This SDPA Summer Conference interview with Lisa Swanson, MD, highlights several notable treatment options for molluscum and hemangiomas.
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“It will, if you do nothing, it will eventually go away,” Swanson said. “That can take up to two to three years, the average is one year, so it can take a while.”
Discussing molluscum contagiosum, Swanson noted the importance of setting realistic expectations for families. She explained that molluscum is ultimately a self-limited condition and will resolve without treatment, though clearance can take anywhere from 1 - 3 years, with approximately 1 year being common. While treatment is never needed, Swanson expressed that many families looking for specialty care have already decided they would prefer active intervention.
Among available agents, Swanson pointed to berdazimer gel, a nitric oxide-releasing topical treatment that became available within the last year. Based on her clinical experience, she described the medication as highly effective in routine practice. Although some individuals experience mild burning or stinging, Swanson explained, most are able to continue their therapy successfully and attain meaningful improvement.
Swanson also reviewed key factors that should prompt clinicians to consider treatment for infantile hemangiomas. Location, she stated, remains 1 of the most important considerations. This is especially true for lesions involving the eyelids, nose, lips, or diaper area, as these sites carry increased risks of functional impairment, cosmetic concerns, or ulceration.
Size is another critical factor, as larger hemangiomas are less likely to resolve without lasting sequelae. She also emphasized the value of recognizing and treating ulcerated hemangiomas, which can be painful and lead to permanent scarring. Beyond clinical risk factors, Swanson noted that patient and parent preferences should also play a role in treatment decisions.
The session concluded with discussion of pyogenic granulomas, for which Swanson presented topical timolol as a valuable noninvasive alternative to surgical removal in selected pediatric patients. While shave excision and cautery remain standard treatment options, she explained that these procedures can be particularly challenging in young children.
Topical timolol, an inexpensive ophthalmic medication commonly used for glaucoma, can provide a painless treatment option when applied directly to the lesion. Swanson noted that improvement is often visible within a month, with complete resolution frequently occurring within 1 - 3 months, making it an attractive option for children and families seeking to avoid procedural intervention.
Disclosures: Swanson previously disclosed serving as a consultant for AbbVie, Alphyn, Arcutis, Boehringer Ingelheim, Castle, Dermavant, Galderma, Incyte, Janssen, Leo, Lilly, Novan, Pfizer, Sanofi-Regeneron, and Verrica.
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