Topical salicylic acid gel as a treatment for molluscum contagiosum in children

Abstract

Objective: To determine if the application of salicylic acid gel or phenol solution affected resolution of molluscum contagiosum (MC) lesions in children. Patients and methods: This was a randomized, prospective controlled trial with two treatment arms and one vehicle arm for treatment of MC in children. The trial was set in the dermatology outpatient clinics of a teaching hospital and a district general hospital. A total of 114 children were enrolled in the study (age range 1–15 years) over a 4‐year period; 83 of the children completed the study. Patients were randomized to receive one of three possible treatments: monthly vehicle application of 70% alcohol, monthly application of 10% phenol in 70% alcohol once or twice weekly 12% salicylic acid gel. All patients also received treatment with daily aqueous cream to reduce eczema. They returned monthly to the clinic for treatment and counting of MC lesions. They were reviewed either until complete resolution or up to 6 months, whichever occurred sooner. The main outcome measure was the time taken for complete resolution of MC lesions. Results: In the intention‐to‐treat analysis there was no difference between treatment arms when the 31 non‐completers were analysed as failures (log‐rank test: p = 0.38). In an ‘as treated’ analysis, 16 of 27 children (59.2%: 95% confidence interval 30.2–88.3) had cleared with vehicle, 18 of 32 (56.3%, 30.3–82.2) with phenol solution and 21 of 24 (87.5%, 50.1–124.9) with salicylic acid gel (log‐rank test: p = 0.03). On an as treated basis, salicylic acid was significantly better at clearing MC than dilute phenol (p = 0.006). The treatment in all groups was very well tolerated or acceptable in 93% of children. Conclusion: Our results suggest that topical salicylic acid may be beneficial in speeding resolution of MC in children. Dilute phenol application does not appear to affect the disease course.