HPV vs Molluscum
HPV is the family of viruses behind warts. On the skin it makes rough, thickened growths, mostly on the hands and feet. Molluscum contagiosum is a different virus, from the pox family. It makes smooth, pearly bumps with a small dimple in the middle, mostly on the trunk and in skin folds. Comparing them means comparing two viruses and the two very different bumps they leave.
What it is
More than 200 HPV types are known. Only a handful cause the ordinary warts people get on hands and feet, and those are the ones this page is about.
Molluscum contagiosum virus has only a few types, and one of them accounts for most childhood cases. It is not related to HPV.
What it makes on the skin
A firm grey-brown lump with a cauliflower surface and a thickened rim. Most warts have tiny dark dots inside, which are small clotted blood vessels.
Firm, dome-shaped and shiny, skin-coloured or slightly pink. The small central pit is the most useful sign, and it holds a soft white core.
Size of what it makes
A single wart thickens over weeks, and several can merge into one larger patch.
Each bump stays about the size of a small bead. What increases is the number of them.
Does it hurt
A hand wart is painless. A wart on the sole takes your weight and can feel like standing on a stone.
Some bumps itch. A scratched one turns red and sore, which often means it is about to clear.
Where it shows up
Backs of the hands, around the fingernails, knees, and the soles of the feet.
Chest, tummy, sides, armpits, the crooks of the elbows and the backs of the knees. Face and neck in small children.
What it does over time
The immune system recognises the virus eventually. Children clear warts faster than adults do.
New bumps appear while old ones fade. Once the immune system catches up, the whole crop goes.
How it is treated
Salicylic acid daily, with gentle filing between applications, then liquid nitrogen freezing in a clinic if that is not enough.
Most crops are left to clear naturally. A clinician can scrape or freeze individual bumps that are irritated or awkwardly placed.
When it needs a doctor
Worth a visit if a growth bleeds without being knocked, changes colour or shape, or keeps spreading despite months of treatment.
Worth a visit if bumps sit on the eyelid, if one becomes hot and swollen with spreading redness, or if you are not sure what it is.
Two viruses, two different bumps
HPV thickens the skin: It drives the cells in the outer layer to multiply, so the result is a hard, raised, rough growth. The dark specks people call seeds are the small blood vessels the wart has recruited.
Molluscum fills a pocket: The virus multiplies inside skin cells and leaves a soft white core in the middle of each bump. The surface stays smooth, and the dimple is the opening over that core.
The names cause the confusion, not the bumps: Molluscum is often called water warts, so people assume it is the wart virus. It is not.
How each one spreads
HPV needs a break in the skin: It travels on direct contact and on damp shared surfaces such as pool decks and changing room floors. It also travels on your own body, so picking a wart or shaving over one can move it.
Molluscum needs contact more than a break: It passes between children through skin contact, shared towels and shared bath water. Scratching one bump and then scratching normal skin is how a line of them appears.
Neither is treated by killing the virus
No drug wipes out either one: Every common treatment works by removing the infected skin or by nudging the immune system to notice it. There is no course of tablets that clears warts or molluscum.
That is why patience is most of the treatment: Warts often take a year or more. Molluscum usually takes under a year and a half. Treating them shortens the wait rather than ending it.
Which types this page is about
The HPV types that cause hand and foot warts are not the same types found elsewhere in the body: HPV is a large family, and different members prefer different tissue. This page covers the skin ones only.
Molluscum has no such split: It is one virus that lives in the outer layer of skin, and it does nothing beyond making the bumps you can see.
