Molluscum Contagiosum in Adults: Symptoms, Causes, and UK Treatment Guide

Molluscum contagiosum is a common viral skin infection caused by a member of the poxvirus family. While it is frequently seen in children due to casual contact in environments like swimming pools, it is also a significant concern for adults in the UK, where it is often classified as a sexually transmitted infection (STI) when bumps appear in the genital area.

According to NHS guidance, the infection is generally harmless and self-limiting, meaning it will eventually disappear on its own without treatment. However, because the virus can be unsightly and highly contagious, many patients seek a medical diagnosis to manage the symptoms and prevent spreading the virus to others.

How to Identify the Bumps

Molluscum bumps, known medically as papules, have a distinct appearance that differentiates them from common spots or heat rash. Key characteristics include:

• Size: Small, usually between 2mm and 5mm in diameter.
• Shape: Firm, dome-shaped, and often pearly or shiny.
• Dimple: A characteristic small central pit or 'umbilication' in the middle of the bump.
• Colour: Usually flesh-coloured, pink, or white.
• Location: In adults, they commonly appear on the lower abdomen, groin, upper thighs, and genitals, though they can occur anywhere on the body except the palms and soles.

The bumps are typically painless, but they can become itchy, red, or inflamed, especially if they are about to heal or if they have been irritated by clothing or scratching.

The virus thrives in warm, damp environments and is easily transmitted through various forms of contact. In the UK, adult cases are most frequently linked to:

• Skin-to-skin contact: This includes close physical contact during sexual activity.
• Fomites: Sharing personal items such as towels, flannels, razors, or gym equipment that has touched infected skin.
• Autoinoculation: Scratching or picking at a bump and then touching another part of your own body, which causes the virus to seed elsewhere.

To reduce transmission, NICE (National Institute for Health and Care Excellence) suggests avoiding the sharing of towels and ensuring that bumps are covered with clothing or a waterproof plaster if you are using shared facilities like public swimming pools.

One of the most common reasons patients speak to a GP online at OnlineDoctor24 is to determine if a new growth is molluscum or genital warts (HPV). While both are viral STIs, they require different management strategies.

• Molluscum: Usually has a smooth, dome-like surface with a central dimple. They are often firm and singular or in small clusters.
• Genital Warts: Typically have a 'cauliflower-like' or grainy surface and may appear flatter or more irregular in shape.

Because it can be difficult to tell the difference without a professional eye, a confidential GP consultation is highly recommended to ensure you receive the correct advice and treatment.

For most healthy adults, the NHS standard approach is 'watchful waiting'. This is because the immune system will eventually clear the virus, though this can take anywhere from 6 to 18 months. However, active treatment may be considered if the bumps are causing psychological distress, are particularly itchy, or are located in areas prone to friction.

Topical Treatments

A doctor may prescribe or suggest topical treatments to irritate the bumps and stimulate the immune response. These include potassium hydroxide solutions or specific creams designed to break down the skin cells containing the virus.

Physical Removal

In some cases, a specialist clinic may offer:

• Cryotherapy: Freezing the bumps with liquid nitrogen.
• Curettage: Scraping the bumps away under local anaesthetic.
• Laser Therapy: Using targeted light to destroy the lesion.

Patients are strongly advised never to attempt to squeeze, pop, or 'home-surgery' these bumps, as this can lead to severe scarring and widespread bacterial infection.

If you have noticed new, persistent bumps in your genital or pelvic region, seeking a professional opinion is a responsible step for your sexual health. Speaking to an online GP in the UK allows you to get a confidential assessment from the comfort of your home.

An online doctor can review your symptoms, provide a provisional diagnosis based on high-quality photographs or video, and advise whether you require a referral to a local GUM (Genitourinary Medicine) clinic. They can also provide a private sick note if physical symptoms or treatment recovery are affecting your work, and offer guidance on how to talk to your partner about the infection.