Question: Over the last few years I have experienced night sweating (possibly a side effect of the Lexapro or Levothyroxin that I take), and cystic lesions on my forehead that are persistent, recurring, and very hard to treat. In fact, they sometimes appear viral and only respond (somewhat) to Zovirax ointment or Valtrex pills. How can I get these lesions and my extremely oily forehead under control?

Dr. Hibberd's Answer:

Perhaps the best thing for you to do is have these lesions properly evaluated, and biopsied if there is any uncertainty. Topical Zovirax is ineffective for controlling herpetic (caused by a herpes virus) lesions, and if these are herpetic lesions, I want to know why you are having such frequent recurrences. Frequent recurrences should trigger an evaluation of your immune system and testing for HIV. Herpetic lesions are not cystic, they are vescicular (blisters) with a painful base.

Cystic lesions may be a type of acne, topical photodermatitis, drug reaction, or simply contact dermatitis. I recommend you have your sweating problem professionally evaluated to exclude underlying disease and drug reactions. Night sweats present in the absence of fever should always be evaluated by a medical doctor experienced in the diagnosis of infections and malignancy.