Leon Kircik, MD

-approved therapy. This meant physical modalities, such as curettage and cryotherapy, were all they would rely on and many viewed them as poorly suited to the young children who make up such cases.

That year, berdazimer gel, 10.3% became the first at-home topical for those living with molluscum contagiosum. This decision followed the phase 3 B-SIMPLE4 trial, during which berdazimer demonstrated superiority over vehicle gel.¹ The 891-patient analysis, conducted across 55 US clinics among children as young as 6 months, demonstrated 32.4% complete lesion clearance at the 12-week mark with the topical gel versus 19.7% with vehicle (

The FDA approved berdazimer gel, marketed as Zelsuvmi, in January 2024, making it the first prescription medication patients or caregivers can apply at home rather than in an office setting.² Pediatric viral skin conditions have historically drawn little drug-development investment, so the approval fills a gap Kircik and other dermatologists have flagged for years. Common adverse events noted in the study were deemed as mild, application-site reactions such as erythema, burning, and itch.¹

At LEADderm 2026 in Newport Beach, California, Leon Kircik, MD, clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai and medical director of DermResearch, Physicians Skin Care, and Skin Sciences, in Louisville, Kentucky joined Lisa Swanson, MD, to challenge the watch-and-wait approach to molluscum and review berdazimer's role in practice. In the following Q&A interview, Kircik spoke with 

 at the meeting about the rationale behind the session and where he sees treatment options heading next:

: Why was your LEADderm talk with Dr. Swanson on challenging watch-and-wait for molluscum important for attending clinicians?

Molluscum is a big challenge in our treatment armamentarium. Until recently, we did not have any FDA-approved treatments, unfortunately. Mostly molluscum affects little children, and that means you have to deal with their parents, which becomes another challenge. It's a virus, a smallpox virus, so people get concerned, and sometimes pediatricians tell parents it's okay, it's going to go away. Yeah, probably, but it can take more than a year. It's a very challenging diagnosis to deal with and treat, even though it looks simple. I think we're very lucky that we now have berdazimer, an FDA-approved treatment that can be done at home. You do not have to curette the kids or freeze the lesions, so you don't have to make them cry and deal with upset parents. It's a really difficult thing to deal with in our offices every day.

: What does the current treatment paradigm for molluscum look like, and how far do we still have to go?

The challenge is it's a virus, and we do not have a cure for viruses, only treatment options. Until recently, as I mentioned, we did not even have an FDA-approved treatment. All we had were off-label options, like topical retinoids approved for acne or topical antivirals approved for genital warts, or physical modalities. The physical modalities are challenging to use on 2- or 3-year-old kids.

You have to curette, and someone has to hold the child while a parent watches, or if you freeze the lesions, that's difficult too. I sometimes apply trichloroacetic acid or liquid nitrogen with a Q-tip so they don't cry, but it's still difficult. Any physical modality on a pediatric population is hard to manage. At-home treatments were limited, and we still don't have much except berdazimer, now an approved treatment. It's challenging, and hopefully we will have more options soon.

: What do you hope berdazimer gel improves, and what has your clinical experience with it been so far?

 Unfortunately, the pediatric population doesn't get much attention in drug development, and this is one of those areas. Look at warts. We still don't have an FDA-approved treatment for warts at this day and age. Antiviral treatments are not a cure; they're just a treatment option. Nothing eliminates the virus permanently, so it's a real treatment challenge with cutaneous viral diseases like molluscum and warts.

: What were the biggest takeaways from the session clinicians should know?

Everybody was welcoming and very interested. The meeting gave us a chance, right before the scientific sessions, to talk about something that grounded us in our profession, which was lovely and different from other meetings. That's what I call the salt and pepper on the scientific session.

: Where do you hope molluscum treatment goes next, and are promising options on the horizon?

 I do a lot of clinical studies, so I closely follow what's going on in development. There are other options being studied and considered, so hopefully we will have more options in our armamentarium for treating molluscum in the coming years.

: Beyond molluscum, what development in dermatology right now are you most excited about?

I'm really excited about the development in treatment options for alopecia areata. This was a forgotten area for a long time, and we didn't have much. Now we have 3 JAK inhibitors approved for alopecia areata, and we're looking forward to many other options. A biologic option would be especially welcome because it would be something we can use long-term, both efficaciously and safely.

Editor’s note: Kircik has disclosed receiving research funding, honoraria, and speaking fees from Novan, Inc., and its successor, Pelthos Therapeutics, maker of berdazimer. This transcript has been edited for grammar and clarity using artificial intelligence tools.

Browning JC, Enloe C, Cartwright M, et al. Efficacy and safety of topical nitric oxide-releasing berdazimer gel in patients with molluscum contagiosum: a phase 3 randomized clinical trial. JAMA Dermatol. 2022;158(8):871-878. doi:10.1001/jamadermatol.2022.2721.

US Food and Drug Administration approves ZELSUVMI as a first-in-class medication for the treatment of molluscum contagiosum. Ligand Pharmaceuticals. Press release. Published January 5, 2024. Accessed September 16, 2026. 

https://investor.ligand.com/news-and-events/press-releases/news-details/2024/U.S.-Food-and-Drug-Administration-Approves-ZELSUVMI-as-a-First-in-Class-Medication-for-the-Treatment-of-Molluscum-Contagiosum/default.aspx

Articles

FDA approval of berdazimer gel 10.3% (Zelsuvmi) in January 2024 established the first prescription, at-home topical option for molluscum contagiosum, addressing a longstanding pediatric dermatology treatment gap. In B-SIMPLE4 (n=891; 55 US sites; age ≥6 months), complete clearance at 12 weeks was 32.4% with berdazimer versus 19.7% with vehicle (P<.001), with mostly mild application-site reactions. Clinicians highlighted drawbacks of watchful waiting and office-based destructive modalities in young children, and anticipate additional pipeline therapies.

In this Q&A, Leon Kircik, MD, discusses challenging watch-and-wait for molluscum contagiosum with berdazimer gel, 10.3%, at LEADderm 2026.

Q&A: Berdazimer Gel and the Case Against 'Watch-and-Wait' for Molluscum

, Leon Kircik, MD, clinical professor of 

 at the Icahn School of Medicine at Mount Sinai and medical director of DermResearch, Physicians Skin Care, and Skin Sciences in Louisville, Kentucky, joined Lisa Swanson, MD, for a talk on molluscum contagiosum and berdazimer topical gel, 10.3%.

Kircik said molluscum contagiosum, a poxvirus infection mostly affecting young children, had no 

-approved treatment until recently, leaving clinicians to rely on irritating topical agents or physical modalities such as curettage, cryotherapy, trichloroacetic acid, and liquid nitrogen.

Why Molluscum No Longer Means Watch and Wait, With Leon Kircik, MD

Those visits often come with an anxious parent in the room, he said, since many families first hear from a pediatrician the virus will simply resolve on its own within a year or more.

"It looks very simple, but it's a very challenging diagnosis to deal with and treat," Kircik said.

Kircik said those physical options are especially hard to carry out in 2- and 3-year-old patients, who need to be held still, and berdazimer gel, 10.3%, gives families an FDA-approved option they can apply at home instead. He was careful to frame it as a treatment rather than a cure, since molluscum is viral and no product yet clears the infection directly. Kircik said pediatric dermatology broadly draws less drug-development attention, noting warts still have no FDA-approved treatment of their own despite affecting more than 20 million people in the US each year.

Kircik said he follows ongoing clinical research closely and expects additional molluscum therapies to reach the armamentarium in coming years, though he did not name specific candidates. He also praised LEADderm's format for opening with sessions like his own before the scientific program, calling the mix a grounding complement to the clinical data covered later on.

Asked what excites him most in dermatology broadly, Kircik pointed to alopecia areata, an area he said went overlooked for years. He noted 3 JAK inhibitors, baricitinib, ritlecitinib, and deuruxolitinib, are now FDA-approved for the condition, and said he is looking forward to a biologic option offering long-term efficacy and safety for patients who need ongoing treatment.

FDA approves Zelsuvmi (berdazimer) topical gel, 10.3%, for molluscum contagiosum. Drugs.com. Updated January 5, 2024.

Pelthos Therapeutics launches Zelsuvmi (berdazimer) topical gel, 10.3%, the first and only FDA-approved at-home treatment for molluscum contagiosum. Pelthos Therapeutics. Published July 10, 2025. Accessed September 8, 2026. 

https://pelthos.com/pelthos-therapeutics-launches-zelsuvmi-berdazimer-topical-gel-10-3-the-first-and-only-fda-approved-at-home-treatment-for-molluscum-contagiosum/

Aboul-Fettouh N. Choosing among approved JAK inhibitors: baricitinib, ritlecitinib, and deuruxolitinib. HCPLive. June 23, 2026. Accessed September 8, 2026. 

https://www.hcplive.com/view/choosing-among-approved-jak-inhibitors-baricitinib-ritlecitinib-and-deuruxolitinib

Videos

Leon Kircik, MD, on why an FDA-approved, at-home molluscum option changes practice, and what is exciting for him in dermatology.

Why Molluscum No Longer Means 'Watch and Wait,' With Leon Kircik, MD

Three recently approved topical non-steroidal treatments for patients living with atopic dermatitis were highlighted by Leon H. Kircik, MD, medical director at Skin Sciences, PLLC, at the 

2025 Revolutionizing Atopic Dermatitis (RAD) Conference

 editorial team at RAD, Kircik highlighted these 3 additions to the 

 treatment armamentarium. He was first asked which drugs he highlighted in his conference talk.

Highlighting New FDA Approvals for Atopic Dermatitis, with Leon H. Kircik, MD

“As you know, the mainstream treatment is still topical steroids for atopic dermatitis,” Kircik said. “We all know that when you have a chronic disease, topical steroids are difficult to use continuously. Especially given that a big population of atopic dermatitis is pediatric or adolescent. We know the side effects, and we're learning more and more about topical steroid side effects, but one thing that we usually don't think about is the disruption of the epidermal barrier when it comes to atopic dermatitis.”

These patients, Kircik explained, already have a disrupted epidermal barrier. He expressed that topical steroids can inhibit lipid synthesis and, unfortunately, worsen epidermal barrier function.

“We're lucky now that we have recently 3 topical non-steroidals approved, including ruxolitinib…roflumilast, a PDE4 inhibitor, as well as tapinarof, an arylhydrocarbon modulator,” Kircik said. “So those 3 have recently become approved for atopic dermatitis, and I think they're going to become an important part of our treatment armamentarium in atopic dermatitis when avoiding topical steroid use.”

Kircik highlighted parental and patient concerns with regard to topical steroids, noting patients’ responses to the presence of non-steroidal options for atopic dermatitis.

“I think those non-steroidal topicals are being welcomed by patients and, more importantly, by parents of the kids with atopic dermatitis,” Kircik said. “Certainly, the efficacy is all there. When we look at the numbers, you see mostly the interruption of itch, so that's really important. Early onset of action [as well], and you see very good efficacy when it comes to IGA or EASI-75 scores. So I think overall, they have great efficacy and, most importantly, a safety profile.”

To learn more about Kircik’s interview, view the full video posted above. For more on subjects related to US Food and Drug Administration (FDA) approvals for atopic dermatitis, check out our 

The quotes used in this video summary were edited for clarity.

This interview highlights 3 new topical non-steroidal options for atopic dermatitis covered in Kircik’s RAD 2025 presentation on FDA approvals.

Over the course of his talk ‘Janus Kinase (JAK) Inhibitors in Atopic Dermatitis Management’ at the 

2025 Revolutionizing Atopic Dermatitis (RAD) Meeting

 in Nashville, Leon H. Kircik, MD, highlighted a variety of useful pieces of information related to the use of Janus-Kinase (JAK) inhibitors such as abrocitinib.

Kircik, who is known for his work as medical director at Skin Sciences, PLLC, in Louisville, Kentucky, was previously asked about the clinical advantages of JAK inhibitors in atopic dermatitis. In this interview segment with 

, he was asked about abrocitinib’s use among patients with the skin disease.

Abrocitinib Advantages Among Patients with Atopic Dermatitis, with Leon H. Kircik, MD

“I will be discussing abrocitinib, and I believe [Andrew F. Alexis, MD, MPH] is going to be discussing upacitinib,” Kircik said. “I was an investigator for abrocitinib in an atopic dermatitis study…It is approved for atopic dermatitis, and they are approved for 12 years of age and above we studied the drug both in 200 milligrams and 100 milligrams. Certainly, 200 milligrams is more effective than 100 milligrams. Across the world, except the United States, the approval said that you start with 100 milligrams and then, if you don't see efficacy, you can go up to 200 milligram after 12 weeks.”

Kircik expressed that he believed the most important label change happened recently regarding abrocitinib for atopic dermatitis.

“Now, they removed that 12 weeks [requirement] and you can actually go up to 200 milligrams the next day if the treating healthcare provider thinks it would be appropriate,” Kircik explained. “So I think that's a big advantage. Now we have much more flexibility with abrocitinib, and I think that's going to be a very important change in the label and give us more flexibility.”

Kircik was later asked why this shift could be viewed as helpful for patients and healthcare providers in terms of atopic dermatitis management.

“Abrocitinib works really fast, especially when it comes to itch,” Kircik said. “When I give a sample to the patient, they call me before they get to the car [saying] ‘What was this that you gave me? My itch is almost gone!’ Unfortunately, the reverse side of it is that, when you stop the treatment, just like any other JAK inhibitor, the half-life is so short with this drug that the symptoms do come back quite fast, unlike the biologics. So you can see that as the advantage or the disadvantage of the JAK inhibitors versus the biologics.”

To learn more about this information and related subjects on recent approvals for atopic dermatitis, view the 

The quotes used in this interview summary were edited for the purposes of clarity.

In this video segment, Kircik described the data highlighted in his JAK inhibitor-related presentation at RAD 2025.