How to tell mollusca from genital warts

Dear Alice,

I read the info on molluscum in the Men's Health section. Are there any signs that distinguish molluscum from genital warts/any way to tell if you have one or the other?

Dear Reader,

Bothersome bumps! Even the essentially harmless (yet still contagious) molluscum can provoke anxiety among it's human host when it inhabits the genital region. To answer your question, yes, there is a way to tell molluscum contagiosum  from genital warts. Mollusca are skin bumps caused by a virus, and they have some distinguishing characteristics health care professionals use for diagnosis. These include:

  • Size: The bumps are typically small (two to five millimeters across) and do not grow or swell
  • Color: Usually mollusca are smooth, pearl-like, flesh colored bumps
  • Location: Mollusca may appear singly or in groups and are usually found on the face, neck, chest, stomach, and groin area

These characteristics are different from genital warts in the following ways:

  • Genital warts grow on or around the internal or external genitals (i.e., on or around the anus or penis and in or around the vagina), are rough textured and "warty" looking, and, if left untreated, can grow much larger and form masses that look similar to cauliflower.
  • Genital warts (especially those around the vagina and anus) are usually dry and itchy. They can cause lesions and sores, increased vaginal discharge, and abnormal menstrual bleeding.
  • HPV can be controlled with proper treatment (including surgical removal of individual warts) but treatment cannot cure HPV. However, the HPV viral load can be reduced or cleared by the body. People with an HPV infection need to be carefully monitored by their health care provider to watch for early signs of pre-cancerous changes in affected areas.

Molluscum are harmless, painless, and typically do not itch. They are often found on children and young adults, especially those who have asthma or eczema. These bumps may be mistaken for small moles or pimples. They can spread to other parts of the body through scratching or other irritation and may proliferate into groups (known as crops).

Some treatments are available for molluscum, but if left alone they typically go away, usually within year to a year-and-a-half. However, they may leave scars if they get infected or scratched and picked. If you are concerned about mollusca spreading to other parts of your body or to your partners, or if you have mollusca that are easily irritated or especially unsightly, they can be removed through freezing, scraping, electrosurgery, laser cautery, or the application of chemical agents.

Whenever you notice new bumps down there, it's a good idea to talk with a health care professional. They will be able to distinguish mollusca from genital warts, discuss safer sex strategies, and suggest appropriate treatment. Keep in mind that health care providers have seen many a bump, on many a body part; if you have a strange bump or slew of bumps, there is no need to attempt self-diagnosis out of embarrassment. With proper consultation and treatment, the bumps will likely diminish or disappear and you'll be able to bother about other matters.

Last updated Jun 01, 2015
Originally published Jul 18, 2002

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