Sometimes a pimple and a cold sore can look similar and be challenging to distinguish in their early stages. These are both common, benign skin lesions, and it is easy to confuse them. However, it is crucial to distinguish the two because they are very different lesions and require different treatments. Read on to learn how to differentiate cold sores from pimples and how to treat them effectively.
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Cold sores are viral infections caused by HSV-1 and, less commonly, HSV-2, while pimples result from pores clogged with dirt, oil, dead skin cells, and bacteria.
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Cold sores appear on the lips, chin, and skin under the nose, while pimples can appear anywhere on the face and body.
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People with cold sores complain of pain or a burning/tingling sensation, whereas only severe cases of cystic acne will cause pain.
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Antiviral pills or creams effectively treat cold sores, but pimples require treatment with antibiotic pills or topicals, retinoid pills or topicals, salicylic acid, or benzoyl peroxide.
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There are ways to prevent contracting the cold sore virus and prevent outbreaks if you acquire the infection. Most cases of pimples are genetic and may not be preventable without treatment.
What is a cold sore?
A cold sore, also known as herpes labialis, results from a viral infection with HSV-1 and, less commonly, HSV-2. Once infected, the virus remains in your body forever; there is no cure. You may have one episode, recurrent episodes, or no episodes. The virus is contagious, and you can transmit the infection to others whether or not you have a visible outbreak.
What is a pimple?
A pimple, commonly known as acne, zit, or blemish, occurs when pores get clogged with dirt, oil, dead skin cells, and bacteria. Genetics, hormone fluctuations, comedogenic products, and some foods can cause an outbreak. Acne can last into adulthood; however, the worst episodes are during the teenage years. The good news is that pimples are not contagious.
Symptoms: cold sore vs. pimple
Cold sores may present with a prodrome of symptoms, including burning, tingling, or pain, a few days before the lesion appears. People may experience pain, burning, or itching once the lesion is visible. These symptoms may last 2–4 weeks.
Pimples present with less severe symptoms than cold sores, such as itching or soreness. In many mild cases, there are no symptoms. Severe cystic acne patients will report soreness, tenderness, or pain.
Signs: cold sore vs. pimple
Cold sores appear as a blister or group of tiny blisters on the lips, chin, and below the nose. When the blisters pop, they ooze clear fluid. These outbreaks tend to recur in the same area every time. The lesion usually resolves in 2–4 weeks. Depending on the severity of the outbreak and how quickly you begin treatment, scarring is possible.
Pimple outbreaks may present as pink-red-purple bumps, whiteheads, or blackheads. They can appear anywhere on the face, except the lips, and the body. When pimples pop, white pus oozes from them. Depending on the severity of the lesion, pimples can last a few days up to weeks. Cystic and inflamed pimples often resolve with scarring.
Treatment: cold sore vs. pimple
While treatment of cold sores and pimples is not required, it will hasten the recovery and prevent scarring and future outbreaks. There are over-the-counter and prescription medications for both conditions. You must avoid touching, picking, or popping these lesions because it can worsen your condition, and lead to scarring and infection. Ice can ease any discomfort and reduce inflammation for cold sores and pimples.
| Cold sore treatments | Treatment options for pimples |
| Prescription antiviral pills | Prescription antibiotic pills |
| Prescription antiviral topicals | Prescription antibiotic topicals |
| Over-the-counter cream | Prescription retinoid topicals |
| Over-the-counter petroleum jelly | Prescription retinoid pills |
| Over-the-counter supplements | Over-the-counter topicals |
Prevention: cold sore vs. pimples
A large portion of the population has the cold sore virus. To prevent contracting the virus, there are a few precautions you can take. If you do contract the virus, don't worry. There are ways to prevent future outbreaks. If you have frequent outbreaks, your doctor can prescribe you antiviral pills to take daily to prevent cold sores.
Ways to prevent contracting the virus:
- Use caution. Be careful who you kiss and have sex with.
- Do not share. Do not share utensils, cups, plates, razors, makeup, and makeup applicators.
- Practice hygiene. Wash your hands before touching your face/body or eating.
| Triggers to avoid | Triggers for pimples |
| Sun | Stress |
| Illness | Products that clog your pores |
| Stress | Hormone fluctuations |
| Trauma | Touching your face with unclean hands |
| Poor diet | Not washing and moisturizing your face twice a day |
| Lack of sleep | Sun exposure and sunburns |
Avoiding pimple outbreaks may be a little more challenging since many cases of acne are genetic. You cannot fight genetics, but you can minimize them. As with cold sores, you should avoid certain triggers. If these don't help, your doctor will prescribe you medications to help keep it under control.
While cold sores and pimples may appear similar, they require different treatments. Correct diagnosis is crucial to rapid and effective treatment. The longer you delay proper diagnosis and treatment, the worse the consequences of scarring may be. If your condition worsens or recurs, or you develop a fever or enlarged lymph nodes, see your doctor immediately. Proper treatment will ensure a good prognosis.
FAQ
Are there any tests for cold sores?
Yes, your doctor can test for cold sores by performing a viral culture on a new active lesion. Some cases may even require a skin biopsy for the diagnosis in question. Also, blood tests are available that can detect the virus.
Are there any tests for pimples?
Yes, in some cases where the diagnosis is uncertain, a skin biopsy may help. However, most cases are diagnosed clinically and do not require any testing. There are no blood tests for acne.
How do I prevent spreading the cold sore virus to others?
When you have a cold sore outbreak, it is important not to spread it to others until the lesion has scabbed over and you are no longer contagious. Do not kiss or share food, drink, utensils, plates, toothbrushes, razors, makeup, and makeup brushes while contagious.
3 resources
- Viruses. A Comprehensive Overview of Epidemiology, Pathogenesis and the Management of Herpes Labialis.
- Cochrane Database of Systematic Reviews. Interventions for prevention of herpes simplex labialis (cold sores on the lips).
- American Family Physician. Acne Vulgaris: Diagnosis and Treatment.
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