Definition – a viral infection of the skin or occasionally of the mucous membranes, sometimes called water warts, they are pink shiny umbilicated papules anywhere on the body except the palms and soles.
As the name implies, this is a contagious infection, spread by direct contact with a lesion, by contact with contaminated personal items like towels, clothing or toys or by bathing together or communal pool use.
These bumps usually start out as tiny pink bumps that are not bothersome. However, over time, they become itchy. Scratching these lesions opens up the contagious contents of the bump and causes spreading. Patients who have a history of eczema are more likely to have this viral infection as it uses broken down skin as an easy portal of entry.
This virus can go away on its own over a period of months to years. The challenge lies in getting the body’s immune system to recognize this infection in the skin. In the meantime, spreading of the bumps will continue and the child will remain contagious. Individual lesions can be treated, but this DOES NOT PREVENT NEW LESIONS. Treatment options include topical medications, scraping off the lesions or freezing. In children, topical medications are usually the only method that is tolerated.
Because this is a pox virus, a small valley may be noted on the skin where a previous lesion existed. This is not a side effect of treatment, but rather the nature of how pox virus infections heal.
Parents often wonder why they do not have lesions. This is likely because they were exposed to this infection as children themselves. Siblings may get lesions if this is their first exposure, however, they may be immune even if they didn’t get lesions on their skin previously. Treating any household contact quickly will help reduce the chance of spreading in the family. No disinfection of the household is needed, however personal items of the affected child should not be shared with others unless washed in hot water and dried in a hot dryer.
At some point, the body’s immune system figures out these lesions are not wanted and incites a response against them. This may be seen over the course of treatment as well. Usually lesions that are resolving will appear inflamed or infected; however, no antibiotics or ointments are needed for this.