Zelsuvmi (berdazimer topical gel, 10.3%) is the first FDA-approved at-home topical treatment for molluscum contagiosum (MC) in adults and children 1 year of age and older. Molluscum contagiosum is a common viral skin infection that causes small, raised, flesh-colored bumps — it's especially prevalent in children and can persist for months or years without treatment.

Zelsuvmi is applied once daily directly to each MC lesion for up to 12 weeks. The medication comes as a two-tube mixing system: patients combine equal amounts from Tube A (berdazimer gel) and Tube B (hydrogel) on a dosing guide before each application.

Zelsuvmi was developed by Novan (later acquired by Ligand Pharmaceuticals) and is now commercialized by Pelthos Therapeutics. It launched commercially in July 2025.

Zelsuvmi works by releasing nitric oxide (NO) when the two gel components are mixed and applied to the skin. Nitric oxide is a naturally occurring molecule with broad-spectrum antiviral properties.

Once applied to molluscum contagiosum lesions, the released nitric oxide is believed to:

• Block viral proteins needed for replication
• Damage viral DNA, preventing the virus from multiplying
• Create a hostile environment for the molluscum contagiosum virus at the application site

The exact mechanism by which berdazimer treats MC lesions is not fully understood, but clinical trials showed significant lesion clearance compared to placebo over 12 weeks of daily use.

Zelsuvmi is available in a single formulation:

• Topical gel, 10.3% berdazimer — supplied as a two-tube kit (Tube A: 14g berdazimer gel + Tube B: 17g hydrogel = 31g total)

How to use:

• Mix equal amounts (0.5 mL each) from Tube A and Tube B on the provided dosing guide for about 20 seconds
• Apply a thin, even layer to each MC lesion once daily
• Let dry for at least 10 minutes before covering
• Avoid swimming, bathing, or washing the treated area for 1 hour after application
• Do not premix or store mixed product
• For external (topical) use only — not for eyes, mouth, or intravaginal use

Zelsuvmi receives a Findability Score of 55 out of 100, reflecting that it is a brand-only specialty medication with no generic alternative. Zelsuvmi was FDA-approved in January 2024 but did not become commercially available until July 2025, creating an 18-month access gap. It is now stocked at retail pharmacies including Walgreens and available through Amazon Pharmacy home delivery, but its high list price (~$2,000 per kit) and prior authorization requirements can make access challenging for some patients.

The ZelsuvmiGO copay assistance program can reduce costs to $0 for commercially insured patients. A patient assistance program (PAP) is also available for uninsured patients. Formulary coverage is expanding following a December 2025 PBM agreement.

Zelsuvmi is most commonly prescribed by:

• Dermatologists — the primary prescribers, as molluscum contagiosum is a skin condition
• Pediatric dermatologists — MC is very common in children
• Pediatricians — often the first point of contact for children with MC
• Family medicine physicians — may diagnose and treat MC in patients of all ages
• Internal medicine physicians — may treat MC in adult patients

Telehealth prescribing is generally not available for Zelsuvmi, as diagnosis of molluscum contagiosum typically requires a visual examination of the skin lesions.

No. Zelsuvmi (berdazimer) is not a controlled substance and has no DEA scheduling. It is a topical antiviral gel with no potential for abuse or dependence. A prescription is required, but there are no special prescribing restrictions beyond the standard Rx requirement.

The most common side effects of Zelsuvmi occur at the application site and include:

• Pain, burning, or stinging at the application site (19%)
• Redness (erythema) at the application site (12%)
• Itching (pruritus) at the application site (6%)
• Skin peeling or exfoliation at the application site (5%)
• Dermatitis or rash at the application site (5%)
• Swelling at the application site (3%)
• Fever (2%)
• Skin discoloration at the application site (1.5%)
• Blistering (vesicles) at the application site (1.5%)
• Vomiting (1.3%)

Serious side effects are rare but may include severe allergic skin reactions, skin erosion (breakdown of the outer layer), or infection at the application site. Contact your healthcare provider if you experience worsening skin reactions or signs of infection.

If Zelsuvmi is not available, too expensive, or not right for you, alternatives for treating molluscum contagiosum include:

• Ycanth (cantharidin 0.7%) — an FDA-approved in-office topical solution for MC in patients 2 years and older. Applied by a healthcare provider, it causes controlled blistering to remove lesions. Requires office visits.
• Imiquimod (Aldara/Zyclara) — a topical immune response modifier used off-label for MC. Applied at home as a cream. FDA-approved for genital warts and other conditions but commonly used for molluscum.
• Cryotherapy (freezing) — an in-office procedure using liquid nitrogen to freeze and destroy MC lesions. Effective but requires repeated visits and can be painful, especially for children.
• Curettage (scraping) — an in-office procedure where a dermatologist scrapes lesions with a small instrument. Effective for fewer lesions but may cause discomfort and minor scarring.

Zelsuvmi's main advantage over these alternatives is that it's the first FDA-approved at-home treatment for MC, avoiding repeated office visits.

Zelsuvmi has no known significant drug interactions. Because it is applied topically to individual skin lesions and has minimal systemic absorption, the risk of interactions with other medications is very low.

There are also no known food interactions.

However, you should tell your healthcare provider about all medications and skin products you use, especially other topical treatments applied to the same area, to avoid potential skin irritation.

Zelsuvmi represents a meaningful advance for patients with molluscum contagiosum — it's the first FDA-approved topical treatment that can be used at home, which is especially valuable for children who may not tolerate painful in-office procedures like cryotherapy or curettage.

The main barriers to access are its high list price (~$2,000 per kit) and the fact that it's brand-only with no generic. However, the ZelsuvmiGO copay assistance program can bring costs down to $0 for commercially insured patients, and a patient assistance program exists for the uninsured.

If you or your child has been diagnosed with molluscum contagiosum, talk to your dermatologist about whether Zelsuvmi might be a good option — and be sure to ask about copay assistance before filling the prescription.