Treatment of Molluscum Contagiosum in Immunocompetent Patients Without HIV Infection

Clinical Scenario

This protocol addresses genital molluscum contagiosum in patients who are immunocompetent, have no HIV infection, and are not receiving immunosuppressive therapy. In this population, expectant management (no active treatment) is a recognised option, as lesions may resolve without intervention.

Treatment Approach

Where active treatment is required, the protocol draws on established physical and self-applied topical interventions targeting the lesions. Where associated dermatitis is present, additional supportive measures may be incorporated alongside the primary approach.

Treatment Goal

Clearance and full resolution of genital molluscum lesions, which also prevents further transmission.

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References

DOI: 10.1177/09564624211070705

Expectant management (no treatment) is recommended for immunocompetent patients (although this recommendation is guided by a Cochrane review of molluscum treatments at non-genital sites).
Where active treatment for genital molluscum is required, we suggest that liquid nitrogen therapy or topical podophyllotoxin may be used.
Cautery of genital molluscum is possible, especially if lesion numbers are not large.
However, cautery is often painful, though discomfort may be lessened by the prior application of local anaesthetic cream (e.g. EMLA cream).
Where molluscum lesions are associated with dermatitis (either due to background atopy or as an immune reaction to lesions), we suggest considering emollients and possibly mild topical steroid to settle inflammation, reduce the risk of scratching and further autoinoculation.
Treatment and full resolution of lesions will prevent further transmission.

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