Treatments for Molluscum contagiosum: A systematic review

Molluscum contagiosum (MC) is a viral skin infection that poses significant physical and psychosocial burdens, particularly in pediatric and immunocompromised populations. Despite the availability of various treatment options, comparative efficacy and safety data remain limited. This systematic review, conducted in accordance with PRISMA guidelines, evaluates and compares the efficacy, safety, recurrence, and adverse effects of MC treatments. A total of 89 studies encompassing 12,955 participants were analyzed. Curettage, potassium hydroxide (KOH), autoinoculation, and podophyllotoxin demonstrated high clearance rates (97.8%, 73.8%, 79.4%, and 75.0%, respectively) with minimal local side effects. Cryotherapy and laser therapies offered rapid lesion resolution though laser treatment was associated with more discomfort and higher cost. Emerging therapies such as berdazimer gel demonstrated favorable safety profiles, particularly for pediatric patients, while intralesional immunotherapies like Candida and MMR vaccine showed encouraging results in patients with persistent or recurring lesions. The management of MC requires an individualized approach, balancing efficacy, safety, and patient-specific factors such as age, lesion severity, and immune status. Cantharidin, KOH, cryotherapy, autoinoculation, and podophyllotoxin offer high clearance rates, with immunotherapies and lasers offering additional options for resistant cases. Further standardized trials are needed to optimize treatment strategies and long-term recurrence.