Can't find or afford Zelsuvmi? Here are real alternatives for treating molluscum contagiosum, including other FDA-approved treatments and in-office options.
If you've been prescribed Zelsuvmi (berdazimer) for molluscum contagiosum but can't fill your prescription — whether because of availability issues, cost, or insurance problems — don't lose hope. There are other treatments that can help.
Zelsuvmi is an important breakthrough, but it's not the only way to treat molluscum contagiosum. In this article, we'll walk through what Zelsuvmi is, how it works, and the real alternatives available to you.
Zelsuvmi (berdazimer) is a prescription topical gel approved by the FDA in January 2024 for the treatment of molluscum contagiosum (MC) in adults and children 1 year of age and older. It's the first and only FDA-approved at-home treatment for this condition.
The medication is a nitric oxide-releasing agent. It comes as two tubes of gel that you mix together on a dosing guide and apply to each MC lesion once daily for up to 12 weeks. The nitric oxide released by the gel has antiviral properties that help fight the virus causing the bumps.
For a complete overview of the medication, see our guide: What is Zelsuvmi? Uses, dosage, and what you need to know.
Zelsuvmi works by releasing nitric oxide (NO) when the two gels are mixed together. Nitric oxide has been shown to have broad-spectrum antiviral activity — it can block viral proteins, damage viral DNA, and prevent the molluscum contagiosum virus from making copies of itself.
While the exact mechanism isn't fully understood, clinical trials showed that 32.4% of patients treated with Zelsuvmi had complete clearance of MC lesions compared to 19.7% with placebo after 12 weeks. Learn more in our detailed explainer on how Zelsuvmi works.
If you can't get Zelsuvmi, here are the main alternatives to discuss with your healthcare provider:
Ycanth (cantharidin 0.7% topical solution) is the first FDA-approved in-office treatment for molluscum contagiosum, approved for patients 2 years of age and older. Unlike Zelsuvmi, Ycanth must be applied by a trained healthcare professional in a medical office.
How it works: A healthcare provider applies the solution directly to each MC lesion using a specialized applicator. The cantharidin causes a small blister to form under the lesion, lifting it away as the blister heals. Patients typically need multiple office visits, with treatments spaced 3-4 weeks apart.
Pros: FDA-approved, no daily at-home treatment required, can treat multiple lesions per visit.
Cons: Requires office visits, causes blistering which can be uncomfortable, not for use on face or genital area, approved only for ages 2+.
Cryotherapy is one of the most widely used in-office treatments for molluscum contagiosum. A dermatologist or healthcare provider applies liquid nitrogen to freeze and destroy each MC lesion individually.
How it works: The extreme cold destroys the infected skin cells and stimulates an immune response. Lesions typically fall off within 1-2 weeks after treatment. Multiple sessions are usually needed, spaced 2-4 weeks apart.
Pros: Widely available at dermatology offices, effective, no prescription medication needed.
Cons: Can be painful (especially for children), may require multiple visits, risk of temporary skin discoloration or scarring, not ideal for large numbers of lesions.
Imiquimod is a topical cream that works by stimulating the immune system. While it's FDA-approved for genital warts, actinic keratosis, and superficial basal cell carcinoma, it's sometimes prescribed off-label for molluscum contagiosum, particularly in adults.
How it works: Applied at home, imiquimod activates the body's own immune cells to fight the virus. It's typically applied 3-5 times per week for several weeks. Note that imiquimod has not been proven effective for MC in children and is not recommended for pediatric use in this condition.
Pros: At-home treatment, available as a generic (lower cost), may stimulate lasting immune response.
Cons: Off-label for MC, not effective in all patients, can cause significant skin irritation and inflammation, not recommended for children with MC, slower onset of action.
Curettage is an in-office procedure where a dermatologist uses a small, sharp instrument called a curette to scrape MC lesions off the skin.
How it works: The provider numbs the area (often with topical anesthetic) and physically removes each bump. Results are immediate — the lesion is gone after the procedure. It's often combined with other treatments.
Pros: Immediate results, effective for smaller numbers of lesions, widely available.
Cons: Can be painful and frightening for children, risk of scarring, may not be practical for patients with many lesions, requires local anesthesia.
It's worth knowing that molluscum contagiosum is self-limiting — meaning it will eventually clear on its own without treatment, typically within 6 to 18 months. For some patients, especially those with a small number of lesions that aren't bothersome, a "watchful waiting" approach may be reasonable.
However, treatment is often recommended when:
Discuss with your dermatologist whether watchful waiting makes sense for your situation.
Here's a quick comparison to help guide your conversation with your provider:
Zelsuvmi is a game-changer for molluscum contagiosum treatment, but it's not your only option. If you can't fill your prescription due to availability or cost, talk to your dermatologist about alternatives like Ycanth, cryotherapy, or other approaches. Every patient's situation is different, and the best treatment depends on the number and location of your lesions, your age, and your preferences.
If you'd like to try finding Zelsuvmi first, use Medfinder to check pharmacy availability near you. And for tips on reducing the cost, see our guide on how to save money on Zelsuvmi.
You focus on staying healthy. We'll handle the rest.
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