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Genital Molluscum Contagiosum

While many medical professionals will not treat molluscum contagiosum in otherwise healthy individuals, molluscum papules (raised bumps) in the genital region should be treated to prevent further spread through sexual transmission. However, there are not many treatments specifically recommended for genital treatment. Curettage (scraping off the papules), cryotherapy (killing the virus by freezing the papules with dry ice, skin refrigerant, or liquid nitrogen), salicylic acid, silver nitrate paste, and Trichloroacetic acid are irritating or painful and are generally unsuited to treating such a sensitive area. Cantharidin (the extract of the blister beetle used to cause blistering and then healing of papules) should not be used to treat papules in the genital area because there is a small risk of scarring or of extreme reactions to the extract and many find it painful. Podofilox, a purified form of the main ingredient in podophyllin (an agent that causes skin to loosen and fall off) may be used as it is frequently prescribed for genital warts. Usually, 0.05 ml of 5% podofilox is applied twice daily for three days. It is unknown what effects it could have on an unborn or nursing child, so women who are pregnant or nursing should not use it. Women needing it should be on a reliable form of birth control.

It is also very important to see a medical professional if you have any persistent skin abnormalities in the genital area, as there are several other conditions that present symptoms similar to those of molluscum contagiosum. Genital warts, herpes sores, pearly penile papules, and genital acne can all be confused with the condition. Pearly penile papules are harmless and require no treatment. The greater concern would be side effects of any treatment for the molluscum lesions. Herpes and genital acne, on the other hand, need treatments very different than those for molluscum papules. Genital warts, caused by strains of the human papilloma virus (HPV), are treated in a manner similar to molluscum lesions. The herpes virus remains in the body for life, and HPV persists even when symptoms are not visible (though the virus usually dies after two years), so it is important that these conditions receive proper treatment to minimize the risk of transmission.

If you have papules in the genital area, you should avoid sexual activity until you have seen a healthcare professional. If you do engage in sexual activity, you should use safer sex practices (only having one, uninfected, monogamous partner and using a barrier method such as a condom or a dental dam, a piece of latex or silicone that acts a barrier between the bodily fluids of the mouth, anus, and vulva during oral sex) and inform your current or potential partner(s) of the lesions and risk so they can make an informed decision about engaging in sexual activities with you.

You should also keep in mind that genital papules can also be spread through non-sexual contact, so you should take precautions to prevent spread before, during, and after treatment. Wash your hands regularly, especially if you have touched your lesions. Many people try to shave their pubic areas to "keep an eye on" their papules, but shaving an infected area can cause the virus to spread to a previously unaffected area. It is better to reduce the frequency of shaving and best to stop it altogether until the infection is resolved. Do not scratch the lesions or they may spread. Do not share personal items such as razors, underwear, towels, or soap. Do not use swimming pools or share bathwater.

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