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Molluscum Contagiosum Treatments in Children: A Systematic Review with Network Meta-Analysis
Letícia Rocha Campos1, Gisella Chiara Carpi2, Ana Beatriz Nardelli da Silva3
1Department of Medicine, Universidade de Ribeirão Preto (UNAERP), Av. Costábile Romano, 2201, Nova Ribeirânia, Ribeirão Preto, SP, 14096-900, Brazil. ichbinleticiarochacampos@gmail.com.
Background/Objectives:
Molluscum contagiosum affects up to 11.5% of children, yet optimal treatment remains uncertain. Previous systematic reviews included mixed adult/pediatric populations, limiting applicability to children. We performed the first pediatric-specific network meta-analysis comparing molluscum contagiosum treatment efficacy and safety.
Methods:
We searched MEDLINE, Embase, Cochrane Library, and Web of Science through December 2025 for controlled trials evaluating molluscum contagiosum treatments in children. Two reviewers independently selected studies, extracted data, and assessed risk of bias using Cochrane Risk of Bias 2 and ROBINS-I tools. We performed frequentist network meta-analysis with random-effects modeling, calculating risk ratios (RR) with 95% confidence intervals (CI). Treatments were ranked using Surface Under Cumulative Ranking (SUCRA) scores. This systematic review and network meta-analysis was registered in PROSPERO (registration number CRD420251040622).
Results:
Eighteen controlled trials involving 2377 pediatric participants evaluating 15 treatments were included. The network demonstrated consistency (inconsistency p = 0.77). Among treatments evaluated in multiple studies, salicylic acid + lactic acid 16.7% (RR 3.16, 95% CI 1.81-5.52, SUCRA 86.0%), cantharidin 0.7% (RR 3.25, 95% CI 1.39-7.58, SUCRA 81.2%), and potassium hydroxide 10% (RR 3.05, 95% CI 1.77-5.24, SUCRA 78.6%) demonstrated superior efficacy versus placebo. Single-study treatments including Backhousia citriodora oil and Candida albicans antigen achieved highest rankings but require validation. Potassium hydroxide demonstrated concentration-dependent efficacy and adverse events.
Conclusions:
Salicylic acid + lactic acid 16.7%, cantharidin 0.7%, and potassium hydroxide 10% demonstrate superior efficacy for pediatric molluscum contagiosum with robust multi-study evidence. Treatment selection should balance efficacy, safety, and patient factors. Top-ranked single-study treatments require validation before clinical recommendations.
Insights
Salicylic acid + lactic acid, cantharidin, and potassium hydroxide show superior efficacy for treating molluscum contagiosum in children. This pediatric-specific network meta-analysis provides robust evidence for these treatments.
Area of Science:
- Dermatology
- Pediatrics
- Evidence-Based Medicine
Background:
- Molluscum contagiosum is common in children, affecting up to 11.5%.
- Optimal pediatric treatment strategies remain unclear.
- Previous reviews lacked pediatric-specific focus.
Conclusions:
- Salicylic acid + lactic acid, cantharidin, and potassium hydroxide are effective treatments for pediatric molluscum contagiosum.
- Treatment choice should consider efficacy, safety, and individual patient factors.
- Further research is needed for single-study treatments.
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