There's a Bump on My Eyelid: Molluscum Contagiosum

Molluscum contagiousum is a viral infection that is most commonly seen in children or adults with weakened immune systems.  Less than 5% of children in the US are infected each year. The virus spreads from direct contact, so it is possible for you to spread the virus to different parts of your skin and to others.

Classic appearance of a molluscum lesion photographed by Dr. Dovie at Blacksburg Eye

You can spot molluscum skin lesions by their appearance: they are round, dome shaped growths with a depressed center and are typically white in color.  They are most commonly found right along the lid margin, but can be seen anywhere on the skin around the eyes.

Like most viruses, there is no treatment for this infection.  For patients with a healthy immune system, the lesions will resolve by themselves given time.  A typical course of infection is two to seven weeks.  As long as the lesions are visible throughout the various molluscum contagiosum stages development you are still contagious, so careful hand washing and avoiding direct contact with others is advisable to prevent spreading the virus. In children and adults with a short course of presentation, typically just monitoring for improvement is the only needed treatment.  For patients that aren't improving, or show signs of multiple lesions, it is best to order blood work to rule out a systemic health condition that would compromise the immune system. Inflammatory conditions like rheumatoid arthritis and sarcoidosis (and the medications that treat them!) can cause depressed immune systems, as can systemic infections like HIV or AIDs and sexually transmitted diseases. In some persistent cases where the patient has a depressed ability to fight off the molluscum virus, the contagious lesions can last up to a year.  In these instances it is possible to perform curettage, where a doctor removes the lesion and treats the area with anti-septic.  Controlling the health condition that is causing immune system depression is the best way to prevent further molluscum infectious lesions after performing curettage to remove them.