Is molluscum contagiosum (a viral skin infection) indicated for cryotherapy (cryosurgery)?

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Last updated: May 17, 2025View editorial policy

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From the Guidelines

Cryotherapy is a viable treatment option for molluscum contagiosum, particularly for lesions that are cosmetically bothersome or occur in patients with underlying skin conditions such as eczema. According to a study published in Pediatrics in 2017 1, cryotherapy with liquid nitrogen has been used to treat molluscum contagiosum, although it may be associated with postinflammatory hyperpigmentation or scarring. The study notes that resolution of uncomplicated molluscum contagiosum typically occurs spontaneously in 6 to 12 months, but cryotherapy can be an effective treatment for lesions that require more immediate attention.

Some key points to consider when using cryotherapy for molluscum contagiosum include:

  • The procedure involves freezing the lesions with liquid nitrogen, which can cause cellular destruction and subsequent immune response to help clear the virus
  • Cryotherapy may be associated with some discomfort during the procedure and possible blistering, redness, or hypopigmentation afterward
  • This treatment is particularly useful for older children and adults with limited lesions, though it may be too painful for young children or patients with extensive disease
  • Alternative treatments include curettage, topical medications, or simply watchful waiting, as molluscum contagiosum often resolves spontaneously within 6-12 months, as noted in the study 1.

It's worth noting that other treatments, such as imiquimod, have not been shown to be of benefit compared to placebo in randomized controlled trials, as mentioned in the study 1. Overall, cryotherapy is a reasonable treatment option for molluscum contagiosum, especially when considering the potential benefits and risks, and the lack of highly successful alternative treatments.

From the Research

Molluscum Contagiosum Treatment Options

  • Molluscum contagiosum is a viral skin infection that can be treated with various methods, including cryotherapy 2, 3, 4.
  • Cryotherapy is a common treatment option for molluscum contagiosum, which involves freezing the lesions with liquid nitrogen 2, 3, 4.
  • The effectiveness of cryotherapy in treating molluscum contagiosum has been compared to other treatment options, such as topical imiquimod, potassium hydroxide, and podophyllotoxin 2, 4.
  • A systematic review and network meta-analysis found that cryotherapy was one of the most effective treatments for achieving complete clearance of molluscum contagiosum lesions, with an odds ratio of 16.81 compared to placebo 4.

Indications for Cryotherapy

  • Cryotherapy may be indicated for patients with extensive disease, associated complications, or aesthetic complaints 5.
  • The choice of treatment method, including cryotherapy, should depend on the physician's comfort level, the patient's age, the number and severity of lesions, location of lesions, and the preference of the child/parents 3.
  • Cryotherapy is considered a method of choice for the majority of patients with molluscum contagiosum, particularly those with symptomatic or widespread lesions 3.

Safety and Efficacy

  • The safety and efficacy of cryotherapy in treating molluscum contagiosum have been evaluated in several studies, with most finding it to be a effective and well-tolerated treatment option 2, 3, 4.
  • However, cryotherapy may cause adverse effects, such as pain, erythema, and itching, although these are typically mild and temporary 2.
  • The risk of serious adverse effects with cryotherapy is considered low, although patients should be monitored for any potential complications 2, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Interventions for cutaneous molluscum contagiosum.

The Cochrane database of systematic reviews, 2017

Research

Molluscum Contagiosum: An Update.

Recent patents on inflammation & allergy drug discovery, 2017

Research

Comparative efficacy of treatments for molluscum contagiosum: A systematic review and network meta-analysis.

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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