Do You Have a Cold Sore or Pimple on the Lip Line?

  • Medically reviewed by Emina Ribic (MD) on August 23, 2018. Written by Linda White (MD).

You’ve noticed a small bump on your lip line or near the mouth. Your first instinct is to seek a way to remove the problem as quickly as possible. But, first, you need to find out what’s wrong with your skin. Telling the difference between cold sores and pimples is easy due to the visual clues!

Forming in clusters, cold sores are different to acne or blackheads. Due to lifelong latent infection with virus known as herpes simplex one (HSV-1), you’ll experience the symptoms days before their formation. Starting with a slight tingle or burning sensation, the lifecycle of a cold sore is different from a pimple.

A pimple, on the other hand, occurs due to an overproduction of oil and bacteria buildup within pores. Pimples aren’t brought on by a virus nor are they contagious.

Let’s explore these two skin conditions in greater detail so that you can make an accurate self-diagnosis. We’ll also rule out some other conditions that are commonly confused with pimples and cold sores.

Cold Sore or Pimple?

If you’ve never had a cold sore, you might find it difficult to make a distinction. Often red, swollen, and painful, cold sores and pimples can look virtually the same to the untrained eye.

Symptoms of a Cold Sore

Tingling, itching, and burning will be experienced on the lips or around the mouth.

Developing in a cluster, cold sores contain a highly infectious fluid. Within 24 to 72 hours of formation, the blisters will burst open. They will ooze clear liquid, resulting in an open sore (ulcer). If there is bacterial contamination of the blister, it can contain pus. The ulcer will soon crust over and a scab will form.

Symptoms can vary depending on the severity of the outbreak. Generally speaking, recurrences are far less symptomatic. Blisters are often the only signs of recurring cold sores.

The first time that you get cold sores is often quite aggressive. Introducing symptoms that can be similar to that of a cold or flu, HSV-1 can leave you feeling genuinely ill.

This is because your body is not yet equipped with the knowledge to fight off the virus. This can leave you feeling severely depleted or even bed-ridden for a short time.

According to the Mayo Clinic, the typical symptoms include:

  • Fever
  • A sore throat
  • A headache
  • Muscle aches
  • Swollen lymph nodes
  • Tender gums (eroding gum line)
  • Ear pain

Symptoms of a Pimple

People get spots (blackheads) when hair follicles become clogged with oil and dead skin cells. Most acne spots are discolored, painful, swollen, and sore to the touch.

Depending on the severity of your acne, permanent skin damage is a possibility. Commonly referred to as pockmarks, acne can leave small pitted marks where a sore (disturbance) once occupied.

Although pimples are primarily defined as small sores with pus-filled tips, many other types of acne can be confused with cold sores.

Here are the types and symptoms:

  • Whiteheads (closed pore acne)
  • Blackheads (open clogged pore)
  • Red bumps (often clustered)
  • Pimples (tips filled with pus)
  • Underskin lumps (solid nodules under the skin)
  • Cystic lesions (pus-filled lumps under the skin)

Through a process of deduction, you will be able to tell which acne symptoms most resemble a cold sore. For example, under-skin lumps and cystic lesions would not mimic a cold sore so that they can be quickly ruled out.

Other Types of Small Blisters on Lips

Cold sores and pimples are not the only lesions that can form on or near the lips.

Because our lips are so tender, even a seemingly minor abrasion could cause the area to swell and turn red. While most lip blisters are minor, some can be severe.

Noted below are some of the possible reasons:

  • Shaving and paper cuts
  • Burns due to hot food, drink, and sun exposure
  • Habitual and accidental biting
  • Allergies
  • Warts
  • Chapping
  • Actinic cheilitis (a pre-cancerous condition caused by sun exposure)
  • Angular cheilitis (Inflammation at the corners of the mouth caused by fungal or bacterial infection)
  • Oral melanotic macule (Non-cancerous dark spot found on the lip)
  • Pyogenic granuloma (Benign growth)
  • Squamous cell carcinoma (a common form of skin cancer caused by excessive sun exposure)

Difference between a Cold Sore and a Pimple

The main difference between cold sores and pimples is origin and location.

The by-product of hair follicles becoming clogged, pimples can form at any location where hair grows. On the other hand, cold sores are born from an incurable virus known as herpes.

Often transmitted due to kissing, blisters mainly develop on the lips and around the mouth area. Of course, there’s a multitude of ways that cold sores can spread.

I have a Cold Sore. What should I do?

Over-the-Counter methods are preferred when it comes to treating cold sores and pimples. Leaning on medicine that has been assigned to the task is much better than attempting to rectify the situation on your own.

Abreva and HERP-B-GONE are two of the leaders when it comes to the treatment and fast healing of cold sores. You can get rid of cold sores in as little as 72 hours if treatment is issued when the cold sore is tingling (during the prodromal stage.)

Two of the best pimple creams are Neutrogena and Clearasil. Neutrogena’s On-The-Spot Acne Treatment and Clearasil’s Ultra Rapid Action Vanishing Acne Treatment Cream are top selections. Containing benzoyl peroxide, both can heal pimples fast while keeping your skin healthy and oil free.

Aside from OTC creams and ointments, the best way to get rid of cold sores is with the Virulite cold sore device. If used during the tingle (prodromal) stage, you may be able to avoid an outbreak entirely. 

Using light technology, the Virulite device only has to be used a couple of times to achieve successful results.

Natural alternative remedies, such as essential oils, are also recommended. The use of aloe vera gel can also be a sound choice to protect and soothe your active blister.

I have a Pimple. What should I do?

Two of the best ways to clear up blackheads and whiteheads and acne issues is through the use of steam and daily moisturizing techniques.

By placing your face over hot (yet manageable) steam, your pores will open. Steam can help your pores to expand thereby treating any blockage caused by oils and/or bacteria.

Properly moisturizing your skin will keep the area fresh and replenish the skin. Keeping your skin vibrant can prevent oil from invading your pores.

Is it a cold sore or a pimple?

Other alternatives include:

  • Oatmeal/honey scrub
  • Baking soda (paste mask)
  • Apple cider vinegar
  • Tea tree essential oil

Spot and Cold Sore Prevention Methods

Cold sore and pimple prevention have several things in common. Each involves taking care of your skin, building your immune system, and avoiding harsh elements, such as extreme sun and wind exposure.

You can prevent acne outbreaks by washing your face daily. Washing your face can help you to avoid clogged pores that are caused by oil and bacteria. You can avoid an oily buildup by washing your face 2-3 times every 24 hours.

Keeping your face moisturized is also critically important. Adding life to your skin, daily moisturizers can keep your skin supple and fresh.

Other preventative measures include:

  • Limit makeup use. Makeup closes pores and can lead to bacterial infection.
  • Keep your hands off your face to avoid self-contamination through bacteria.
  • Limit sun and wind exposure.
  • Reduce stress as hormonal changes can cause acne breakouts.

Many of the same methods apply for keeping HSV-1 at bay. Reducing stress, reducing sun and wind exposure, and keeping your hands away from your mouth are all helpful methods.

Everything begins and ends with your general state of health. Taking care of your body through proper diet and exercise can limit the number of cold sore outbreaks that you experience each year.

Other preventative measures include:

  • Avoiding food and beverage triggers, especially ones that are rich in arginine.
  • Limiting exposure to indoor heating
  • Keep your lips healthy so that you avoid cracking, dryness, and lip damage.

It’s hardly surprising that pimples and cold sores on the lip line are so often mistaken. Both skin conditions can result in reddish-colored bumps on a similar part of the face. They have some basic similarities. But you can use the above advice to make a self-diagnosis and heal your skin.

FAQ

Can You Get Whiteheads on Your Lips?

It’s unlikely. Because whiteheads are the result of a clogged hair follicle and/or pore, most whiteheads form on the face, forehead, back, etc.

While it is possible for a whitehead to form on the edge of your lip line, the likelihood of this happening are small.

Can a Zit Turn into a Cold Sore?

A zit cannot become a cold sore. Because the two concerns have no common connection, they are completely different skin conditions.

While a zit ‘may’ look like a cold sore, most notably during the blister stage, the two could not be more different in origin.

What Causes Cold Sores and Acne?

Cold sores are the result of HSV-1. They’re highly contagious, and as many as 50-80% of the population carries the virus. The transfer of contaminated saliva from person-to-person is the underlying cause.

Acne is the by-product of greasy secretions from your sebaceous glands, plugging the openings of your hair follicles. This blockage can result in swollen and tender bumps known as pimples and nodules. The type of acne depends on the severity of the clog and the size of the pores that have been impacted.

According to the American Academy of Dermatology (AAD), most acne cases begin between the ages of 10-13. Acne is quite common for those who have naturally oily skin. Heredity and hormones are the primary causes in most cases.

Although annoying and even quite painful, acne is not contagious.

How Can Cold Sores Be Medically Diagnosed?

Most primary care physicians can properly diagnose a cold sore by visual appearance alone. However, for 100% confirmation, a sample may be extracted and taken away for lab testing.

Viral Culture

Performing a viral culture can help your doctor confirm the presence of the herpes virus, in addition to confirming the virus type.

Extracting a sample of fluid from an active sore, the collection is then taken away for examination. This test is typically done by passing a cotton swab across the blisters.

Do cold sores have pus in them?

Biopsy

Similar to a viral culture, unidentified sores can be partially removed and examined. Primarily done when the growth is suspected of being cancerous, HSV testing can be performed in this manner.

If you are a regular user of tobacco products, for example, your primary care physician may wish to take a more detailed look at your growth or blister. In cases such, a biopsy can be performed.

Can You Pop a Cold Sore Like a Pimple?

While you could pop a cold sore like a pimple, this practice is not recommended. The risk of infection and potential scarring exist if you don’t allow healing to take place naturally.

Cold sores, similar to pimples, follow a natural lifecycle. It is best to treat your cold sore and allow it to heal in its own time. The same can be said and applied to a nasty pimple.

Listed below are possible side effects of popping a cold sore:

  • You will experience intense pain. The bursting of an active blister will cause immediate pain that can radiate throughout your face.
  • Once your sore has been popped, the virus is no longer contained. The oozing of fluid also signals the oozing of an active virus. You run a great risk of infecting others as well as yourself once your blister has been popped and exposed.
  • The natural healing cycle of a cold sore is thrown off once your blister is popped prematurely. This can lead to improper healing and scarring.

Last update on 2018-09-25 / Affiliate links / Images from Amazon Product Advertising API

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