Hot Tub Use and Contagiousness in Molluscum Contagiosum
Children with active molluscum contagiosum lesions should avoid hot tubs and swimming pools, and they remain contagious until all lesions have completely resolved, which typically takes 6-12 months but can persist up to 4-5 years without treatment. 1
Transmission Risk and Pool/Hot Tub Avoidance
- Molluscum contagiosum virus (MCV) is transmitted through direct skin-to-skin contact, fomites, and self-inoculation, making shared water environments like hot tubs and swimming pools high-risk settings for transmission 1
- Childhood infections are frequently linked to swimming pool attendance, where the combination of close physical contact, shared surfaces, and compromised skin barriers from prolonged water exposure facilitates viral spread 2, 3
- The virus is highly infectious and can be transmitted through intimate skin-to-skin contact or contaminated surfaces in aquatic environments 2
When Contagiousness Ends
- A child is no longer contagious only when all visible lesions have completely resolved 1
- The natural course of untreated molluscum typically lasts 6-12 months, though lesions can persist for up to 4-5 years 1, 4
- The "beginning of the end" (BOTE) sign—an inflammatory response around lesions—indicates imminent resolution, with complete healing typically occurring within approximately 2 months after this sign appears 5
- Even nascent (early, barely visible) lesions are infectious and should be identified and treated to reduce transmission risk 1
Practical Recommendations for Pool and Hot Tub Use
- Exclude children from hot tubs and swimming pools until all lesions are completely gone 2, 3
- If treatment is pursued (physical removal, cryotherapy, or topical agents), the child should still avoid shared water environments until all treated areas have healed and no new lesions appear 1
- Hand hygiene with alcohol-based disinfectant or soap and water is the most important method to prevent transmission to others 1
Important Caveats
- Covering lesions with waterproof bandages does not adequately prevent transmission in aquatic environments, as the virus can spread through self-inoculation and contact with contaminated surfaces 1, 4
- Children with atopic dermatitis are at higher risk for widespread lesions and should be particularly cautious about exposure settings 3
- Immunocompromised children may have more extensive, persistent disease and pose a higher transmission risk 1, 6