Molluscum Contagiosum Contagiousness
Molluscum contagiosum is contagious at all times when lesions are present, from their appearance until complete resolution, with transmission occurring through direct skin-to-skin contact, fomites, or autoinoculation. 1
Transmission Mechanisms
Molluscum contagiosum virus (MCV) is transmitted primarily through:
- Direct contact with infected skin - both sexual and non-sexual contact 2
- Autoinoculation - spreading from one part of the body to another by scratching or touching 2
- Fomites - shared items like towels, clothing, or sports equipment 1
The virus is most easily transmitted when lesions are visible, characterized by their distinctive shiny, dome-shaped umbilicated appearance 1. These lesions contain viral particles that can be released and transferred to others.
Duration of Contagiousness
- Contagiousness begins when lesions first appear
- Remains contagious until all lesions have completely resolved
- Lesions typically persist for 6-9 months but can last up to 4 years in some cases 1, 2
- Immunocompromised patients may have more extensive and persistent lesions, prolonging the contagious period 1
High-Risk Scenarios for Transmission
- Contact sports - athletes in contact sports have higher transmission risk 1
- Shared facilities - swimming pools, communal showers, gyms
- Intimate contact - sexual transmission in adults 2
- Household contact - especially among children sharing toys, towels, etc.
- Ocular involvement - lesions on eyelids can cause follicular conjunctivitis 1
Prevention of Transmission
To prevent spreading molluscum contagiosum:
- Avoid touching or scratching lesions
- Cover lesions with clothing or bandages during activities with close physical contact
- Avoid sharing personal items like towels, clothing, or sports equipment
- Maintain good hand hygiene
- For athletes in contact sports, consider more aggressive treatment 1
Clinical Implications
The contagious nature of molluscum contagiosum has important clinical implications:
- Although lesions can resolve spontaneously in 6-9 months, treatment may be indicated to prevent transmission 3
- Patients with extensive disease, complications, or aesthetic concerns should receive active treatment 2
- Immunocompromised patients require more aggressive management due to prolonged contagiousness 1
- Ocular involvement requires prompt treatment to prevent complications like conjunctivitis 1
Common Pitfalls in Management
- Misconception: Assuming molluscum is only contagious when lesions are inflamed or ruptured. In reality, intact lesions are also contagious.
- Delayed treatment: The "benign neglect" approach can increase risk of spreading infection 4
- Incomplete treatment: Failure to identify and treat all lesions can lead to autoinoculation and prolonged infection
- Inadequate prevention measures: Not providing sufficient guidance on preventing transmission
Understanding the contagious nature of molluscum contagiosum is essential for effective management and prevention of spread within communities, particularly in settings like schools, households, and sports facilities.