Is It a Cold Sore or Pimple?

When you wake up with a red bump next to your lip, you may be wondering if it’s herpes or a pimple. Although these are completely different skin problems, they can start to look very similar.
How do you know the difference? This article looks at clues that can help differentiate between the two and how best to treat each.
Verywell / Jessica Olah
How to detect a cold sore?
Herpes is caused by a virus, specifically the herpes simplex virus (HSV-1 or HSV-2). This is a common virus. It is estimated that about 70% of people have this condition, although it does not always cause acne. Signs of a bump on the face that are herpes include:
- Cold sores form clusters of blisters. A good way to determine the difference between a boil and a cold sore is to look at its appearance. Herpes cause tiny red blisters. Eventually, the blisters break open and may drain.
- Cold sores develop around the lips, nose and nostrils, chin, and (less commonly) on the eyes. Cold sores usually appear in the area around the mouth, just below the lip on the chin, or between the mouth and nose. They can also form directly on your lips.
- Tingling or burning cold sores. In the days or hours before cold sores appear, you may notice your skin itching or tingling. However, as it develops, herpes can become painful and may sting or burn.
- Cold sores crust over after a few days. As it dries, the blister may crack and ooze.
- Cold sores are contagious. HSV-1 is spread from person to person by kissing, sharing utensils, or drinking from the same cup. HSV-2 is more often transmitted sexually, but it can also spread to the face.
How to detect acne?
Pimples develop when pores become clogged. Pores are openings in the skin where oil and sweat are secreted. When a pore is clogged, normal bacteria on the skin can enter the pore, causing a red and raised pimple.
You can feel the acne before you actually see it. For example, an area just under the skin may be tender or you may feel a small lump under the skin. However, quite often, acne appears without any warning signs. You can go to bed one night and wake up with a big wound. Some things that distinguish boils from herpes include:
- Acne can develop on the entire face, including the lip line. When blisters appear on the edge of the lips, they are easily confused with herpes, especially in the early stages.
- Acne never occurs directly on the lips. If you have a pimple in the middle of your lip, it could be herpes.
- A boil forms a raised red bump, not a blister. As acne progresses, it can develop into a whitehead in the middle of a red pimple. But it’s still clearly not a blister. Most comedones have a single whitehead, but some are so large that they develop into multiple heads.
- Acne is not contagious. Unlike herpes, boils are not contagious. So you can hug, kiss, and share lip balm with a person with acne without ever getting a breakout yourself.
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Never occurs directly on the lips, but can be on the lip line
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Forms a red, raised bump that may develop into a whitehead, but not a blister
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Not contagious
How to treat a cold?
Treating herpes requires patience. It will heal over time, but in the meantime, it’s important to make sure the virus doesn’t continue to spread. So here are some tips for dealing with herpes:
- Avoid touching the blisters. Remember that the virus that causes herpes can be contagious. So touching your sores can spread the virus to other people or other areas of your body.
- Don’t break the blisters. It won’t help sores heal any faster and can actually make acne flare-ups worse.
- Try over-the-counter (OTC) cold sore treatments. Most cold sores will heal on their own. Unfortunately, this process usually takes anywhere from 10 days to two weeks. OTC treatments like Abreva can help shorten this healing time.
- See your healthcare provider for prescriptions. If you are prone to herpes, your healthcare provider may prescribe medication. These prescription antiviral medications need to be taken as soon as an outbreak begins. They can significantly reduce the severity and length of healing.
- Use lip balm and salt water, if needed. For cold sores that have crusted over and have dried up, apply a balm that will keep the sores moist. Moisture can help prevent painful chapping. Apply the balm and salt water with a cotton swab instead of your fingers.
- Avoid pollution. Always use a new cotton swab (don’t use a “double dip”) to avoid contaminating your product. For the same reason, always wash your hands before touching the balm to avoid contaminating and prolonging the problem.
How to treat and prevent pimples?
Because acne isn’t contagious, you can’t infect other people or other areas of your body. Keep in mind that the pimple should start to heal within a day to a week. Here are some tips for dealing with pimples:
- Don’t pick or pop your pimples. Popping a pimple can make it a lot worse. It can also cause scarring.
- Apply ice to particularly large or painful pimples. Wrap an ice cube in a soft cloth and place it on the pimple for a few minutes at a time. If you do this several times a day, it can help reduce swelling and reduce pain.
- Apply an over-the-counter topical treatment to each pimple. Acne treatments can help speed healing. However, don’t apply them more often than directed because they can dry out and irritate your skin.
- Take acne medicine every day. If you have frequent breakouts or breakouts on your entire face or body, you may benefit from medication. Effective acne treatments stop pimples before they form. Using these can help keep your skin clear of acne in the long run.
Avoid all the quirks that are said to be the “miracle” acne cure. This includes toothpaste, Windex and garlic. They won’t heal acne and can actually cause more irritation.
Summary
Herpes and herpes may look similar, but there are several ways to tell them apart. Herpes are contagious and cause clusters of blisters. These marks usually occur on and around the lips. On the other hand, pimples are not contagious and cause red, raised bumps. Although they can also appear around the lips, they never occur directly on the lips.
Antiviral medications and moisture can help speed the healing of cold sores. Pimples can benefit from the use of topical treatments, daily medications, and ice.
A very good word
For both herpes and boils, the best treatment is simply time. They will eventually go away, but it can take days to weeks to fully heal.
Of course, if you’re not sure exactly what’s going on on your skin, or if the lesion isn’t healing or is getting worse, you should see your doctor.
With a simple test, your healthcare provider can tell you if you have herpes, a boil, or something else entirely. Even better, your healthcare provider can help you treat that discomfort so you’ll be on your way to healing.
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