What is the treatment for molluscum contagiosum on the vulva?

From the Guidelines

Treatment for molluscum contagiosum on the vulva should prioritize cryotherapy with liquid nitrogen due to its efficacy and relatively low risk of complications, as supported by recent studies 1. When considering treatment options, it's essential to weigh the benefits and potential drawbacks of each approach. For instance, cryotherapy may be associated with postinflammatory hyperpigmentation or scarring, but it appears to have similar efficacy to other treatments like 10% potassium hydroxide. Some key points to consider when treating molluscum contagiosum on the vulva include:

• Resolution of uncomplicated molluscum contagiosum typically occurs spontaneously in 6 to 12 months, although complete resolution of lesions can take up to 4 years 1.
• Cryotherapy with liquid nitrogen and 10% potassium hydroxide have been used to treat lesions that are cosmetically bothersome or for patients with underlying skin conditions such as eczema 1.
• Imiquimod was not shown to be of benefit compared with placebo in randomized controlled trials, making it a less favorable option 1.
• Cantharidin may be an effective treatment, but its efficacy is based on open-label and observational studies, and a small randomized controlled trial did not find statistically significant improvement 1. It's crucial to approach treatment with caution and consider the potential risks and benefits of each option, prioritizing the patient's quality of life and minimizing the risk of complications.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Treatment Options for Molluscum Contagiosum on the Vulva

• The treatment of molluscum contagiosum (MC) is controversial, but it is generally recommended in cases of extensive disease, associated complications, or aesthetic complaints 2.
• Several treatment modalities are available, including mechanical, chemical, immunomodulatory, and antiviral options 2.
• Topical imiquimod has been shown to be an effective and safe treatment for MC in children, with a complete remission rate of 73.91% in one study 3.
• Imiquimod is a topically applicable Toll-like receptor (TLR)-7/8 agonist that stimulates the innate cutaneous immunity and the cellular arm of the adaptive immune response, exerting potent anti-viral, anti-tumor, and immunoregulatory effects 3.
• Other treatment options for MC include physical treatments (cautery, curettage, and cryotherapy), topical chemical treatments (e.g., podophyllotoxin and imiquimod), or waiting for spontaneous resolution in immunocompetent patients 4.
• In pregnancy, physical procedures (e.g., cryotherapy) are considered safe for the treatment of MC 4.
• Immunosuppressed patients may require treatment with cidofovir, imiquimod, or interferon to manage severe and recalcitrant MC lesions 4.
• Cantharidin is another treatment option for MC, which can be applied topically and has been shown to be effective in some cases 5.

Considerations for Treatment

• The choice of treatment for MC on the vulva should take into account the patient's overall health, the extent of the disease, and the potential risks and benefits of each treatment option 2, 4.
• Patients with MC should be offered screening for other sexually transmitted infections 4.
• The treatment of MC should aim to alleviate symptoms, prevent the spread of the infection, and minimize the risk of complications such as scarring and superinfection 5, 6.