Ranitidine for Molluscum Contagiosum in Children

Ranitidine is not effective for treating molluscum contagiosum in children and should not be used for this condition. 1, 2

Evidence Against Ranitidine for Molluscum Contagiosum

While H2 receptor antagonists like ranitidine have been investigated for warts due to their ability to increase IL-2 and IFN-c expression from T lymphocytes, there is no evidence supporting their use specifically for molluscum contagiosum 1
The British Association of Dermatologists guidelines mention ranitidine only in the context of wart treatment, not molluscum contagiosum, with limited evidence even for warts 1
Current guidelines from the American Academy of Pediatrics and American Academy of Dermatology do not include ranitidine among recommended treatments for molluscum contagiosum 2, 3

Physical removal methods are recommended as first-line therapy, including:
- Curettage - highly effective with 70% of children cured after one treatment and 26% after two treatments 4
- Cryotherapy with liquid nitrogen 2
- Simple excision or excision and cautery 2

10% potassium hydroxide solution has similar efficacy to cryotherapy in children and is recommended by the American Academy of Pediatrics 2
Cantharidin has shown effectiveness in observational studies, though randomized controlled trial evidence is limited 2

Imiquimod 5% cream lacks efficacy compared to placebo for molluscum contagiosum, with high-quality evidence showing no significant difference in clinical cure rates at 12,18, or 28 weeks 5
For children under 2 years, salicylic acid is contraindicated due to risk of systemic toxicity 3
Watchful waiting is a reasonable approach as molluscum contagiosum typically resolves spontaneously within 6-12 months 3, 5

Confirm diagnosis by identifying characteristic skin-colored, whitish, or pink papules with central umbilication, typically on the trunk, face, and extremities 6
Assess extent of disease and presence of complications such as associated conjunctivitis if lesions are near the eyes 2
Consider patient's age, location of lesions, number of lesions, and presence of symptoms when selecting treatment 2, 3
For extensive or recalcitrant disease, consider screening for immunocompromised state 2

For limited, asymptomatic lesions: Consider watchful waiting with monitoring 3, 5
For symptomatic, numerous, or cosmetically concerning lesions: Use physical removal methods (curettage preferred) 4, 2
For children who cannot tolerate physical methods: Consider 10% potassium hydroxide solution 2
For periocular lesions: Physical removal with monitoring for associated conjunctivitis 2

Avoid using ranitidine or other H2 blockers for molluscum contagiosum as there is no evidence supporting their efficacy for this condition 1, 2
Be aware that ranitidine's primary indication is for gastroesophageal reflux and reducing gastric hypersecretion, not for dermatological conditions 1
Do not use salicylic acid in children under 2 years due to risk of systemic toxicity 3
Recognize that imiquimod, despite theoretical promise, has been proven ineffective in high-quality studies 5