“It Keeps Spreading and It Breaks My Heart” | Pediatric Molluscum (Water Warts) in Children
“It keeps spreading and it breaks my heart” | For worried parents
Pediatric Molluscum (Water Warts)
\n\n| \n “Director, my child’s water warts started appearing one or two at a time, and now they seem to be spreading all over the body. I’m worried if this will last a lifetime, I can’t even send them to daycare or a swimming pool, and it breaks my heart and worries me so much.” This is the desperate voice of parents I often hear in the clinic. When a child gets water warts (Molluscum contagiosum), wordless worry comes first. Particularly as it commonly appears in young children whose immune systems are still immature, and often once it occurs, it spreads easily or recurs, parents’ anxiety inevitably grows.<sup>[1]</sup> Why do our child’s pediatric water warts keep spreading? Instead of just a simple skin problem, what story is contained within the child’s body? \n |
The Real Cause of Water Wart Spreading: Stories Inside the Body Beyond the Virus
Water warts are a skin disease caused by Molluscipox virus infection.<sup>[2]</sup> However, just because a child is infected with the virus doesn’t mean water warts appear for all children, or that once they appear, they must unconditionally spread.
When I see the water wart spreading phenomenon, I often explain it using an analogy of ‘fish in a fish tank.’
Just like how it is more important to manage the water (environment) in the fish tank itself to be clean and healthy rather than just isolating one or two sick fish in a tank.
Like this, I interpret that the spreading of water warts is not just a problem with external viruses alone, but the result of a complex interplay of the child’s environmental vulnerability and lifestyle habits inside the body.
The most common cause is direct skin contact.
Water warts are highly contagious, so they can easily spread when children’s skin touches or when sharing contaminated towels, clothes, toys, etc.
This is why the prevalence is high in spaces where children live in groups, such as daycares, schools, and swimming pools.
A bigger problem is ‘Autoinoculation.’
If children scratch or touch a lesion because it is itchy, the virus moves to other areas through their hands, creating new water warts.<sup>[3]</sup>
There is one more important factor here.
It is the weakening of the skin barrier.
Particularly, children with atopic dermatitis tend to have weakened skin barrier function, making them more vulnerable to virus infiltration, so lesions tend to occur extensively or the transition period tends to be long.
When immunity weakens, our body’s defense ability against viruses drops, and the skin barrier itself is difficult to maintain strongly.
\n\n| \n I think of 5-year-old Jun-su (pseudonym) whom I met in the clinic. At first, he had two or three small water warts on the back of his knees, but unable to stand the itchiness, he scratched all night and visited the clinic as they spread to dozens on his arms, legs, and stomach within a week. Jun-su usually got minor illnesses often and caught colds easily. Like this, the spreading of pediatric water warts is a phenomenon that appears as the child’s internal lower immunity, skin barrier damage, and scratching habit mesh with the infiltration of external viruses. \n |
Win Over “Evil Qi (邪氣)” by Cultivating “Vitality (正氣)”: Water Warts from a Korean Medicine Perspective
I do not see water warts simply as a problem revealed on the skin.
Rather, I interpret it as a sign showing the health state of our child’s entire body.
Particularly, as Korean medicine expresses skin as a ‘mirror of the internal organs,’ we believe skin problems stem from issues with the balance of internal organs and Qi and Blood circulation.
In the 『Donguibogam (동의보감)』 ｢Extra-corporeal Part (外形篇)｣, while explaining the causes of skin diseases, it considers not only external Evil Qi (邪氣) such as Wind-Cold-Heat-Dampness (風寒暑濕) but also important the weakening of internal Vitality (正氣), which is the body’s immunity and resistance.
This perspective is in line with the immunity mentioned in modern medicine.
If our body’s ‘Vitality’ is full, even if the virus, which is the external ‘Evil Qi,’ infiltrates, we do not easily get sick, or even if we do, we can quickly overcome it.
The fact that pediatric water warts keep spreading could be a signal that the child’s body does not currently have sufficient immunity and recovery power to effectively fight the virus.
Frequent fatigue, irregular sleep, a constitution prone to colds, nutritional imbalance due to picky eating, emotional stress, and rapid environmental changes are all main culprits that weaken a child’s immune system.
These elements work in complex ways to make the child’s internal environment a state good for the virus to breed and cause water wart spreading.
I focus like this on correcting the imbalanced internal environment and cultivating the strength for the child to overcome the disease themselves.
Water Warts: A Companion Integrated Management Strategy for Our Child’s Recovery Journey
Pediatric water wart management essentially requires a long-term perspective of cultivating the child’s own body strength to overcome the virus, beyond just checking off visible lesions in the short term.
Most water warts naturally heal within 6 to 12 months if immunity improves, but as that process can be long or re-infection can occur at any time, active and integrated management is important.<sup>[4]</sup> With a heart of walking the recovery journey together with the child, I recommend the following companion management measures to parents.
1.
Strengthening immunity to raise the body’s defense power: This is the most fundamental solution.
Sufficient and regular sleep: The best tonic for a child is sufficient sleep.
As it is essential for growth hormone secretion and immune cell activation, please help them go to bed at a fixed time and get enough sleep.
Balanced diet and digestive management: You must supply nutrients necessary for immunity enhancement by reducing picky eating and having them consume sufficient seasonal foods, especially vegetables and protein.
Also, as nutrients can only be absorbed well when the digestive system is strong, it is good to avoid overeating or irregular meals.
Appropriate exercise and outdoor activity: Running and playing while getting sunlight helps Vitamin D synthesis and facilitates Qi and Blood circulation through physical activity, which is essential for a child’s immunity and physical development.
Stress management and stable emotional environment: Children feel as much stress as adults.
It is important to create a stable emotional environment, listen to the child’s story, and make their mind comfortable.
* Herbal medicine treatment: We conduct customized herbal medicine treatment by carefully diagnosing the child’s constitution and current immune state.
Herbal medicine is not just to suppress simple symptoms but can be a great help in fundamentally pulling up immunity by correcting internal imbalances, supplementing Vitality (正氣), and cultivating strength for the child to overcome the virus themselves.
2.
Strengthening the skin barrier to block infiltration from the outside and hygiene management: This is about making the external defense line strong.
Meticulous moisturizing and maintaining cleanliness: After bathing, you must wipe off moisture meticulously and apply sufficient low-irritant moisturizer to maintain the skin barrier strongly.
This plays an important role in blocking virus infiltration.
Foster the habit of washing hands cleanly after going out, after using the bathroom, and before and after meals.
Meticulous management to prevent scratching: To prevent autoinoculation, which is one of the major causes of water wart spreading, keep fingernails cut short so the child doesn’t scratch lesions, and use cold compresses or gentle sedatives when itching is severe, or attaching a band if necessary is also a good way.
Thorough personal hygiene*: It is good to use personal items like towels, clothes, bath products, and pajamas separately.
It is important to minimize direct skin contact with other friends during group life and to shower and moisturize immediately after using a swimming pool or public bath.
Pediatric water warts are a disease that requires parents’ patience and consistent interest.
Focus should be placed on making the child’s entire body healthy to cultivate strength to overcome the virus themselves, beyond just being urgent to remove warts visible to the eye.
If you are worried about our child’s water wart spreading, I recommend seeking help from experts who can integrally look at the child’s immune system, lifestyle habits, and internal environment.
I will gladly accompany you on the journey toward the child’s healthy skin recovery.
