Molluscum contagiosum is a skin infection caused by the molluscum contagiosum virus (MCV), a DNA virus in the poxvirus family. The virus infects only the top layer of skin (the epidermis), which is why the lesions are superficial and almost always heal without scarring. There are four genetic subtypes (MCV-1 to MCV-4), with MCV-1 being most common worldwide and MCV-2 more commonly associated with adult genital lesions. The infection produces small dome-shaped bumps that are pearly white skin-coloured or slightly pink, typically two to five millimetres across, with a characteristic tiny dimple or pit in the centre called umbilication.

Around five percent of adults will have molluscum at some point in their life, and it is even more common in children where it usually appears on the face arms or trunk through casual skin-to-skin contact. In adults the lesions on the lower abdomen pubic area inner thighs genitals or perianal area almost always come from sexual transmission, which places genital molluscum in the category of sexually transmitted infections. The reassuring framing is that molluscum is one of the mildest STIs — it does not cause cancer, does not damage internal organs, does not affect fertility, and clears completely either with or without treatment.

Molluscum is not the same as HPV (the virus that causes genital warts and cervical cancer), not the same as herpes (which causes painful blister-like sores), and not the same as folliculitis (inflamed hair follicles). The distinction matters because the management and the implications are very different. For broader STI context see STIs in Indian Women: Screening, Symptoms, Treatment, and NACO's Free Care.

Molluscum spreads through direct skin-to-skin contact with someone who has the lesions, and the virus is highly contagious where contact is close and prolonged. In adults, lesions on the genitals lower abdomen pubic area inner thighs buttocks or perianal area are almost always the result of sexual contact with a partner who had the lesions (sometimes without realising it, because molluscum is often painless and easily missed). This is why genital molluscum is classified as a sexually transmitted infection in adults, even though it is not a serious STI in the way HIV syphilis or chlamydia are.

Beyond sexual contact, molluscum can spread through any close skin-to-skin contact (which is why children pick it up at school or in playgrounds on the face arms and trunk), and through shared towels razors clothing or sports equipment that has touched the lesions. The virus does not spread through casual contact like handshakes, through air, or through toilet seats in any meaningful way — it needs direct close skin contact or contact with very recently contaminated items.

The most important and underappreciated mode of spread is autoinoculation — spreading the virus from one part of your own body to another by scratching squeezing or rubbing the lesions and then touching another area of skin. This is how a small patch of molluscum can become widespread within weeks, and why the single most important self-care instruction is do not scratch or squeeze the bumps. Shaving over the lesions is a particularly effective way of spreading them across the shaved area and is best avoided until the lesions clear.

Molluscum lesions have a recognisable appearance once you know what to look for. They are small dome-shaped bumps two to five millimetres across (occasionally up to ten millimetres in larger lesions or in immunocompromised people), pearly white skin-coloured or slightly pink in colour, with a smooth shiny surface and a characteristic tiny dimple or pit in the centre called umbilication. The umbilication is the single most useful identifying feature and is what distinguishes molluscum from most other small bumps. Inside the central dimple is a small core of white waxy material that contains the virus.

The lesions are usually painless, occasionally mildly itchy, and do not bleed unless scratched or traumatised. They typically appear in small clusters of five to twenty lesions in a localised area, although they can be solitary or, in immunocompromised people, very widespread. On the genitals lower abdomen pubic area inner thighs or buttocks the lesions can blend in with skin colour and can be easy to miss in the early stages, particularly if there is no itch or discomfort drawing attention to them.

New lesions often appear over weeks or months while older lesions are clearing, which is why the overall infection can last six to twelve months. A single lesion that is briefly inflamed red and crusted may be a sign that the immune system is starting to clear it, which is a good sign rather than a worrying one. Photographing the lesions periodically helps you track which are clearing and whether new ones are appearing, which is useful information to share with the doctor.

Several other conditions can cause small bumps on or near the genitals and confusing them with molluscum is common. The most important distinction is from HPV genital warts (condyloma acuminata), which are caused by a completely different virus, look very different (rough cauliflower-like or flat skin-coloured growths rather than smooth pearly domes), do not have the central dimple, are caused by HPV which has cancer-risk subtypes (16, 18) that molluscum does not, and need different treatment. See HPV in India: Types, Symptoms, Diagnosis, and Treatment Explained and Genital Warts (Condyloma) From HPV in Indian Women: Diagnosis, Treatment Options and Prevention for that condition.

Genital herpes (HSV) produces small painful blisters that cluster in groups, are filled with clear fluid, often burn or tingle before they appear, break open to form shallow ulcers, and heal in seven to ten days only to recur in the same area. Herpes lesions are painful where molluscum lesions are painless, and form fluid-filled blisters where molluscum forms solid pearly domes. Herpes needs antiviral treatment (acyclovir, valacyclovir) and has implications for partner notification that molluscum does not.

Folliculitis (inflamed hair follicles) produces small red bumps centred on hair follicles, often with a tiny pustule on top, usually itchy or tender, and commonly appears after shaving or waxing in the pubic and inner thigh area. Folliculitis does not have the central dimple of molluscum and is red and inflamed rather than pearly. Pubic lice nits sebaceous cysts skin tags and Fordyce spots (normal sebaceous glands) can also be mistaken for molluscum but each has its own distinct appearance. When in doubt, a dermatologist or OB-GYN can diagnose molluscum on visual examination alone in most cases, sometimes with a dermoscope. For folliculitis see Vaginal and Pubic Folliculitis in Indian Women: Causes, Treatment and Prevention After Waxing or Shaving.

Molluscum contagiosum is a self-limiting infection, which means the immune system eventually clears it on its own without any treatment in immunocompetent people. The typical timeline is six to twelve months from first appearance to complete clearance, although it can be shorter in some people and longer (up to eighteen to twenty-four months) in others. Individual lesions usually last two to three months each before resolving, but new lesions appear over the course of the infection through autoinoculation, which is why the overall infection lasts much longer than any one lesion.

In people with normal immune systems the clearance is usually complete and the skin returns to normal, sometimes with a small temporary pigment change that fades over months. Scarring is rare unless the lesions are picked at squeezed or treated aggressively. In people who are immunocompromised (HIV positive with low CD4 count, on chemotherapy, on long-term immunosuppressants after transplant, or with certain rare immune conditions) molluscum can be much more extensive (hundreds of lesions), can last much longer (years), can be larger and more disfiguring, and may need more aggressive treatment along with addressing the underlying immune state.

The natural course matters because it informs the treatment decision. For many people with a small number of asymptomatic lesions, watchful waiting is a reasonable option — the infection will clear on its own and treatment carries some discomfort and small risk of scarring without changing the eventual outcome. For others (lesions spreading, cosmetic concern, partner risk, immune compromise) active treatment makes more sense and is straightforward.

Treatment of molluscum is a personal decision rather than a medical necessity for most adults, and both watchful waiting and active treatment are reasonable choices that an Indian dermatologist or OB-GYN will discuss with you rather than dictate. Watchful waiting (waiting for the immune system to clear the infection over six to twelve months) is sensible when there are only a few lesions, they are not in a particularly visible or symptomatic location, they are not spreading rapidly, you have a stable single sexual partner who is informed and is also being checked, and your immune system is normal.

Active treatment is more often chosen when the lesions are causing symptoms (itching tenderness or visible discomfort), are spreading rapidly across the genital and pubic area, are causing cosmetic distress that affects daily life or intimate relationships, are in a location where they are at high risk of being traumatised or autoinoculated (the shaving area for example), you have a new sexual partner you want to protect, you are immunocompromised and the lesions are not clearing on their own, or you are pregnant and want clearance before delivery to reduce the small risk of neonatal exposure.

Treatment is also more strongly recommended if there is uncertainty about the diagnosis and the lesions need to be removed for confirmation, or if they are in a sensitive location (around the urethra anus or vagina) where they need a doctor's assessment and intervention rather than home management. The dermatologist or OB-GYN will help you weigh up the options based on your specific situation rather than treating reflexively.

Several effective treatments for molluscum are available in India, and the choice depends on the number of lesions their location your tolerance for the procedure and the dermatologist or OB-GYN's preference. Curettage is the most common in-clinic option — the doctor uses a small sharp instrument (a curette) to scoop out each lesion under a topical anaesthetic cream like EMLA (lignocaine-prilocaine cream), which is applied for thirty to sixty minutes before the procedure to numb the area. Curettage is quick (a few minutes for several lesions), effective in a single session for most cases, and costs around five hundred to two thousand rupees per session at a dermatologist or OB-GYN private clinic.

Cryotherapy with liquid nitrogen freezes each lesion for a few seconds, causing it to blister and fall off over the following week. It is well-tolerated, effective, and costs around five hundred to two thousand rupees per session, with most cases needing one to three sessions spaced two to three weeks apart. Cantharidin (a blistering agent applied by the doctor in the clinic, not available for home use) is sometimes used in specialised dermatology practice for sensitive areas. Topical podophyllotoxin 0.5 percent solution (Wartec, around four hundred to seven hundred rupees) applied at home twice daily for three consecutive days each week is effective for genital molluscum and is one of the more accessible home options, though it should be used under dermatology guidance and is not safe in pregnancy.

Topical imiquimod 5 percent cream (Imiquad, around four hundred to eight hundred rupees) applied a few times a week is sometimes used as an immune-stimulant approach and is reasonably effective but slower (weeks to months) than curettage or cryotherapy. NACO STI clinics across India provide free or low-cost consultation and basic treatment for STI-related skin conditions including molluscum, with full confidentiality. ASHA workers can provide a confidential referral to a government STI clinic. Free confidential HIV testing is also available through NACO if there is any concern about underlying immune status.

Preventing autoinoculation — spreading the virus from one part of your own body to another — is the single most important thing you can do at home, and several practical measures make a real difference. Do not scratch squeeze pick at or otherwise disturb the lesions, however tempting it may be. The waxy core of the lesion contains live virus and breaking it open releases that virus onto your fingers and then onto whatever you touch next. If the lesions itch, a gentle moisturiser or a brief application of a mild anti-itch cream (calamine lotion, or a mild hydrocortisone cream short-term under doctor guidance) can take the edge off without breaking the skin.

Wash your hands thoroughly with soap and water after touching the area for any reason (including after changing clothes or after the toilet), and avoid touching the lesions with the same hand that then touches the face other parts of the body or other people. Do not share towels washcloths razors loofahs underwear or other intimate clothing while you have active lesions — wash these in hot water and dry on high heat after each use during the infection. Use your own towel for the genital area and a separate towel for the rest of the body.

Avoid shaving over or near the lesions, because shaving drags the razor across the lesions, spreads the virus along the path of the shave, and is one of the fastest ways to develop dozens of new lesions in the shaved area. If you normally shave the pubic area, pause shaving until the infection has cleared. Cover the lesions with a loose cotton dressing or clothing where practical to prevent rubbing against other body parts. If you swim use your own personal towel and do not share lockers or benches in direct skin contact.

Molluscum on the genitals in an adult is sexually transmitted in almost all cases, and an honest conversation with your sexual partner is part of responsible management — both so they can be checked and treated if they have lesions, and so they can take precautions to avoid contracting the infection from you. The conversation can be difficult but the framing helps: molluscum is one of the mildest STIs, is not the same as HPV herpes or HIV, does not cause cancer or long-term damage, and is treatable. It is not a sign of infidelity in either direction because molluscum lesions can be present for weeks before they are noticed, and partners can carry and transmit lesions without realising.

The simplest precaution during an active infection is to abstain from sexual contact in the genital and pubic area until all visible lesions have cleared, which usually takes a few weeks with treatment or several months without. This is the most reliable way to prevent transmission. Condoms provide only partial protection because they cover the penis but not the surrounding pubic skin lower abdomen inner thighs or scrotum, which is where many lesions sit and where skin-to-skin contact still happens during sex. Condoms are still worth using during this period for their protection against other STIs and for the partial reduction in molluscum risk, but they should not be relied on as complete protection.

If your partner has lesions they should also be assessed by a dermatologist or OB-GYN and treated in parallel, otherwise you may pass the infection back and forth indefinitely. Both partners should also consider broader STI screening (HIV, syphilis, chlamydia, gonorrhoea, hepatitis B) because the same sexual contact that transmitted molluscum can transmit other infections, and free confidential STI screening is available through NACO clinics across India.

Most cases of suspected genital molluscum benefit from at least one visit to a dermatologist or OB-GYN to confirm the diagnosis and discuss the treatment options, even if you ultimately choose watchful waiting. The visit is particularly important when there is uncertainty about whether the bumps are molluscum or something else (HPV warts, herpes, folliculitis, sebaceous cysts), when the lesions are spreading rapidly across the pubic and genital area, when they are in sensitive locations like the perianal area or around the urethra where they are harder to manage at home, or when they are causing significant itching pain bleeding or cosmetic distress.

Specific situations that need prompt OB-GYN review include lesions that may be inside the vagina or on the cervix (which need colposcopy for proper assessment because they cannot be seen on simple external examination), pregnancy with active genital molluscum (because of the small risk of neonatal exposure during delivery), any suspicion of immune compromise (recurrent unusual or widespread infections, known HIV positive status, on immunosuppressant medication, after organ transplant), and lesions that have been present for more than six months without showing any signs of clearing.

Indian options for evaluation include private dermatology clinics (Kaya Skin Clinic, Oliva Skin Clinic, Apollo dermatology departments) with consultations typically in the range of five hundred to two thousand rupees, OB-GYN clinics for genital lesions where a gynaecological perspective is helpful (Apollo Cradle, Cloudnine, Manipal, Max), and NACO-funded STI clinics across India that provide free confidential consultation and treatment for sexually transmitted skin conditions including molluscum. ASHA workers in primary healthcare can provide a confidential referral to the nearest government STI clinic and can support women who are concerned about privacy when discussing genital health issues.