in the middle of each spot (NICE 2017).

The spots shouldn't be painful for your child, and he's unlikely to have any other symptoms (NHS 2017). In some cases, though, the spots can be uncomfortably itchy, or you may notice dry and cracked skin surrounding them (NHS 2017).

Individual spots may well begin to crust over and heal within two months (NHS 2017). It's not unusual for new spots to develop elsewhere as old ones heal, as your child still has the virus in his system (NHS 2017).

On the whole though, the spots usually clear up altogether within about 18 months, without any treatment (NICE 2017). In some cases, it may take up to five years for the final spots to disappear completely, but it usually happens much sooner than this (NICE 2017).

Sometimes, the spots can become infected, making them swollen and painful. You can reduce the risk of this happening by encouraging your child to avoid scratching or squeezing his spots (NHS 2017).

If your child has a weakened immune system, he may have more spots than usual (over 100), and they may appear larger than normal (NICE 2017). In this case, your GP will be able to advise you about the best treatment for your little one.

What’s the best way to treat molluscum contagiosum?

Treatment isn't usually recommended, because the spots almost always clear up by themselves (NICE 2017). However, it's still a good idea to visit your GP, just so she can confirm what's causing the spots, and check for any signs of infection.

If the spots are very itchy, your GP can prescribe a mild corticosteroid cream to help your little one feel better (NICE 2017). If there's any sign of infection, she may prescribe an antibiotic cream to help clear it up (NICE 2017).

In rare cases, if the spots are particularly bad, your GP may refer you to a dermatologist, who can offer treatments such as freezing the spots (cryotherapy), cutting the spots off (curettage), or using heat or chemicals to remove them (NICE 2017). However, these treatments don't always work, and they can be painful for your child and increase the risk of scarring, so they're not usually recommended (NICE 2017).

In most cases, the spots shouldn't bother your child, or cause him any problems at all. In these cases, your GP will probably recommend that you just follow the hygiene steps below to help prevent the spots from spreading while you wait for them to clear up (NICE 2017).

How does molluscum contagiosum spread?

The spots are caused by a virus, which can be passed from person to person. Your child may have caught it by touching someone who has molluscum contagiosum, or by sharing objects such as towels, flannels or toys with them (NHS 2017).

Fortunately, although the spots can pass from person to person, they're not usually very contagious. This means that your child can still go to school as usual while he has it, and enjoy his usual activities, including swimming (NHS 2017).

Nonetheless, it's a good idea to take some basic hygiene precautions while your child has molluscum contagiosum, to help prevent it spreading to the rest of the family:

• Avoid squeezing or scratching the spots, and encourage your child to do the same. If the spots are itchy, ask your GP for a cream to soothe them.
• Where possible, keep the spots covered with loose clothing.
• If you're taking your child swimming, you can use a waterproof bandage to cover the spots.
• Don’t let your child share clothes, towels, flannels or baths with anyone else until the last spot has disappeared.
  (NHS 2017)

Will molluscum contagiosum cause scarring?

Fortunately, molluscum contagiosum doesn't usually cause scarring, unless the spots become infected, or have been treated in some way (NICE 2017). To reduce the risk of infection, don't squeeze or scratch the spots, and encourage your child to do the same (NHS 2017).

Will my child get molluscum contagiosum again?

The good news is that once a bout of molluscum contagiosum has completely cleared up, it is rare for it to return (NICE 2017).

Not sure if it's molluscum contagiosum or something else? See what else can cause spots in our photo gallery of common skin conditions.