famvir aftermath

[jjguy]

I ended up getting a cold sore last summer (in July) after having a couple of puffs off of someone else's cigarette.  It was only after the fact that I saw the person had an active cold sore.

My doctor gave me a prescription for famvir, which I was able to start taking approx 30 hours after being infected...already had a significant patch of little white dots.  It was the first one had every had (I know because I became very ill with a fever and night sweats etc a couple of days later).

The white dots became several white patches from one corner of my mouth to the other mostly on the part of the lip that isn't really visible when my mouth is closed. However, I had one significant patch in the middle of my top lip about 3/4 of an inch long.

The cold sore never really developed past the first couple of stages and then it stopped, but the white dots/patches havent gone away.  To make matters worse I have little cracks or fissures that have developed in the patches that hurt regardless of what type of lip balm/salve I use.

I could probably live with the patches that aren't that visible when my mouth is closed, but the patch of dots in the middle of my upper lip is quite visible.  It sort of looks like I am perpetually just about to get a cold sore just without the redness and swelling.

I have been refered to a dermatologist/laser surgeon but the appointment isn't until mid Dec.  I have been carrying on a long distance "friendship", and I am supposed to go see her before my appointment.  I am a little worried that she is going to think that it is contagious, and that i look like a freak.  I am not quite sure how to reassure her.  I have considered cancelling the trip.

Anyway, my questions:
Have you seen this sort of thing before?
Is there any sort of cream or treatment that will get rid of the patches or dots in 4 weeks? (doc also gave me zovirax, which I used for about a month - nothing.)
Why don't they grow out with my skin since they appear to be very close to the surface of the lip?
Is laser treatment a viable option on the lips for this sort of thing...would it get rid of the dots and patches...or just cost me $1000 and leave me with really pink lips for three months?

Thanks,

jjguy

[bluebird05]

Also, herpes does not show up that fast.

[Alan Rockoff, MD]

Hi.  You'll need to see a doctor to sort this out.  Dr. Rockoff

[jjguy]

Hi Doc,

The patch dots in the middle of my lip is quite close to the surface and is therefore visible as several hundred dots.  I described the patches on the underside of lip as white, but in reality they are patches white dots as well.  It is just hard to tell that unless stretch out the skin a little.  

I don't think that my gums were bleeding, but I do know the glands under my chin were swollen.  My lip also swelled up quite significantly for a couple of days.  I certainly wasn't rubbing the area and had no trauma or anything else that I can think of that would explain the swelling.  I also recently had braces taken off of my teeth and I have close up pictures of my teeth and lips that do not show the patches of dots.  

If it is Fordyce's condition, can it come on over a weekend? Do you normally see patches of hundreds of white spots?  If it is the remnant of a cold sore, is that something that you have seen before as a response to an anti viral med like famvir?  Is it something that can be dealt with through laser or some other means?

[Alan Rockoff, MD]

What you describe sounds nothing like herpes.  First of all, it's almost impossible to transfer herpes via a cigarette, even from an active lesion.  Second, the first attack of herpes consists not just of fever but of bleeding hums, painful swollen glands, and days of hectic fever.  Third, herpes doesn't look anything like, "several white patches from one corner of my mouth to the other."

My best guess is that you have Fordyce's condition, namely small oil glands visible against the pink background of the lip, that you began to notice when you started to worry about herpes (or that you perhaps aggravated by rubbing, etc.)

Of course you should see the doctor to get a definite diagnosis, but in the meantime, I highly doubt that you "look like a freak" or that you should spend $1,000 (or $10) on laser treatments that probably would do little or nothing.

Take care.

Dr. Rockoff