From the Guidelines
Topical treatment with 10% potassium hydroxide or cryotherapy with liquid nitrogen is recommended for molluscum contagiosum lesions that are cosmetically bothersome or occur in patients with underlying skin conditions such as eczema. When considering treatment options, it's essential to weigh the potential benefits and risks, as resolution of uncomplicated molluscum contagiosum typically occurs spontaneously in 6 to 12 months 1. Some key points to consider when treating molluscum contagiosum include:
- Cryotherapy with liquid nitrogen may be associated with postinflammatory hyperpigmentation or scarring 1
- Imiquimod has not been shown to be of benefit compared with placebo in randomized controlled trials 1
- Cantharidin may be an effective treatment, but its efficacy is not consistently supported by high-quality evidence 1
- Treatment should be individualized based on the patient's specific needs and circumstances, taking into account the potential risks and benefits of each option 1. In clinical practice, the choice of treatment will depend on various factors, including the patient's age, health status, and personal preferences, as well as the severity and location of the lesions.
From the FDA Drug Label
Imiquimod cream was evaluated in two randomized, vehicle-controlled, double-blind trials involving 702 pediatric subjects with molluscum contagiosum (MC) (470 exposed to imiquimod; median age 5 years, range 2-12 years). These studies failed to demonstrate efficacy Similar to the studies conducted in adults, the most frequently reported adverse reaction from 2 studies in children with molluscum contagiosum was application site reaction Adverse events which occurred more frequently in Imiquimod-treated subjects compared with vehicle-treated subjects generally resembled those seen in studies in indications approved for adults and also included otitis media (5% imiquimod vs. 3% vehicle) and conjunctivitis (3% imiquimod vs. 2% vehicle). Erythema was the most frequently reported local skin reaction Severe local skin reactions reported by treated subjects in the pediatric studies included erythema (28%), edema (8%), scabbing/crusting (5%), flaking/scaling (5%), erosion (2%) and weeping/exudate (2%) Imiquimod cream has been evaluated in children ages 2 to 12 years with molluscum contagiosum and these studies failed to demonstrate efficacy.
Topical Molluscum Treatment: Imiquimod cream is not effective for the treatment of molluscum contagiosum in pediatric patients, as demonstrated by two randomized, vehicle-controlled, double-blind trials 2. The most common adverse reactions were application site reactions, including erythema, edema, and scabbing/crusting.
- Key Points:
- Imiquimod cream is not effective for molluscum contagiosum treatment
- Application site reactions are common adverse events
- Erythema, edema, and scabbing/crusting are frequent local skin reactions
- Imiquimod cream has been evaluated in children ages 2 to 12 years with molluscum contagiosum, but studies failed to demonstrate efficacy 2
From the Research
Topical Molluscum Treatment Options
- Various treatment options are available for molluscum contagiosum, including topical imiquimod, cantharidin, and nitric oxide-releasing products 3, 4, 5, 6
- Topical imiquimod has been shown to be effective in treating molluscum contagiosum in children and adults, with a complete remission rate of 73.91% in one study 3
- Cantharidin is another topical treatment option that has been used to treat molluscum contagiosum, with a practical approach to its application and use described in one study 6
- New developing treatments, such as VP-102 and SB206, have shown promising results in terms of safety and efficacy in large cohorts of patients and may potentially be the first FDA-approved therapies for the treatment of molluscum contagiosum 5
Efficacy and Safety of Topical Treatments
- Topical imiquimod has been shown to be safe and effective in treating molluscum contagiosum, with mild to moderate irritation in the application area being the only reported adverse reaction 3, 4
- Cantharidin has been reported to be effective in treating molluscum contagiosum, but its use requires careful consideration of distribution sources, application, and caveats 6
- The efficacy and safety of new developing treatments, such as VP-102 and SB206, have been demonstrated in large cohorts of patients, but further studies are needed to confirm their effectiveness 5
Comparison of Topical Treatments
- Topical imiquimod and cantharidin have been compared in terms of their efficacy and safety in treating molluscum contagiosum, with both treatments showing promising results 3, 4, 6
- New developing treatments, such as VP-102 and SB206, have been designed to overcome the limitations of current treatments and may offer improved efficacy and safety profiles compared to existing topical treatments 5