Genital Molluscum in Adults, and Whether to Treat It

What Molluscum Actually Is

Molluscum contagiosum is a common skin infection caused by a poxvirus, and it shows up as small, firm, dome-shaped bumps, often with a tiny dimple or pit in the center — a feature called umbilication that helps distinguish it from a wart or a pimple. The bumps are usually flesh-colored or slightly pink, painless, and range from the size of a pinhead to a pencil eraser.

They typically appear in clusters of a few to a few dozen, most often where skin has had direct contact with an infected area — which, in adults, usually means the genitals, lower abdomen, or inner thighs rather than the trunk and limbs where the virus more often shows up in children.

How Adults Get It on the Genitals

In adults, molluscum on the genitals, lower abdomen, or inner thighs spreads mainly through skin-to-skin contact during sex, which is different from how children usually pick it up — through casual skin contact, shared towels, or bath water, typically on the trunk, arms, or legs rather than the genital area. Condoms lower the risk somewhat but do not fully prevent it, since molluscum spreads by contact with skin a condom does not cover, the same limitation condoms have against herpes and HPV 1Ref 1Centers for Disease Control and Prevention (2024).Condom Use: An Overview.Used to support that condoms give only partial protection against infections spread by skin-to-skin contact, analogous to their limited protection against molluscum..

A single sexual encounter with an infected partner is enough to transmit it, and because the incubation period can run from a few weeks to several months, it is not always possible to trace exactly when or from whom it was picked up.

Telling It Apart From Warts, Sores, or a Rash

Among the many things bumps in the genital area can turn out to be, molluscum has a fairly distinct look: firm, round, and dome-shaped with that central dimple, usually appearing in small clusters rather than one at a time. What do genital warts actually look like by comparison? Warts tend to be softer, more irregular or cauliflower-like in texture, and lack the central dimple that molluscum almost always has.

If what you're seeing is more open sore or ulcer than firm bump, the genital sore differential points toward a different set of causes entirely — molluscum does not ulcerate or break open the way a herpes or syphilis sore does. And while molluscum bumps are usually painless, some people do notice itching around them, which overlaps with the broader genital itch differential of causes worth ruling out.

Does It Need Treatment, or Will It Clear on Its Own?

Left alone, molluscum contagiosum's natural course in an otherwise healthy adult is to resolve on its own, though it can take anywhere from several months to a couple of years, and new bumps can keep appearing near old ones while the body clears the virus. Treatment isn't required, but it is an option for bumps that are bothersome, cosmetically unwelcome, or at risk of spreading through shaving or scratching — options a clinician might offer include freezing (cryotherapy), physically removing individual bumps (curettage), and topical treatments applied in the office.

There is no single right answer between treating and waiting; it comes down to how many bumps there are, where they are, and how much they bother the person who has them.

When a Bump Turns Red and Inflamed

A molluscum bump that suddenly turns red, swollen, and inflamed — sometimes called the BOTE sign, short for 'beginning of the end' — often means the immune system has started actively fighting the virus, and it frequently signals the bump is about to resolve rather than that something has gone wrong. It can look alarming, especially compared to how quiet the bumps usually are, but inflamed molluscum is not automatically a sign of a secondary bacterial infection.

That said, a molluscum bump turned red and inflamed alongside spreading warmth, pus, or fever is different from the ordinary immune-clearing pattern and is worth having examined rather than assumed to be the reassuring version.

It's Also Worth a Broader STI Check

Because genital molluscum usually means recent skin-to-skin sexual contact, it is a reasonable moment to ask about a fuller STI panel rather than treating the molluscum as an isolated issue. USPSTF guidelines recommend HIV screening for adolescents and adults aged 15 to 65 regardless of the reason for the visit 2Ref 2US Preventive Services Task Force (2019).Human Immunodeficiency Virus (HIV) Infection: Screening.Used to support that USPSTF recommends HIV screening for all adolescents and adults aged 15 to 65, underlying the advice to request a fuller STI panel after a genital molluscum diagnosis., and syphilis screening for adults at increased risk of infection 3Ref 3US Preventive Services Task Force (2022).Syphilis Infection in Nonpregnant Adolescents and Adults: Screening.Used to support the recommendation to screen adults at increased risk of infection for syphilis, as part of a fuller STI panel after a genital molluscum diagnosis. — both reasonable to request at the same appointment.

Sex, Intimacy, and Avoiding Spread to Yourself or a Partner

Molluscum can spread to new areas on the same person through scratching or shaving over an active bump — a process called autoinoculation — and it can spread to a partner through direct skin contact during sex, even in areas a condom covers only in part. Covering visible bumps with clothing or a bandage during close contact, avoiding shaving directly over them, and not sharing towels or razors all reduce the chance of spreading it further.

Molluscum is generally considered no longer contagious once every bump has fully resolved and the skin has returned to normal, though there is no blood test to confirm the virus is gone the way there might be for other infections.