A Dermatologist Explains All Molluscum Treatments Available

Welcome to our latest episode of the Skincredible podcast, where we dive into the often misunderstood world of molluscum contagiosum treatments. Dr. Swanson breaks down how molluscum affects patients and the various treatment options available. Make sure to listen to our molluscum episode first, if you haven’t already!

Molluscum contagiosum is a viral skin infection that leads to the appearance of small, raised bumps on the skin. While these bumps may seem alarming, they typically resolve on their own in a period ranging from two to three years. Many parents find this timeline concerning, prompting them to seek treatment options to expedite the process. Dr. Swanson emphasizes that, while treatment is not mandatory, it is available for those who prefer not to wait for spontaneous resolution.

During the episode, Dr. Swanson outlines all the treatment paths for molluscum. She details both topical remedies, in-office treatments, and one oral treatment option, noting that the goal of some treatments is to engage the immune system to recognize and combat the virus. Here are some of the main categories of treatment discussed:

Topical: OTC naturals like tea tree oil, prescription Retinoids, Imiquimod, KOH, Zelsuvmi  

In Office: Bettlejuice (cantheradin), liquid nitrogen, candida antigen, curettage 

Oral: Cimetidine 

Doing nothing: also an option

Whether you choose to wait for natural resolution or explore treatment pathways, it's essential to consult with a dermatologist to find the best approach for you or your child. Remember, the immune system is a powerful ally in overcoming molluscum, and understanding your options can lead to a more comfortable experience.

Keywords

molluscum contagiosum, skin treatments, dermatology, pediatric dermatology, viral skin infections, immune system health, skincare tips, skin health

Links, Attachments

Portico Pharmacy for Aron Regimen for Molluscum Dermatitis (must be prescribed by a provider)

Chapters

00:00 Welcome & Intro

02:00 There Are Options to Treat Molluscum

03:30 Treating Molluscum Dermatitis

04:20 Pseudofurunculoid Molluscum

06:30 Topical, In Office, Oral Treatments

07:40 Tea Tree Oil

10:00 No Treatment Stops Spread of Molluscum

11:10 Topical Retinoids (Irritating)

12:14 Imiquimod, Controversial but Effective

17:00 KOH: Potassium Hydroxide

20:25 Dr. Swanson’s Reaction to PDT (A Side Note)

22:00 Easing Into Therapies and Treatments

22:45 Zelsuvmi (Berdazimer)

25:28 Nitric Oxide: Molecule of the Year in 1992

31: 00 In Office Treatments: Beetle Juice (Cantharadin)

39:00 Liquid Nitrogen (LN2)

41:00 Candida Antigen Yeast Protein Injections

43:00 Redness & Swelling, Don’t Panic

44:34 Curettage for the Highly Motivated Patient

47:45 Oral Cimetidine or Doing Nothing (Also an Option)

52:00 Thank you, Goodbye + Disclosure from Dr. Swanson

The information shared on this podcast is for educational purposes only and is not a substitute for personalized medical advice. Always consult your  physician regarding your health.

Transcript

SPEAKER_00 0:04

Welcome to Skin Credible, where we tell you what you should know about your skin and how to blow. Because your skin's incredible.

SPEAKER_01 0:17

Hello, everybody, and welcome to another fun-filled episode of the Skin Credible Podcast. I'm your host, Dr. Lisa Swanson, and guess who I have with me today? Anna! Anna! Yay! Because today we are going to take you guys through the wonderful world of molluscum treatments.

SPEAKER_02 0:38

I bet some people haven't even heard of molluscum before.

SPEAKER_01 0:42

I know, right? And for those of you that haven't, please listen to our previous episode where we talk in depth about what molluscum are, what causes them, what the deal is, what can happen with them. We break it down, we make it understandable, we take away the panic. Yes.

SPEAKER_02 0:59

Right? No panic.

SPEAKER_01 1:00

No panic. Molluscum are caused by a virus, and they will always eventually clear on their own. You wait long enough and they'll clear, they'll clear on their own. It can take up to two to three years. The average is one year. So for that reason, a lot of my patients and their families do want to treat. Treatment is never mandatory, but you can treat if you want to. So I notice in my practice that a lot of primary care doctors, they'll tell families, like, just let them be and let them go away. And that is absolutely correct. That is an okay method of surviving mollusca. But if you don't want to wait potentially two to three years for your child to be free of them, then there are treatment options available and you can seek those from your closest dermatology professional and discuss some of these options. I encounter so many patients in my practice where they come in just so sad that they've been told there's nothing for molluscum. And there there is, you don't have to do it, but you can, you know? And so I like to break down all the options and see what vibes best with my patients. I learned the word vibe recently.

SPEAKER_02 2:18

That's fun. Uh-huh. So you're just, you know, inserting it or you can.

SPEAKER_01 2:22

Right in everyday conversation.

SPEAKER_02 2:24

Does this treatment vibe with you? Right. Three-year-old.

SPEAKER_01 2:26

Yeah. Yeah.

SPEAKER_02 2:27

Does it work?

SPEAKER_01 2:28

Uh, I think so. I think I'm communicating effectively. But I learned the word vibe on Bachelor in Paradise.

SPEAKER_02 2:35

Really? Yeah. That seems okay. Bachelor, not the golden one.

SPEAKER_01 2:38

No. Well, there were Goldens there. Oh. That was the fascinating thing. They had they had the young bachelor and bachelorette people, and then they also had Goldens. I know.

SPEAKER_02 2:49

Is it the golden people using the vibe word?

SPEAKER_01 2:51

No. It was the young people. Checks out. And what I learned is that if you're vibing with something, you need to explore it. That's what I learned.

SPEAKER_02 3:00

Is this dating advice or regular life advice?

SPEAKER_01 3:03

I've applied it to everything. Yeah. Treatment advice. Treatment of molluscum. Yeah. Like if you're vibing with treating your molluscum, let's explore it. Let's explore it. I like it. Yeah.

SPEAKER_02 3:13

Good application.

SPEAKER_01 3:14

Yeah. Now, another throwback to our previous episode, we're going to talk through molluscum treatments, like treatments aimed at the little viral bumps. But it's always, always, always important to manage some of the consequences of molluscum. We talked about molluscum dermatitis in the previous episode. And molluscum dermatitis is an eczema-like rash that occurs around the molluscum. And when I see a patient with molluscum and molluscum dermatitis, the first thing, the only thing I'm doing at that visit is treating the dermatitis. Yeah. Because the dermatitis is, it's the immune system's way of trying to help, but it's not doing a very good job. The dermatitis breaks down the barrier, which allows molluscum to spread. The dermatitis is itchy, and then the kids scratch and that spreads them.

SPEAKER_02 4:02

Oh, yeah.

SPEAKER_01 4:03

You know? And so it's very important at that first visit to calm down the dermatitis. One of my favorite treatments for that is the Aaron regimen. But you can also use a more basic topical corticosteroid like a hydrocortisone 2.5 or something like mometazone. That would be okay too, but the Aaron Regimen's my favorite. And then also, if you're noticing the big red angry molluscum, those are called pseudoferunculoid molluscum. You learned on the last episode how to spell that.

SPEAKER_02 4:28

I wouldn't say learned, but you did. I hope that I would remember, but we're not going to test that theory right now.

SPEAKER_01 4:34

I think if you were in a spelling bee and the person was like, pseudoferunculoid.

SPEAKER_02 4:40

I I would remember.

SPEAKER_01 4:41

I think you could do it. Yeah.

SPEAKER_02 4:43

I was used to be really good at spelling bees.

SPEAKER_01 4:45

Me too. Yeah. In sixth grade, I won our school spelling bee.

SPEAKER_02 4:48

Did you? I was younger, but I I can like pronounce words in Spanish in my brain, and it helps me to spell the word in English. Yes.

SPEAKER_01 4:56

Yes. Well, and so I won my school spelling bee, and so I got to go to like the state spelling bee thing. That's so cool. And then I got like second or third place, and the word I messed up was embarrassment.

SPEAKER_02 5:08

Oh, that's not good.

SPEAKER_01 5:10

That should even be a word in a spelling bee. No. Right? That's rude. And then I went home and I told my mom, and she said, You don't know how to spell embarrassment. And then she said, How I remember it is bare ass.

SPEAKER_02 5:26

Sounds like something your mom would say.

SPEAKER_01 5:29

No. Yeah, that's a Connie Swanson original. So now I never forget how to spell embarrassment.

SPEAKER_02 5:36

No, I won't either. Neither will the listeners.

SPEAKER_01 5:38

And none of you, yeah, none of you are ever going to misspell that word. So um so if you see pseudofronculid molluscum, that's a sign that the molluscum are actually gonna go away. And so you really want to do minimal things in that situation because they're they're dying. The immune system is attacking them. And so typically within, you know, four to six weeks from the angry molluscum, you're gonna have complete resolution. So hypothetically speaking, the immune system is also a treatment option. Yes, the immune system is our best treatment option. And actually, a lot of the treatments that we use are basically just focused on getting the immune system to pay attention to the molluscum because the molluscum are occurring so high up in the epidermis that our immune system is not aware. So a lot of our treatment options are designed to wake up the immune system to their presence and say, hey, immune system, come check this out. Because the immune system is totally capable of getting rid of these. So I broke it up into topical remedies, in-office treatments, and one oral medication. And so I thought we could go through the list. I feel a little bit like we're on Big Bang with fun with flags. I didn't watch that.

SPEAKER_02 6:45

You didn't? No, I watched some big bang, but not that. I don't remember that.

SPEAKER_01 6:49

Yeah, Sheldon had a show. I don't think it was a podcast because this was before a podcast really took off. Yeah. But he had a show called Fun with Flags, and he would have a whiteboard and he would show flags of different countries that he thought were were cool or had like a cool story.

SPEAKER_02 7:05

What a Sheldon thing.

SPEAKER_01 7:06

Yeah. So every time I look at the whiteboard, I think a little bit of fun with flags. So let's think about our topical options. First of all, over-the-counter natural things. There used to be so many over-the-counter natural remedies for molluscum. I had a couple favorites. There was one called Zymoderm. There was another one called Molluscum RX. But as we got FDA approved treatment options for molluscum, because of FDA rules, those over-the-counter remedies promising to fix the molluscum, they had to go away. I know. And so those don't exist anymore. Now, the active ingredient in most of them was tea tree oil. So you could consider using tea tree oil on a Q-tip, just dab it on the molluscum. The one caution there is tea tree oil can be irritating. So if your kiddo is prone to eczema, if they're kind of a sensitive skin kid, if the molluscum are in like the undie area or on the face, tea tree oil is probably not the best option. It's kind of funny because when I'm talking with eczema patients and their families, all they want is something natural. When I'm talking to molluscum families about the options, and I mention the natural choices, none of them want it.

SPEAKER_02 8:25

None of them want it. They're just like more desperate. I feel like it brings out a desperation in parents for sure.

SPEAKER_01 8:30

Yes, and a hatred. They hate rid these molluscum so much. They want the most corrosive, explosive thing. That's so funny. Yes, yes. They don't want to mess around with the, you know, natural biggest bomb you have. Yes, yes. Let's let's get the let's get rid of that. Yeah, you know? And they want the molluscum to suffer. You know? They're like, what can we do to punishment? Yes, yes. I hate these molluscum. I want them to suffer.

SPEAKER_02 9:02

Do you think it's the contagious part or the look of it?

SPEAKER_01 9:06

I think, you know, I can understand the psychology of being a parent and watching your child have these spreading bumps everywhere. And it's one thing if they're like on their torso and covered easily with clothes and swimsuits. It's another if it's in more, you know, visible areas, their face, their arms, their legs in the summer, and they just keep multiplying and you feel like you have no control over the situation. So I empathize with the psychology of watching your kiddo go through that and just being like, oh my gosh, there's nothing I can do. Which actually brings up a really important point because a lot of parents come to me and they say, We'd like to do treatment and we'd like to choose a treatment that like stops the spread of the molluscum. None of these treatments stop the spread of a molluscum. Any molluscum can have a baby molluscum, you know? Yeah. And so until they're all gone, new ones are possible. And I think that's an important point to really drive home because sometimes families will come to see me and they've tried one of these options and they say, well, some of them have gone away, but we've got new ones. And I say, I don't let new ones discourage me. I expect new ones. I'm just wanting to see that the treatment we're utilizing is impacting the molluscum in some way, shape, or form, and that we're triggering the immune system to help come get them. And so I don't let new ones discourage me. And I try to really hammer that message home. Yeah. Again, I understand the psychology of it all, things spreading, nobody likes things spreading. But it's just, it's, it's part of the molluscum journey. And once we've triggered the immune system, the immune system's gonna catch up to those new molluscum, you know, it's gonna catch up and get rid of them. So our over-the-counter natural things are a more limited list than they used to be. And if people want to try tea tree oil, I think that's just fine. But if irritating or in a location or a child where it's just not a good fit, maybe skip it. Topical retinoids. So these are things like retin A, like different, which is over-the-counter. Basically, what these do is they work by irritating the skin. So they irritate the skin so much that the immune system comes to be a part of that. They want to join the party. Yeah. And because of the irritation, they're like, they're present. And so then they might see the molluscum and the immune system might get rid of them. I don't love topical retinoids for molluscum. A lot of people do it, and there's absolutely nothing wrong with it. Yeah. And it's appropriate care. I just don't like it because you never want the treatment to be worse than the condition. Yeah. And I feel like sometimes with topical retinoids, you cross that line. Um, topical retinoids are also not appropriate for a kiddo who's eczema prone, a kiddo who already has molluscum dermatitis. Like that's not cool. Right. That's just gonna aggravate all of that. Yeah.

SPEAKER_02 12:07

Just make the issue worse.

SPEAKER_01 12:08

Yeah, just make the issue worse. And molluscum dermatitis is not something we want to provoke, you know? Um, amicwamod. It was a mikwomod what used to be Aldera. Yes, Aldera was its brand name. Yes. And Amicwomod, we're going into controversial territory. Why? There are a lot of people who don't think it works, and a lot of people that think it's too irritating or could have side effects and stuff. And there have been articles written, small studies using Amicomod for Milluscum. And it's true that in those studies they did not see good efficacy. So that's one side of the story. That's one side of the coin. And I respect and understand that side of it. Then there's the side that I'm on because I actually think it works.

SPEAKER_02 12:58

I think it works based on your patient population and experience.

SPEAKER_01 13:03

And it's a really easy treatment. Probably inexpensive as it's generic. Inexpensive. Yes, yes. And so with a Mikkelmod, I think where sometimes people run into problems is with the instructions of use.

SPEAKER_03 13:16

Yeah.

SPEAKER_01 13:17

So I tell patients and their families, just treat two or three of the molluscum.

SPEAKER_02 13:22

Don't like rub it on all the time.

SPEAKER_01 13:24

Rub it on all of them, right? Just pick two or three, you know, the ones you hate the most. Yeah, you know, and apply it Monday, Wednesday, Friday at bedtime.

SPEAKER_02 13:33

Not every day.

SPEAKER_01 13:35

Right. And I tell folks they're like, any, you know, any side effects we can expect. And I say the only time I've seen side effects is when people either mishear me or really hate the molluscum and choose to hit them harder than I've recommended. And that, you know, they use it every night, they use it on every spot. That's going to cause some irritation and some reaction. Yeah. But I've never had a kiddo have a bad experience with two to three spots Monday, Wednesday, Friday. And it's such an easy routine. It costs less than$20 on the Good RX app. It's common for insurance to not cover treatment for molluscum because they self-resolve. And so I just never have to worry about cost with a MICL mod. And that's a big deal. Yeah. When I'm prescribing a MICL mod, I tend to follow up with patients at eight weeks and I tell them at eight weeks we're going to know if it's working or not. You know, it might not be perfect, but we'll either be seeing clear improvement and we'll opt to continue, or nothing's happening and we're like, okay, let's move on. You know, so at eight weeks we kind of know what's happening. So point counterpoint. You know, and sometimes I feel like when I'm speaking at conferences and I'm speaking about molluscum, I feel a little embarrassment. Right. Right. About treating molluscum with a Miqamod. Because is there such a stigma? There's such a stigma. And there's a lot of people that just don't, they don't do it, they don't recommend it.

SPEAKER_02 15:01

Even in the professional community.

SPEAKER_01 15:02

Even in the professional community. And again, I understand their opinions. Yeah. Because I've read all those articles too. And I understand that those articles show it doesn't work. Yeah. But my personal experience over the past 16 years is that I think it does. Yeah. And I think it's pretty easy and painless. Yeah. Sometimes I feel like I'm in like a confessional. Like, my name is Lisa Swanson, and I think a Miquimod works for Meluscom, you know? So now it's on record. It's officially on record. It's on the internet.

SPEAKER_02 15:37

You're so controversial.

SPEAKER_01 15:38

Oh my gosh. Unintentionally controversial. No, I like a Miquimod. The one thing I tell patients about it is that I say, we use a Miquimod in dermatology for all sorts of stuff. We use it to treat pre-cancers. We use it to treat skin cancer. We use it to treat warts, molluscum. The package insert talks about all of that. Don't let that concern or confuse you. It's simply a multi-purpose agent. Because I had a family that I saw from Molluscum and we talked about options. We chose the Mikkelmod. And then the family called later that day and said, does that mean these are cancer? And I'm like, oh no, no, no.

SPEAKER_02 16:13

No, no, no. So does the package insert also talk about molluscum or just the cancer stuff?

SPEAKER_01 16:18

It doesn't, because that's not one of like the official indications for a MICLMOD, but it is indicated to treat skin cancer. It's indicated to treat precancers. It's indicated to treat some types of warts, particularly genital warts. And, you know, that kind of factors into my liking of a micomod. It has been studied in the undie area for genital warts. And of course, molluscum are not genital warts. But we have data showing its efficacy and safety in such a sensitive skin area. And a lot of kids have molluscum in their undie area. And you just have to treat two or three. You don't have to treat all of them. So I think that gives me confidence in using it in those sensitive areas. I also feel comfortable using a MiComod for molluscum on the face, unless they're too close to the eye, nose, or mouth. But if you've got some molluscum up on the forehead, you can feel free to use it there. Again, it's used for skin cancer and precancer, so it's used on the face all the time. Moving on to KOH. So KOH is potassium hydroxide. And we use potassium hydroxide in dermatology clinics for fungal scrapings. Do you remember that from the practice? Oh, the little orangey gel stuff.

SPEAKER_02 17:27

Wait, no, the stuff you look at under the microscope. Yeah, yeah, yeah.

SPEAKER_01 17:30

Yeah. So, like if you're a patient and you come in and you might have a fungus rash, sometimes your dermatologist will do a KOH. And that means they do a skin scraping, they put some KOH on the slide, they look at it under the microscope, and the KOH helps them see fungus. Those were Dr.

SPEAKER_02 17:46

Grant's favorite.

SPEAKER_01 17:47

I know a lot of people really like a KOH. Like a lot of people are really into a KOH.

SPEAKER_02 17:53

It's the same solution?

SPEAKER_01 17:54

It's the same solution, but a different strength. Okay. So I don't know how this happened, but somebody somewhere was like, maybe we could use KOH for Molluscum. Interesting. I don't know. Maybe somebody in a derm clinic somewhere like spilled a bottle of KOH on on Melush, you know. Yeah. You never know how these things happen.

SPEAKER_02 18:10

Yeah, you never know.

SPEAKER_01 18:11

These serendipitous surprises in medicine. But somebody was like, maybe we use KOH for Meluscom. And so there was a small study where they compared KOH 10% to KOH 15%. And they found that overall both of the strengths were reasonably effective. The 10% was much more well tolerated.

SPEAKER_02 18:29

Oh, okay. So it can be irritating or something.

SPEAKER_01 18:32

It can be irritating. Yeah. And so if I use KOH, I do the 10%. Now it has to be compounded at a compounding pharmacy. So you remember I talked about that a little bit with respect to the Aaron regimen. Yeah. And so it has to go to a compounding pharmacy, which means insurance doesn't cover it. But KOH is pretty darn cheap. I remember when I was prescribing more of it, it was like$30 for a good size container.

SPEAKER_02 18:56

Is it like a Q-tip? You like go and do you treat like your least favorite ones or do you treat all of them?

SPEAKER_01 19:02

That's a good question. That's a good question. And so what I would tell people to do is use a Q-tip to apply it. Start out with Monday, Wednesday, Friday, and start out with the ones that are in less irritable locations just to assess tolerability. And then if that's going okay, then you can start using it every night. You can start treating all the spots. But I always like people to ease into treatments. I'm kind of an easer-inner, Anna. I like it.

SPEAKER_02 19:30

You don't want people to come back with the worse issue.

SPEAKER_01 19:32

Yes. Yeah. Well, and I think also I have personally had sure reactions to things. Yeah.

SPEAKER_02 19:39

And you really have. I know a lot. I know, right? In the time I've known you, I'm like, I can think of a few just now.

SPEAKER_01 19:46

Yes. I commonly say that I'm the most difficult patient I have. Because everything weird and rare and odd happens to me.

SPEAKER_02 19:58

You think you have a good network of dermatologist friends?

SPEAKER_01 20:00

I do. And I reach out to them. I reach out because it's so different when it's you. You know, you cannot be objective.

SPEAKER_02 20:06

Not at all.

SPEAKER_01 20:07

And so I constantly reach out to my derm friends. They're probably like, Lisa, you're a dermatologist.

SPEAKER_02 20:12

Like maybe No, I think they understand. I think they understand.

SPEAKER_01 20:16

I think it's the appropriate thing to do too.

SPEAKER_02 20:18

Yeah, then you're like far removed from it, and you're like, okay, that's what I was thinking, but good confirmation.

SPEAKER_01 20:23

It's just nice to have confirmation. There's an expression, the doctor who's being treated by himself is being treated by a fool.

SPEAKER_02 20:30

I like that. Yeah. That's probably true for like nurses and stuff too, sometimes. Yeah, just anybody. Yeah.

SPEAKER_01 20:35

Yeah. Um, but yeah, I've had a lot of weird reactions. Do you remember what happened to me with PDT?

SPEAKER_02 20:42

Yeah, that was the first one I thought of because it was so bad. Didn't you have to like cancel clinic for a few days?

SPEAKER_01 20:47

I had to cancel clinic because it was so embarrassing. Because it was on your face. It was my face. So, listeners, audience, PDT stands for photodynamic therapy, and it's a treatment for pre-cancers. And you um have this chemical applied to your face, and then you sit in front of this bright light for 16 minutes. And I did it preventatively. I'm fair skinned, I grew up in Arizona. Chances are I'm gonna get a precancer or a skin cancer one day. And so I thought, hey, I'll be proactive and I'll do PDT for prevention. And I had the most awful reaction to it. I was swollen, red, like borderline unrecognizable, appealing. I texted two of my dermatology friends that you know, and I said, I'm gonna send you a picture of me, but I wanted to warn you first because it's so awful, and I didn't want you to be afraid. And just wanted to warn you. And I'm having this reaction to PDT. This is what I think I should do. Do you agree? And I fired off that picture and immediately they were like, oh my gosh, Lisa, yes, that's what you should do. I can't believe this is happening to you. Oh my gosh. If you look at the number of times Dr. Swanson recommended PDT before I did it myself and then after, there was a really sharp drop. Really sharp drop.

SPEAKER_02 22:19

A little more cautious.

SPEAKER_01 22:20

Yes. And that my reaction to all the PDT lovers out there, or those of you who might go for PDT, my reaction was not at all typical. That is not a good idea.

SPEAKER_02 22:30

Yeah, we would do them all day every day.

SPEAKER_01 22:32

All day, every day. And nobody reacts like I did. So I have learned that I need to ease into things. And I translate that to my patient care as well. Because if you're easing in and something bad happens, it's never as bad than if you dive in a hundred percent. Yeah. So that's how I manage KOH. And then Zelsuve Me. Have you heard of Zelsuve Me?

SPEAKER_02 22:58

I've never heard of Zell ZellSuve Me. Yes. It's new.

SPEAKER_01 23:03

Name brand, I'm assuming. That's the name brand. But actually, I like its other name better. What's like the generic name? Or it's the like ingredient. Yes. So for you know, for the listeners out there, every drug has two names. It has the name that it is developed with, which becomes its generic name eventually. And then it has its brand name when it gets launched and approved by the FDA. And the generic name of Zelsuv me is Berdazimer. Berdazimer? Berdazimer. It's so much better because you can say like bedazzle. But bedazzle. Doesn't that sound kind of like a street drug? Kind of, kind of sorta. Yeah. You know, like where can I get some bedazzle? Yeah. Right? Doesn't it sound a little bit like that? And so I wish I could just call it Berdazimer.

SPEAKER_02 23:51

Yeah, that'd be nice.

SPEAKER_01 23:52

But its brand name is They'll Sue Me. And it came out in July 2025. So it's a newbie. Yeah, yeah, it's a new kid on the block. Okay. If you will. Have you tried it? Yes. And I have been very impressed with it. So the data from the pivotal trials was pretty good. You know, enough to get approved, but maybe not enough to dazzle. Maybe. Maybe not enough. Not yet. Not yet. But the real life use I have found to be very remarkable. Very remarkable. So Zelsuve me is a topical medicine to be applied at home. It is a nitric oxide releasing gel.

SPEAKER_02 24:34

Nitric oxide releasing gel. Wait, is nitric nitrous oxide the racing car thing? Good job.

SPEAKER_01 24:41

You got there. I was watching it all happen. I was watching your brain work.

SPEAKER_02 24:45

You're like, wait, wait, she might get it.

SPEAKER_01 24:47

The wheels are spinning. Yes. So nitric oxide is very different from nitrous oxide. Nitrous oxide is what you get at the dentist when you need some help. It's what's known as laughing gas. And I love, I love laughing gas. Shout out to Laughing Gas. I had to have a root canal a few months ago. You remember?

SPEAKER_02 25:07

Yeah, I've never had laughing gas.

SPEAKER_01 25:09

It's a good time.

SPEAKER_02 25:11

Yeah.

SPEAKER_01 25:11

It makes a bad experience a good time.

SPEAKER_02 25:15

I wish somebody would have taken some video footage of you. We could use it on social media.

SPEAKER_01 25:20

Oh my gosh. That was before the podcast. So shoot, we missed out.

SPEAKER_02 25:24

We'll just have to do another root canal.

SPEAKER_01 25:26

We'll just have to do another root canal. Nitric oxide is a gas. And did you know that nitric oxide was the molecule of the year in 1992?

unknown 25:40

What?

SPEAKER_01 25:41

Molecules get recognition like that? Apparently. Okay. Apparently.

SPEAKER_02 25:45

What did it do to earn it? I don't know.

SPEAKER_01 25:47

I mean, I guess just be itself. Yeah, and be perfect. Yeah. Yeah.

SPEAKER_02 25:52

What is it used for other than I mean.

SPEAKER_01 25:54

Um, that's a good question. What else is it used for? I don't know. It is a a blood vessel dilator. Okay. And so that's an important thing that I tell families because when you apply it, oftentimes the area will turn red and it's not a reaction, it's just those blood vessels dilating. Oh.

SPEAKER_03 26:11

How interesting.

SPEAKER_01 26:12

But it must do other things to be the molecule of the year. Right. Yeah. Because that was, you know, 30 years before it became Zelsuve me. Yeah. So it had to have fame in some other way. It has to.

SPEAKER_02 26:24

Yeah. That might be a good lookup. So does it have the gas in the vehicle or like does it turn into the gas when you apply it?

SPEAKER_01 26:32

What a good question, Anna.

SPEAKER_02 26:34

I'm very curious now.

SPEAKER_01 26:35

I know. I love the way your brain is working today. So you can't put a gas in a tube, right? Sure. You can't. It would evaporate. You know, sure, yeah. And so when you get Zelsuv me, it comes in a box, and the box has two tubes, and they're labeled tube A and Tube B. One is the active ingredient, the other is the activator, the thing that turns it on. And so the medicine comes with an applicator card, and it clearly has labeled to put some from tube A in this box and some from tube B in this box and then mix and then apply.

SPEAKER_02 27:13

They can't just like live in the same tube then.

SPEAKER_01 27:15

They do not. They it goes poof. Yeah. Yeah. Yeah. But I think they did a nice job with their application card and kind of clearly laying it out because it could have been very confusing for folks.

SPEAKER_02 27:25

Yeah.

SPEAKER_01 27:26

And then one of my patients taught me something really nice about applying it. So I've I've had a lot of patients who have tried Zel Sumi. The results have been really good. Some patients will complain of burning and stinging upon application, particularly if they kind of put too much on. Interestingly enough, a lot of my patients have reported a little bit of burning and stinging, but none of them have stopped it, have stopped the medicine.

SPEAKER_02 27:51

Well, because everybody hates molluscum, apparently. Well, it's not. Everybody who's seeing you.

SPEAKER_01 27:54

Exactly. Again, to my point, like they want these molluscum to suffer. They're like, we're, you know, we don't want them to die a quiet death.

SPEAKER_02 28:01

So it won't go poof out here when you're applying it.

SPEAKER_01 28:04

No, it will. So you have to apply it within 15 minutes after mixing. Okay. Okay. So you mix and then apply within 15 minutes. And my patient's mom gave me this clever trick. So she said that she would mix it on the applicator card and then take a Q-tip, dab it in the medicine, and then dab on the mollusca. Nice. And that helped prevent getting too much on it and too much burning and stinging. Yeah. So that was really smart. So I tell my patients to do that. I have overall been really impressed with Zelsuvme. Already. Already. And I give my patients similar instructions to with like the KOH. Like start out Monday, Wednesday, Friday. The official indication for Zelsuvmi is to apply it to every molluscum every night. Whoa. Right. That's so much because some kids have so many. Some kids have so many. Yes. Yes. And so I tell people ease into it. Treat, you know, a few molluscum in non-sensitive areas that you really hate and want to go away. Treat those first. Do it Monday, Wednesday, Friday to begin with. If that goes okay, then you can ramp it up. And so that's how I advise them to use it. Is it also targeting the immune system? It is not directly targeting the immune system. But anytime you inflame something because you're putting putting something on it that irritates it or inflames it, then the immune system gets involved. So we don't think of it as like an immune system triggerer per se, like a Miquamod is, but it does generate some degree of response.

SPEAKER_02 29:34

The reaction might be like in a little alert to the immune system.

SPEAKER_01 29:38

Yes, yes, yes, yes. And the biggest issue with Cell Subme since it launched in July is probably just like patient access to it. It's been difficult because historically insurance companies would typically not cover treatment from a lesson. Because they self-resolve, insurance companies are like, we don't need to cover it, just you know, just wait it out. And now we have this FDA approved topical, first one of its kind. And so we're kind of challenging the insurance companies with that. Like none of the other treatments are FDA approved. And so if we're following FDA approved guidelines, they'll suve me is the thing, right? And so we're we're kind of challenging that. And it's been a bumpy road. I think it's going to get better as the medicine is out for longer. But when I prescribe it, I tell families like it might be a month before we sort ourselves through the insurance navigation. So just don't hold your breath, you know, for it to arrive. With the complicated application, I'm assuming no samples. No samples. Exactly right. No samples. There are copay cards. The pharmacy works with those, but no samples in the office because of the packaging and everything. So those are our topical therapies for Mollusca. And there are really quite a few, and they each have their own pros and cons. Nice. Are we ready to talk about in-office treatments? Yeah. Let's do it. Okay. So Betelgeuse. I don't say it three times, right?

SPEAKER_02 31:07

We gotta watch ourselves.

SPEAKER_01 31:09

That's the rule because from the movies. Oh yeah.

SPEAKER_02 31:13

There's two now, no? Like the remake?

SPEAKER_01 31:15

Yeah. Yeah. Yeah. And uh, if you say Betelgeuse three times, then Betelgeuse appears. We don't want that. We don't want that. I think I did just say it three times. But not in a row. Not in a row, but still it counts. Oh, yeah. Whoopsies. So we'll have to watch for Michael Keaton to appear in his black and white striped outfit. Do we see it? Nothing so far. Okay, I think we're in the clear. The other name for beetle juice is Cantheridin. So you might hear some people call it that. This truly comes from beetles. And I had the cutest patient in the world one day. I was telling him about beetle juice and how it comes from beetles. And he said, How do they get it from the beetle?

SPEAKER_02 31:54

How do they get it from the beetle?

SPEAKER_01 31:56

And I was like, I don't want to think about that. Yeah. I think nowadays it's synthesized. I don't think they're in the early days, there were like beetle farms. Oh. Yeah. For it's called the blister beetle. And there were beetle farms. And then they would get the beetle juice and then they'd put it in a jar.

SPEAKER_02 32:14

Maybe it's like the snail mucin where they're eating the best lettuce. No, they're well taken care of.

SPEAKER_01 32:20

Privileged snails living the golden life.

unknown 32:23

Yes.

SPEAKER_02 32:24

Is this the one that used to come in like a little red bottle and a little green bottle?

SPEAKER_01 32:27

Yes. So that's been one of the packaging. But the thing with beetle juice through the years is that dermatologists have had to procure it in several different ways. Yeah, I remember it was hard to get. Sometimes hard to get.

SPEAKER_02 32:38

I don't know, discontinued, back ordered a lot or something.

SPEAKER_01 32:41

Yes. And so sometimes we were ordering it from a medical supply company. Sometimes we were ordering it from Canada. Sometimes we were having it compounded. And there was a lot of variation. You know, you'd get a batch of Betelgeuse and it would be either stronger than you were used to or weaker than you were used to. There was a little bit of variation with it. And so a company created a brand name form of Cantheridin, and it's called Why Can't. And it's a beautiful lavender color. I think it's the color of lavender haze. Swifties.

SPEAKER_02 33:13

Swifties out there. Uh it's somebody just commented that they love coming to see you because you love Taylor Swift, and they drove here from Nebraska to see you because you love Taylor Swift.

SPEAKER_01 33:24

Oh my God. That was the selling point. It's like she's an okay dermatologist, but she really loves Taylor.

SPEAKER_02 33:31

No, it was definitely the you're a great dermatologist first. But like what really sealed the deal was the Taylor Swiftness.

SPEAKER_01 33:38

I think I know who you're talking about. And I think she came to the clinic that first visit in like an Aeros Tour t-shirt. And I was like, did you see the Ares? And she's like, yes. And I was like, oh my gosh, tell me all about it. I think I remember that situation. Explain. Uh so why Kant came out as like a brand name Beetlejuice in a beautiful lavender haze color in a nice applicator. And we were excited about it because it was a consistent formulation made in a consistent lab setting. We could kind of trust that it is what it is. But it became really hard to access. It was difficult. There were two models of how to get it. You could have your office like buy it and just like keep it in the office and then bill it to the patient. But again, coverage was weird because insurance commonly doesn't cover treatment of molluscum. And then you could also send it to this one pharmacy, and then the pharmacy would send it to your office, and then you could call the patient and have them come in for the treatment. So much work. And that was a little cumbersome too because then you couldn't treat the first day that you talked about treating, and that's not great. You know, I think that it's always nice to be able to start a treatment right when a patient makes the decision to start that treatment. I think of it as like when I'm at Nordstrom and I find a pair of shoes that I like, and they're like, I'm so sorry we don't have your size in that color, we can ship it to you. And I'm like, No, I want I want them now. Right? I want to take them home. I want to wear them tonight. Yeah. And understandably so. Right. And I'm presenting all these options to families. They're giving it a great deal of thought. We come to a conclusion of what we're going to treat. They want to start right away. So that was difficult. And because YCANTH was born, it led to the demise of all these other ways that we were getting cantheridin. Yeah. And so cantheridin became very hard to access, and still to this day is a little hard to access. We at our practice finally found a compounding pharmacy that's making it in a slightly different formulation. So it's it's just a little bit of an interesting thing. It's a good treatment for listeners. Basically, in the office, we apply a dab of betel juice to each molluscum using the not q-tip end of a Q-tip. Well, that's right. The wooden end. Yes. Yeah, the wooden end. And it's painless when we apply it and you wash it off in four hours. Does it turn kind of white still? Some of them do, some of them don't, again, depending on where you get it from. Sure, sure. And so you wash it off in four hours. It causes blisters tonight or tomorrow. The blisters are usually small and not a big deal, but sometimes they're big and uncomfortable. The blisters usually last about three to four days. Do you still like cover it with tape when they leave the office or something? I don't, and this is a good question because I've never occluded, we call it occlusion. I've never occluded Betelgeuse. Some clinicians will. Which might make it a worse reaction, potentially. Exactly, which is why I don't occlude it. And it dries very quickly. You don't need to occlude it. There was one time in the clinic where I spilled it on me. Uh-oh. And I wash it off immediately. Yeah. And I still got blisters. You did? Yeah. On your hand or something? On all the way down my arm. Oh wow. Yeah, because I spilled it.

SPEAKER_02 36:54

So it'll blister even non-molluscum areas. Oh, yeah. It'll be a little bit more. So you gotta be careful.

SPEAKER_01 37:02

Yeah. Yeah. The idea is that it like blisters up the molluscum so that then the molluscum kind of peels off with the blister and then it heals. Yeah.

SPEAKER_02 37:10

And then that'll maybe wake up the immune system, also the reaction?

SPEAKER_01 37:14

You know, I would say cantheridin is pretty solidly in the destructive category. In general, treatments of molluscum are divided into destructive or immune system triggering. And cantheridin's pretty solidly in the destructive.

SPEAKER_02 37:27

Yeah. Do you pair that up then with other things that you can do at home for immune system? Typically, no.

SPEAKER_01 37:32

Typically, if I'm doing cantheridin, that's all I do. Okay. And the treatment is repeated every three to four weeks until they're gone. With each treatment, we expect 50% of them to go away. That's success. And so we whittle them down each visit. By 50%.

SPEAKER_02 37:48

So you probably wouldn't do it on somebody who has like a ton.

SPEAKER_01 37:51

No. And never treat the armpit or the underwear area with Betelgeuse. Rubbing? Yes. The blisters are enormous. One of the angriest phone calls I've ever had was in my first year of practice, and I had treated Molluscum in the armpit with Betelgeuse, and a mom called very upset with me. I will never do it again. Uh, I think it's the friction. Yeah. It just makes the blisters so big. So I'll never use Betelgeuse in the armpit or the underwear area. The other thing I advise to folks is the first time you have betel juice done, just treat four or five spots. Because I tell all the families, we're going to put this on in the office, you'll wash it off in four hours, causes blisters tonight or tomorrow. The blisters are usually small and not a big deal, but sometimes the blisters are big and uncomfortable. The blisters last about three to four days. Anna, how many times did I say blister? A lot. A lot. I can't count how many times I'll have a parent call the next day. There's blisters.

SPEAKER_02 38:53

We would get a lot of those calls.

SPEAKER_01 38:54

A lot of those calls. And they're still surprised by it. And so I like to the first treatment treat four or five spots. That way we can see how it goes. Yeah. Because some kids react really easily to Betelgeuse, and then others, it's more impressive of a response. And it gives the parent and family chance to understand what these blisters are, what they look like, what they feel like on four or five spots rather than 30. Yeah. And at that point they can come back and be like, can you treat 30? Exactly. So if it goes well and it's, you know, nice and smooth and everything is easy, then of course let's treat more. Yeah. So those are kind of my tips about Betelgeuse. Got it. Liquid nitrogen, freezing. Liquid nitrogen is an appropriate treatment for molluscum. People do it all the time. I don't. The reason is molluscum come in herds. Yeah. You know, there's tons of them. Sure. And to freeze more than one molluscum in a child, good luck.

SPEAKER_02 39:54

I mean, in an adult, honestly. Some of those precancers that were being frozen. I saw grown men cry.

SPEAKER_01 40:00

Yes. It hurts.

SPEAKER_02 40:02

Especially on the nose.

SPEAKER_01 40:03

It hurts. Yeah, the nose is so sensitive. Yeah. And so with freezing, like if they have one or two, okay. Yeah, that's reasonable. But if they have a lot more than that, too traumatic. It's too traumatic. Again, you never want the treatment to be worse than the condition. And I think freezing can cross that line.

SPEAKER_02 40:21

Is this the one where they use sometimes the Q-tips instead of the gun?

SPEAKER_01 40:25

Yes, sometimes. But I think that's so time consuming. Yeah. And you don't get as good of a freeze. So in the rare situations that I'm treating molluscum with liquid nitrogen, I'm using the squirt gun. But you don't have to treat molluscum as long with the liquid nitrogen as for things like warts or precancers, because they're superficial little bubbles. You don't have to hit them hard. And so it's a very light freeze. But again, it's only for the situation where there's like one or two or a very motivated patient who's a little bit older who understands. Sure. And even in those situations, I say, okay, well, let's let's treat one and see how you feel before we treat more. You know? Candida antigen. Candid antigen is one of my favorite treatments for molluscum. Do you remember me using candidate at Denver office? Injected, and it's like, is it a yeast? It is. It's a yeast protein. So it's not live yeast. You can't get a yeast infection from it. It's just the protein. And it's what our immune system is circulating for, trying to find and identify. And so you inject it just a little bit. You can use anywhere from 0.1 to 0.3 milliliters, inject it into one molluscum. So you only have to treat one. The immune system is attracted to the candidate and says, oh, look, there's molluscum here. Let's go after them.

unknown 41:45

Okay.

SPEAKER_01 41:46

It is a series of treatments. So you have to treat every three to four weeks until they're gone. Typically takes three to five treatments to have them all gone. The one advantage, I guess two advantages. Number one, families don't have to do anything at home. You know? So for busy families that it's easier to just come into the office every three to four weeks, this is a great option for them. Yeah. The second advantage is for people with a ton of molluscum. Yeah. Where, you know, to put the KOH or the Zelsuv me or even the retinoids on all of them, like that's too much of a burden. So when kids come to see me and they've got like 50 molluscum, I'm thinking more of the Amiquimod because you only have to treat two or three. Yeah. Or the Candida because you only have to treat one. Yeah. These treatments are nice when there's a ton of molluscum. With Candida, a small percentage of patients will get a little bit of redness and swelling around the one that you treat. It kind of looks like a bug bite, like a bee sting, but it doesn't tend to hurt or itch. And it resolves quickly within 72 hours. It happens pretty soon after you've done the SHOT. That's the other thing in Clinic Anna. I always spell SHOT. I never say the word. Yeah. Never say the word shot. When people get the redness and swelling, it tends to be a positive sign of immune system response. Oh, like kind of quick. Yes, very quick. Okay. And so it's like, okay, this means that this is going to work really well for you. Yeah. And we just let it settle down again. It settles down within 72 hours. The first time I had a patient develop this redness and swelling, it was, and we can we can cut this out if we choose to, but it was a young girl back in Denver, and we had treated molluscum on the hand or the finger. It was something like that. Yeah. And we had injected one. And the father called in about the redness and swelling. And the father is a lawyer in Denver who is on billboards. Oh. On billboards. And so I like, uh oh. But it's a good sign of immune response. Yeah. And it's a positive thing. It means it means good things are gonna happen. Okay. And so don't panic.

SPEAKER_02 43:58

Don't panic. Don't panic. But this one is It's probably not going to blister like the Betelgeuse and the liquid nitrogen do.

SPEAKER_01 44:03

Definitely not, definitely not. And so the candida hurts a little bit when we do it, doesn't hurt at all later. The betle juice doesn't hurt when we do it, hurts later.

SPEAKER_03 44:12

Sure.

SPEAKER_01 44:13

Okay, good to know. Interestingly enough, I think that's why a lot more dermatology clinicians do beetle juice. Because then they're not the responsible kind of. Exactly. They're not dealing with the pain, the child in pain. That's so funny. Because they don't experience the pain till later. Yeah. Um curatage. So curatage is where we take a utensil called a curette and we scrape off the molluscum. That sounds intense. It is kind of intense. Are they numbed or no? No. Oh, you just go for it. You just go for it. Okay.

SPEAKER_02 44:48

Because it probably hurts just as much to numb it.

SPEAKER_01 44:50

I know, right? To numb every little molluscum spot. Yes. This is only, in my opinion, for the highly motivated patient who is probably a little bit older, maybe preteen or early or teenage years. Yeah. Also for the wrestler. So wrestlers have to have their molluscum gone in order to compete. Yeah. And curatage is the only option on this list where their molluscum can be gone today. Okay. Right? So a wrestler who's really motivated and says, I want these gone today because I have a tournament this weekend. Curatage can make sense.

SPEAKER_02 45:29

And with that, is there a potential of a little baby scar?

SPEAKER_01 45:32

There is. So curatage can cause scarring. It hurts when we do it. They actually bleed a lot. And the dry salt that we put on it to stop the bleeding burns and stings like crazy.

SPEAKER_02 45:44

Yeah.

SPEAKER_01 45:44

It's not a fun process. It's not for everybody. It's for a select patient population. Sure. Uh, and you really have to be willing to put up with some stuff to have the molluscan go on that day, sort of situation. You bring up an interesting point about um scarring. So on this list, the only treatment that typically causes scarring is curatage. Now, if you over-freeze with liquid nitrogen, if you leave the beetle juice on too long or you occlude it for too long, you might get some scarring from that. But typically the only one on the list that causes scarring is curatage. Molluscum commonly leave behind an area of discoloration and sometimes a little bit of a divot, even in ones that are not treated at all. That's kind of the natural resolution process of the molluscum. Do they stretch the skin a little bit or like you know, honestly, we don't understand it. And when the molluscum clear, it looks for all the world like this is going to be permanent scarring. It tends not to be. You give it enough time, it goes away. But we're talking like two or three years before it naturally resolves. Yeah. But it's good to tell parents about that. So sometimes I'll take a look at the child and I'll see that some of the molluscum have gone away and left behind those things. I'll always bring it up and I'll say, you know, I see these spots here. They always look like true scars, but they typically eventually fade. Yeah. Um, do we feel good about our in-office treatments?

SPEAKER_02 47:10

Yeah, I love this. I mean, on Reddit, it was like wipe them with alcohol, stab them, buy a little surgical kit online. Yeah. You know, um, don't do that.

SPEAKER_01 47:21

Please don't do that, listeners. Please. No home surgery. It's painful for those kiddos. And we have options that can be comfortable and effective. And please don't do that.

unknown 47:35

Yeah.

SPEAKER_02 47:35

Please don't do that. Scary stuff.

SPEAKER_01 47:38

There's one last treatment option on the list, and it's our one oral medication that we sometimes use to treat molluscum, and it's called cmetidine. And cementidine, the name might sound familiar to you because it's a heartburn medicine. It's a heartburn medicine, and for reasons we don't understand, it can help treat molluscum and warts. Wart. Yeah. It's my opinion that cementidine doesn't do much on its own, but it can make other things work better. So if I have a patient who, like maybe they're doing a Mikkel mod and they're getting some response, but just not as much as we'd like, I'll suggest adding cemetidine. The other situation that I use cemetidine is in patients who only have molluscum on their face in a sensitive area, like on their eyelids. That's the only place they've got them. So we can't do any of these other things. No. I'm not gonna put betel juice there, I'm not gonna put a mikelemod there, I'm not gonna put any of this stuff on the eyelid. And so the cementidine comes in handy in those situations. The only side effect of cementidine is increased gassiness. Yeah. So they're gonna fluffy a little bit more. For those of you who are not familiar with Bluey, fluffy means fart or toot, passing gas.

SPEAKER_02 48:47

Yes, it's so cute. Yeah. I mean, nobody can be mad at a fluffy. I know.

SPEAKER_01 48:51

So I always tell the kids, I always look at him and I was like, the only side effect is you might toot a little bit more.

SPEAKER_02 48:56

They probably think that's funny.

SPEAKER_01 48:58

What? Yeah, they're like, cool, let's do it.

SPEAKER_02 49:00

Especially the boys. Yes.

SPEAKER_01 49:02

And the parents are like, please no. Cementidine used to be used to be available in pills and liquid. Okay. They discontinue the liquid. You can have it compounded, but then insurance commonly doesn't cover compounds. Yeah. And so you're talking typically about$50 a month. So that's a little bit unfortunate. But if kids are old enough to swallow pills, cementidine's super, super cheap.

SPEAKER_02 49:22

Is it always written as a prescription, never over-the-counter?

SPEAKER_01 49:27

There is an over-the-counter version. I'm blanking on the name. It has a brand name and I'm blanking on the name. Um I sometimes recommend that, but insurance will commonly cover it when you prescribe it and then it's just covered. Yeah, it's better. So, and I think if you're gonna try cymedidine, don't just like dive in. There is weight-based dosing to cymedidine. It's just better to get a prescription. So talk to your medical professional and get the appropriate dose for your size and weight. Cymedidine also can have interactions with other medications. So anytime I prescribe cymedidine, I'm gonna ask patients what other meds they're on. I'm gonna type them into my interaction checker and make sure everything is okay. And I tell people if they're not on any other medicines, I say, while your child's on cymedidine, if they get sick and you go to the ER or the urgent care and they need a prescription, just make sure to mention to them that they're on cymedidine.

SPEAKER_02 50:19

Yeah, such an important point. So many people just like they don't mean to. They just like don't mention things.

SPEAKER_01 50:25

Yes, yes, yeah. We have really done it here.

SPEAKER_02 50:29

Yeah, I thought the list was gonna be much shorter, to be honest with you. I think I haven't worked in Durham for like probably five years, and so it seems like the list is longer.

SPEAKER_01 50:39

Yeah, yeah. I mean, really the only new thing since you were working in Durham is Zel Suv me. And this the cementidine, I don't remember. Maybe it was a thing and I just don't remember it. It's a super old medicine, but a lot of times we, you know, we repurpose old medicines and yeah, and try to find new uses for them. Hopefully, in the future, we'll have even additional treatments for molluscum. I think that would be super great because people really hate molluscum.

SPEAKER_02 51:07

Yeah.

SPEAKER_01 51:07

Yeah. If only insurance could get on board, hopefully they will. I know, right? Yes. I think having FDA approved options is going to help us in that battle. That's great. Yeah. So to those of you out there that really hate molluscum, hopefully you feel armed with the knowledge to go out there and talk to your dermatology clinician about treating these molluscum and getting them gone. Because again, once they're gone, you don't get them again. It's great. They're a one-time deal.

SPEAKER_02 51:39

Yeah, and it's not gonna spread anywhere. You told us that it's not gonna like get into your organs. It's so superficial. So superficial. It's not gonna hurt you if you decide not to be aggressive.

SPEAKER_01 51:49

Yes. And so I put on the bottom always okay to leave them alone and let them resolve naturally. That is always an okay choice. But if you want to treat them, now you're prepared. Thank you guys so much for tuning in. Thank you, listeners, and stay tuned for more fun skin credible podcast episodes. Share it with your friends too. Oh yes, we share and like and subscribe. During this episode, we talked about oodles of treatments to tackle molestium. I wanted to disclose that I have been a speaker and an advisor for the companies that make the branded form of Cantheridin, which is called YPM, as well as the company that makes sales to me. Thank you so much for listening.