Molluscum Contagiosum Duration
Yes, molluscum contagiosum can last for years, typically persisting for 6 months to 5 years without treatment. 1, 2
Natural Course and Duration
- Molluscum contagiosum presents as characteristic skin-colored, whitish, or pink papules with a central umbilication, typically affecting the trunk, face, and extremities in children 3
- Although generally self-limiting, lesions typically persist for 6-12 months but can last up to 4-5 years without treatment 1, 3
- In immunocompetent individuals, spontaneous resolution eventually occurs, but the extended duration can lead to social and cosmetic concerns 2
- In immunocompromised patients, lesions may persist even longer and be more extensive, with greater difficulty clearing the infection 2, 4
Factors Affecting Duration
- Immune status significantly impacts duration - patients with weakened immune systems (including those with HIV or on immunosuppressive therapy) experience more prolonged and extensive infections 4, 5
- Location of lesions can affect duration - eyelid lesions may cause associated conjunctivitis that can take weeks to resolve even after elimination of the primary lesion 6
- Multiple or widespread lesions may indicate an underlying immunocompromised state, particularly in adults 6, 4
- Self-inoculation (spreading to other body areas) can prolong the overall duration of infection 2
Treatment Considerations
- The American Academy of Ophthalmology recommends physical removal methods for lesions causing symptoms or near sensitive areas like eyelids 6, 1
- Treatment options include incision and curettage, simple excision, excision and cautery, and cryotherapy 6, 1
- The American Academy of Pediatrics recommends cryotherapy with liquid nitrogen or 10% potassium hydroxide solution as first-line treatments 1
- While "watch and wait" is sometimes recommended due to the self-limiting nature, active treatment may reduce transmission risk, shorten infection duration, and minimize psychosocial impact 5
Important Clinical Considerations
- When treating eyelid lesions, identify and treat all lesions including nascent ones to reduce recurrence risk 6
- Extensive or persistent molluscum contagiosum should prompt consideration of underlying immunodeficiency, particularly in adults 6, 4
- A Cochrane review found limited evidence supporting any single treatment as convincingly effective, suggesting natural resolution remains a reasonable approach in many cases 7
- Imiquimod, despite some clinical reports of success, has not shown benefit compared to placebo in large randomized controlled trials 1, 7