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Sexually Transmitted Molluscum

Sexually active (and often young) adults are one of the higher risk groups for contacting the molluscum contagiosum virus (MCV). In cases where the papules (raised bumps) appear on or near the genital area, it is likely that the virus was transmitted sexually. Vaginal intercourse, oral sex, and anal sex, and mutual masturbation all risk transmission as MCV is passed via skin-to-skin contact, rather than through bodily fluids. Sexual transmission is common in adults while, unsurprisingly, rare in children. When children's papules are concentrated in the genital area, however, the slight possibility of sexual abuse should be investigated.

If papules are present, you should request to be tested for other sexually transmitted infections (STIs) which you may also have contracted. It is not uncommon for other STIs to be found alongside a molluscum contagiosum infection. The lesions are often confused with those caused by the herpes simplex or genital warts caused by the human papilloma virus (HPV) and are sometimes only distinguished by laboratory sample results. Pearly penile papules and genital pimples can also be similar in appearance, with genital acne also having a visible whitish core. Pearly penile papules require no treatment and are harmless, so the greater concern would be whether or not any treatment mistakenly undergone for "molluscum" papules would leave any scarring or have any side effects. Treatment for genital acne and herpes varies widely from that for molluscum lesions. Genital warts can be treated in a similar manner to molluscum papules, using podophyllin or podofilox. Unlike MCV, HPV can remain in the body for years (though in most cases the individual is HPV-free after two years) and herpes for life, even if neither virus presents any symptoms. For this reason, it is particularly important to treat these conditions. If you have any sort of bumps in the genital area, do not engage in sexual activity until you have met with a doctor.

If you do engage in sexual activity, do so only with one uninfected partner and use condoms or dental dams (a rectangular piece of latex or silicone that acts as a barrier between the fluids of the mouth, vulva, and anus during oral sex), though these methods will only minimize skin-to-skin contact, not eliminate it. You should also explain molluscum contagiosum, your papules, and the risk of transmission to any of your potential or current sexual partners, so they can make an informed decision about engaging in sexual activity with you.

The virus can still be spread by non-sexual contact if it was acquired through sexual activity, so the usual precautions should be taken to prevent spread. You may be tempted to shave the pubic area to "keep an eye on" papules, but shaving the infected area can spread lesions to previously uninfected areas. It is best to let the hair grow or at least reduce the frequency of shaving. Do not share personal items such as underwear, soap, towels, or razors. Do not use swimming pools or share bathwater. Do not scratch the lesions or they may spread. Wash your hands regularly, particularly after touching the papules.

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