It's officially summer and that means it's shorts and tank-top season. It also means that you may have noticed some bumps or growths on your child's skin you've never noticed before. Many of these skin lesions can just be left alone and monitored, but some may require that you make an appointment with your child's primary care provider (PCP) to make sure all is well.
If you've recently taken a look at your child's skin and found tiny, skin to pink colored lesions, approximately pinpoint to pencil-eraser in a size, these could be molluscum contagiosum (see here). Molluscum contagiosum sounds scarier than it actually is, but they can become troublesome if not closely monitored. They are warts caused by molluscum virus, which is a poxvirus and causes these annoying non-cancerous lesions. They are painless and spread by direct skin-to-skin contact or by sharing towels with someone who has molluscum contagiosum. The good news is, most times, if left alone, they will resolve on their own. The bad news is that it can take anywhere from 6 months up to 2 years for these pesky little lesions to go away and during that time there is risk of it spreading to other parts of the body, especially if your child has atopic disease like eczema.
So what to do? Honestly, less is more. Make sure your child keeps his skin well-moisturized. That way he will be less inclined to scratch at the bumps and spread them to other places. Also, pay attention to where and how many lesions he has. If you start noticing more lesions appearing or if they spread to other parts of the body, you should make an appointment with his PCP for further evaluation. Your PCP can assess the situation and decide whether or not your child can continue to wait it out or if treatment is necessary. While there are many treatment options available, there aren’t any that are approved by the Food and Drug Administration (FDA) for children, and none are guaranteed to speed up resolution. Nonetheless, and depending on the comfort level of your PCP, some treatment options include destruction of molluscum lesions with liquid nitrogen or cantharidin. Liquid nitrogen causes destruction of the lesions by using extremely low temperatures to destroy the tissue at the cellular level. Cantharidin, on the other hand, is a colorless, odorless, terpenoid that is secreted by blister beetles. This causes the skin to blister and in turn, theoretically, destroys the tissue onto which it is applied. Both of these treatments, while effective, can be painful and often leave a pinpoint scar behind after they heal. Other treatment options include application of topical imiquimod or retinoids, oral cimetidine, and Candida antigen injections.
If you’ve recently noticed firm, rough, flesh-colored bumps on your child’s body, most often hands or feet, these could be warts. They can also be tan, yellow, grayish, brown or black in color and sometimes they are flat and smooth (see here). Warts are caused by the human papillomavirus (HPV). They are contagious, but more easily acquired with a cut or scrape on your skin. Warts will often go away by themselves without requiring treatment, however, there are some over-the-counter salicylic acid preparations (see here) that are effective and your child’s PCP can treat stubborn ones in the office using liquid nitrogen. In some cases, your child’s PCP may refer you to a dermatologist for reasons such as multiple, recurring warts, if the wart is in sensitive areas such as the face or genitalia, large or painful warts, or if the wart is bothering your child. If you have questions or concerns, just give us a call at ABC Pediatrics. We’d love to see you!
Information presented adapted from:
Mary-Faith Fuller, CPNP
I am a Pediatric Nurse Practitioner who has worked at ABC Pediatrics since January 2014.