Warts and molluscum

What are warts?

Warts are benign viral growths of the skin caused by infection with human papillomavirus (HPV). There are more than 100 strains of HPV — the strains that cause common skin warts are different from those associated with genital or cervical disease.

Warts can appear anywhere on the body but are most commonly found on the hands, fingers, feet (plantar warts), and around the nails (periungual warts). They vary in appearance depending on their location:

• Common warts — rough, raised growths most often on the hands and fingers
• Plantar warts — flat or inward-growing warts on the soles of the feet, often painful when walking
• Periungual warts — warts around or under the fingernails or toenails
• Flat warts — smooth, flat-topped lesions that often appear in clusters on the face or legs
• Filiform warts — thread-like projections commonly found on the face around the nose and mouth

Warts are especially common in children, young adults, and individuals with a weakened immune system. They are not a sign of poor hygiene and carry no social stigma — they are simply a viral infection, like any other.

What is molluscum contagiosum?

Molluscum contagiosum is a viral skin infection caused by a poxvirus — the molluscum contagiosum virus (MCV). It presents as small, round, pearly or flesh-coloured bumps with a characteristic dimpled centre, most commonly appearing in clusters on the trunk, arms, legs, and face.

Molluscum is particularly common in children between the ages of one and ten, where it spreads readily in school and childcare settings and through shared bathing and swimming. It can affect adults, particularly those who are immunosuppressed or who have had close skin contact with an infected person.

Unlike warts, molluscum lesions are generally smooth and soft rather than rough and hard. Individual lesions are typically two to five millimetres in diameter and may become inflamed, red, or itchy — particularly in individuals with a background of eczema, where the skin barrier is already compromised.

How do warts and molluscum spread?

Both conditions are contagious and spread through direct skin-to-skin contact with an infected person or an infected surface.

Warts spread through:

• Direct contact with a wart on another person's skin
• Touching contaminated surfaces — swimming pools, gym floors, shared towels, bath mats
• Self-inoculation — spreading from one body site to another by picking, scratching, or biting affected areas
• Entry through small cuts, abrasions, or dry, cracked skin

Molluscum spreads through:

• Direct skin contact with an infected person
• Shared baths, towels, clothing, or swimming pool equipment
• Scratching molluscum lesions and then touching other skin areas
• Close contact in communal environments — schools, childcare centres, swimming pools

Both conditions can be present for weeks to months before lesions become visible, making it difficult to identify the source of infection.

Who is most at risk?

Certain groups are more susceptible to warts and molluscum:

• Children — immune systems that haven't yet developed full responses to these viruses, combined with close contact in schools and childcare
• Swimmers and athletes — frequent exposure to communal wet environments
• People with eczema or atopic dermatitis — a compromised skin barrier makes it easier for viruses to enter the skin
• Immunosuppressed individuals — those on immunosuppressive medications or with conditions affecting immune function may develop more extensive or treatment-resistant infections
• Anyone with cuts, abrasions, or dry skin — impaired skin barriers provide an entry point for infection

Do warts and molluscum go away on their own?

Both conditions can resolve without treatment, but this can take considerable time — often one to two years or longer — and carries risks of further spread to other body sites and to close contacts in the meantime.

Molluscum in otherwise healthy children will often eventually clear without treatment, but the process can be slow and some children develop secondary eczema or scarring around the lesions. In children with a background of eczema, professional treatment is generally recommended to prevent complications.

Warts are less predictable. Some resolve spontaneously; others persist for years and become increasingly resistant to over-the-counter treatments. Early professional treatment reduces the duration of infection and the risk of spread.

When should I see a dermatologist?

We recommend seeking a dermatologist assessment if:

• Over-the-counter treatments have not achieved clearance after several weeks of consistent use
• Warts or molluscum are spreading to new sites
• Lesions are painful, particularly plantar warts causing difficulty walking
• You or your child has a background of eczema, which can complicate molluscum management
• Lesions are in a sensitive or difficult-to-treat location — around the nails, on the face, or in the genital area
• You are immunosuppressed or taking medications that affect immune function
• You are uncertain whether a lesion is a wart, molluscum, or something else entirely — accurate diagnosis is the essential first step