Is It a Cold Sore or Pimple?

How to tell the difference and effectively treat each

Medically reviewed by Katlein Franca, MD

In some ways, the features of a cold sore vs. a pimple on the lip line are very similar—so much so that you may easily mistake one for the other, especially in a cold sore's early stages.

Knowing the unique characteristics of the two can help you differentiate these lookalikes. For example, pimples near the lip only occur on the lip line, while cold sores can appear anywhere on or around the lip.

This article looks at the signs and symptoms of a cold sore versus a pimple on the lip line. It also explains the underlying causes and how each condition is treated.

How to Identify a Cold Sore

A "pimple" on the lipline might be the start of a cold sore. The herpes simplex virus causes cold sores (also known as oral herpes), most commonly herpes simplex virus type 1 (HSV-1). It is a widespread virus, affecting over 65% of the world's population, although it doesn't always cause breakouts.

Once you have HSV-1, the virus does not go away and can reactivate at any moment, causing a localized outbreak of blisters and sores.

There are several ways to tell if the bump on your face is a cold sore:

• Cold sores form clusters of blisters. When an HSV-1 reactivates, it causes a sudden outbreak of tightly clustered blisters. The blisters are small but can merge into a larger blister over hours.

• Cold sores most often affect the lip or lip area. Cold sores can also develop between the mouth and nose or just below the lip on the chin.

• Cold sores typically cause pain or discomfort. Days or hours before they appear, you may notice a burning or tingling sensation on or around the lip. As the blisters form, stinging, throbbing, or shooting pain may occur.

• Cold sore blisters tend to rupture. Typically, they burst open and ooze clear fluid. The open sore, called an ulcer, can be extremely painful. The sore will quickly crust over as it begins the healing process.

How Herpes Is Spread

Herpes is contagious. HSV-1 can be spread through oral-oral contact like kissing and sharing drinks. Herpes simplex virus type 2 (HSV-2 ) is more commonly associated with genital herpes but can also spread to the face.

There is often no rhyme or reason as to why a cold sore appears. They typically occur when your immune system is low, such as when you are run down or fighting an infection. Extreme stress or sudden changes in temperature or humidity can also trigger an outbreak.

How to Identify a Pimple

What looks like a pimple on the lipline can be just that. Pimples develop when a pore becomes blocked with dead skin cells and body oils. The blockage causes bacteria found commonly on the skin to multiply, leading to the formation of a raised, red, pus-filled blemish.

You might feel a pimple before you see it. Quite often, though, pimples will appear spontaneously without any warning.

There are several ways to tell if the bump on your face is a pimple:

• Pimples can develop over the entire face, including the edge of the lip. When pimples appear on the border of the lip, they can easily be confused for a cold sore, especially in the early stages.

• Pimples never occur directly on the lip. If you have a blemish in the middle of your lip, it's likely a cold sore.

• Pimples form a raised red bump, not a blister. As the pimple progresses, it may develop a whitehead that peaks in the middle of the red bump. But, it still is distinctly not a blister. Most pimples have a single whitehead, but some get so big that they develop several heads.

Unlike cold sores, pimples are not contagious. So you can hug, kiss, and share lip balm with someone who has a pimple and never get one yourself.

Cold Sore

• Can form directly on the lip

• Forms a cluster of fluid-filled blisters that can merge into a larger blister

• Cause the formation of an open, oozing ulcer when it breaks open
  

• Caused by a virus known as herpes simplex virus (HSV)
  

• Is contagious

Pimple (Acne) on Lip Line

• Never forms directly on the lip but can appear on the border

• Forms a raised, red bump, often with a whitehead

• Can cause an infected sore if it breaks open but not an ulcer
  

• Caused by the blockage of a pore with dead skin, body oils, and bacteria
  

• Is not contagious

How to Treat a Cold Sore

Treating a cold sore requires patience. It will heal over time, but while you're waiting for that to happen, it's important to ensure the virus doesn't continue to spread. So here are some tips for coping with a cold sore:

• Avoid touching your cold sore. Remember that the virus that causes cold sores is contagious. So touching your sore can spread the virus to other people or other areas of your own body, including the eyes.

• Don't pop the blisters. Doing so won't help the sore heal faster and can make the breakout worse.

• Try an over-the-counter (OTC) cold sore treatment. Most cold sores heal on their own, but this typically takes 10 days to two weeks. OTC treatments like Abreva (docosanol) can help shorten this healing time.

• See your healthcare provider for prescription medication. If you're prone to cold sore breakouts, your healthcare provider can prescribe antiviral medications. These must be taken at the start of a breakout and can drastically reduce the severity and healing time.

• Use lip balms and salves if needed. Applying a balm will keep the sore moist for cold sores that are crusted over and dry. Moisture can help prevent painful splitting. To avoid contamination, apply balms and salves with a cotton swab rather than your finger.

How to Treat and Prevent Pimples on the Lip Line

A pimple on the lip line can't always be prevented, but there are some steps you can take to care for your skin that will help.

Since pimples aren't contagious, you can't spread them to other people or other areas of your body. Take heart in knowing that the zit should start healing within a day to a week. Here are some tips for coping with pimples:

• Don't pick at or pop your pimple. Squeezing a pimple can make the blemish much worse. It can also cause scarring.

• Ice down blemishes, especially large or painful ones. Wrap an ice cube in a soft cloth and hold it over the pimple for a few minutes at a time. Doing this a few times a day can help reduce swelling and ease the pain.

• Apply an over-the-counter spot treatment to individual pimples. Acne spot treatments can help speed healing. Don't apply them more frequently than directed since they can dry out and irritate your skin.

• Take a daily acne treatment medication. If you often get pimples or have them over your entire face or body, you may benefit from medication. Effective acne treatments will stop pimples before they form. Using these can help clear your skin long-term.

Related: How to Treat and Prevent Acne

Takeaway

If you're not exactly sure what is happening on your skin, or a lesion isn't healing or is getting worse, see your healthcare provider. They can order tests, if needed, to diagnose the underlying cause and ensure you get the correct treatment.

Summary

A pimple on the lip line might be just that—an acne spot. However, what looks like a pimple on the lip line can also be the start of a cold sore. Knowing how to tell a lip line pimple from a cold sore is important.

Cold sores are contagious and cause clusters of tiny blisters, usually on and around the lip. Pimples are not contagious and cause raised, red bumps that can also appear around the lips but not directly on the lip itself.

Antiviral medication and moisture may help speed the healing process for cold sores. Spot treatments, daily medication, and ice may benefit pimples.

Related: How to Tell a Chancre, Canker, and Cold Sore Apart

Read the original article on Verywell Health.