My doctor visits

At first it was just a few tiny red bumps. I hoped they would go away on their own. At first I thought they were pimples, then a fungal infection. Only about four weeks later did I see a dermatologist. There it all got a name: molluscum contagiosum.

In the two years that followed, there were more doctor visits. In between, I applied creams and liquids, disinfected and hoped. So I am not against seeing doctors, quite the opposite. But I also know how it feels when new spots keep appearing after several appointments.

Mostly I saw the same dermatologist, and over the two years a few other doctors as well. At first every few weeks, later, as I grew more desperate, more often. At some point I felt like a permanent patient, and that was uncomfortable, almost shameful. At the appointments we counted how many new spots had appeared since the last time. Nothing worked during that time.

My dermatologist told me that six to 18 months, or even longer, was not unusual. For me, in the end, it was around two years.

GP or dermatologist?

A question many people ask: where do you actually go with this? For many people the GP practice is the first port of call, for skin changes there are dermatologists, and for children it is the paediatrician.

In the German pharmacy magazine Apotheken Umschau I read that dermatologists usually make the diagnosis based on the typical appearance of molluscum. In the British health system, the NHS names the GP as the first step. According to the NHS, a GP may refer you to a specialist from there, for example if spots appear on the eyelids or the eye, or if the immune system is weakened.

Which route fits depends on your own situation. Both are possible.

Talking about molluscum was hard for me, even with a doctor. It would have helped to know that molluscum is not an unusual reason for an appointment. The Mayo Clinic describes it as a fairly common viral skin infection. So I am probably not the first person to sit in a consulting room with this.

How much the shame stayed with me back then, I describe in the article Molluscum and shame.

When the sources mention seeing a doctor

The NHS lists several situations in which to see a GP about molluscum. In summary, as I read it:

  • if you are not sure it is molluscum at all,
  • if spots are very itchy, painful, swollen or crusted,
  • if spots appear near the eyes or in the genital area,
  • if your immune system is weakened.

The Mayo Clinic, too, writes that you can contact a doctor if you suspect that you or your child has molluscum.

This is not a complete list and does not replace a conversation with a doctor. I am only passing on what it says there. Please read it yourself.

For me, the first point mattered most. At first I simply didn’t know what was on my skin. Without a diagnosis, I would probably have worried even more.

How the diagnosis is made

How does a diagnosis actually work? The American Academy of Dermatology writes that dermatologists can usually recognise molluscum just by looking closely at it. If more information is needed, some of the affected skin can be scraped off and examined under a microscope.

In a review from 2019 I read that the diagnosis is usually made from the appearance. It names dermoscopy as an aid, meaning an examination with a special magnifier with a light. If there is doubt, a tissue sample can help.

From what I have read, the diagnosis itself is usually straightforward. The hard part for me was something else: going back again and again.

Genital area and eyes

Two parts of the body come up again and again in the sources. For spots in the genital area, there is even a separate sexual health guideline in the UK. It describes how specialists proceed with adults who have molluscum in the genital area. I write more about this in the article Molluscum in the genital area.

For spots on or near the eye, the sources also mention seeing a doctor. The Mayo Clinic describes that conjunctivitis can develop when spots appear on the eyelids. That belongs in a doctor’s hands, not in a forum.

What an appointment can and can’t do

A doctor can tell you whether it is molluscum and talk with you about the options. The American Academy of Dermatology writes that treatment is not always needed and that, in people with a healthy immune system, the body clears the virus on its own. Treatment is considered there, for example, with eczema, with spots in the genital area, with a weakened immune system and many spots, or with spots that are especially bothersome.

The Cochrane review from 2017 concluded that none of the treatments it examined clearly performs better than the others. For me, that explains why a doctor’s appointment doesn’t automatically mean the end of molluscum. It is more the start of a conversation.

What an appointment still did for me: it turned something unknown into something with a name. That was a first step against the uncertainty.

What molluscum looks like and what it can be mistaken for, I have gathered in the article Molluscum or something else? After two years it was over for me. Was it coincidence? I don’t know. How it came about, I tell in my story.