Noticing new smooth bumps on the genital skin can understandably cause concern. One possible explanation is molluscum contagiosum, a common viral skin infection caused by a poxvirus.
In adults, genital lesions are most often transmitted through direct skin-to-skin contact, including during sexual activity. Outside the genital area, molluscum is also common in children through everyday close contact.
The condition is benign and self-limiting, meaning it resolves naturally in most people, although this can take several months.
What Is Happening in the Skin?
The virus infects the outermost layer of the skin (the epidermis).
It does not enter the bloodstream and does not cause internal illness in otherwise healthy individuals.
Lesions tend to develop and resolve in recognisable stages.
The Stages of Molluscum Contagiosum
The infection follows a specific cycle. By observing the stages of Molluscum contagiosum, you can often tell whether the virus is just beginning or if your immune system is starting to clear it.
Stage 1: Early Lesions
Small, firm bumps appear on the skin. They are typically:
- Flesh-coloured or pearly
- Smooth and dome-shaped
- 1–2 mm in size initially
- Usually painless
At this point, they may resemble ingrown hairs, small cysts, or early genital warts.
Stage 2: Characteristic (Umbilicated) Stage
As lesions enlarge (often 2–5 mm), they develop a small central indentation. This feature — called umbilication — is a key clinical sign.
The centre contains a white, waxy material made up of viral particles and skin cells. Squeezing or scratching lesions can spread the virus to nearby skin, leading to additional spots.
Stage 3: Inflammatory Phase
Some lesions become:
- Red
- Slightly swollen
- Crusted
- Mildly itchy or tender
Although this can appear worrying, it often represents the immune system beginning to clear the virus. This phase does not usually indicate a bacterial infection.
However, increasing pain, spreading redness, or discharge should be assessed by a clinician.
Stage 4: Healing and Resolution
Lesions gradually flatten and disappear.
In people with a normal immune system:
- Individual bumps may resolve within a few months
- The overall condition may last 6–12 months
- Some cases persist longer, particularly if new lesions continue to appear
Temporary pigmentation changes can occur but permanent scarring is uncommon unless lesions are traumatised.
Do All Cases Require Treatment?
No.
According to UK clinical guidance, molluscum contagiosum does not require treatment in most cases because it clears spontaneously.
Treatment may be considered when:
- Lesions are increasing in number
- They are causing distress or embarrassment
- There is uncertainty about the diagnosis
- Transmission risk is a significant concern
The decision is usually guided by patient preference rather than medical necessity.
Treatment Options
Management approaches include:
- Watchful waiting
- Physical removal methods (such as curettage or cautery)
- Other procedural treatments, depending on location and number
Procedural treatments remove visible lesions but do not alter the underlying immune response. New lesions can still develop until natural clearance occurs.
Any intervention carries small risks, including discomfort, pigment change, or rarely minor scarring. A consultation allows these risks and benefits to be discussed clearly.
How Long Does Molluscum Contagiosum Last?
Without treatment, the stages of Molluscum contagiosum can take a long time to complete. While individual bumps might resolve in a few months, the virus can spread to adjacent skin, leading to new crops of bumps appearing just as the old ones heal. This “autoinoculation” can mean the condition persists for 6 to 18 months, or sometimes longer.
Why Seek a Consultation?
While the virus eventually clears on its own, many of our patients choose to seek treatment for several reasons:
- To prevent transmission: Removing the lesions reduces the risk of passing the virus to a partner.
- Aesthetic concerns: The bumps can affect confidence and sexual well-being.
- Clarity: It is important to rule out other conditions, such as Genital Warts (HPV, Folliculitis, Benign cysts) or fungal infections, which may require different management.
Treatment at our Clinic
While molluscum contagiosum will usually resolve naturally over time, many patients prefer active treatment for practical or personal reasons.
Within our Genital Dermatology service, we offer procedural removal options such as hyfrecation (precise electrocautery). This method targets the visible lesion directly and can reduce the number of active lesions more quickly than waiting for natural resolution.
Treatment is performed under local anaesthetic to maximise comfort. In suitable cases, removal may be offered during the same visit following assessment.
As with all procedures, small risks such as temporary pigmentation change, mild discomfort, or recurrence are discussed beforehand so you can make an informed decision.
Taking the Next Step
If you have noticed new or changing genital skin lesions and would like a professional assessment, our team can guide you through the process.
Your care pathway typically includes:
- Pre-appointment questionnaire
A confidential online form allows you to share relevant medical details in advance. Where appropriate, photographs can be submitted for preliminary review.
- Clinical consultation:
A specialist examination is performed to confirm the diagnosis and discuss management options tailored to your situation.
- Treatment (if indicated):
When clinically appropriate and agreed upon, procedures such as hyfrecation may be performed during the same visit. In some cases, staged treatment or monitoring may be recommended instead.
Molluscum contagiosum is common and manageable. Our approach is discreet, respectful, and focused on helping you make an informed decision about your care.
