Is It a Cold Sore or Pimple?

How to tell the difference and effectively treat each

In some ways, the features of 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.

Cold Sores vs. Pimples

Verywell / Jessica Olah

How to Spot a Cold Sore

A "pimple" on the lip line might actually be the start of a cold sore. Cold sores (also known as oral herpes) are caused by the herpes simplex virus, most commonly herpes simplex virus type 1 (HSV-1). It is an extremely common 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 the course of 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. In the days or hours before a cold sore appears, you may notice a burning or tingling sensation on or around the lip. As the blisters form, there may be stinging, throbbing, or shooting pain.
  • Cold sore blisters tend to rupture. Typically, a cold sore blister will 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 process of healing.

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.

How to Spot a Pimple

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

You might feel a pimple before you actually 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 itself. If you have a blemish in the middle of your lip, it's likely to be 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 any faster and can actually make the breakout worse.
  • Try an over-the-counter (OTC) cold sore treatment. Most cold sores will heal on their own. Unfortunately, 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 need to be taken at the very start of a breakout and can drastically reduce the severity and healing time.
  • Use lip balms and salves, if needed. For cold sores that are crusted over and dry, applying a balm will keep the sore moist. Moisture can help prevent painful splitting. Apply balms and salves with a cotton swab rather than with your finger to avoid contamination.

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 especially large or painful blemishes. Wrap an ice cube in a soft cloth and hold it over the pimple for a few minutes at a time. If you do this a few times a day, it 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, though, 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.

Summary

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

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 with cold sores. Pimples may benefit from the use of spot treatments, daily medication, and ice.

A Word From Verywell

Whether the pimple on your lip line is acne or a cold sore, the best treatment is often just time. They will eventually go away, but it can take several days or weeks to fully heal.

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.

Frequently Asked Questions

  • What causes a cold sore?

    A virus known as the herpes simplex virus type 1 (HSV-1) can cause a cold sore to develop. HSV-1 is highly contagious and spreads through saliva or close contact with people infected with the virus.

  • Can you get a pimple on your lips?

    While you can get a pimple on your lip line, you cannot get a pimple on your lips. A "pimple" on the lips is more likely a cold sore. If you're still unsure if the pimple on your lip line is really a pimple or if it could be a cold sore, here are a few key points to remember:

    • Cold sores tingle or burn, and may become painful.
    • Cold sores cause tiny, red blisters to form in a cluster.
    • After several days, cold sore blisters will crust over.
  • Can you get a pimple inside your nose?

    Yes, it is possible to get a pimple inside the nose. Most over-the-counter acne treatments are meant for topical treatment on the skin, so unless the label says otherwise, don't use it on a pimple in the nose. If the pimple persists or gets worse, contact your doctor or dermatologist for further assistance.

  • Why did I get a cold sore out of nowhere?

    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.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. World Health Orgnanization. Herpes simplex virus.

  2. Crimi S, Fiorillo L, Bianchi A, et al. Herpes virus, oral clinical signs and QoL: Systematic review of recent data. Viruses. 2019;11(5):463. doi:10.3390/v11050463

  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Acne.

  4. American Academy of Dermatology. Herpes simplex.

Additional Reading
  • Ramdass P, Mullick S, Farber HF. Viral Skin Diseases. Primary Care: Clinics in Office Practice. 2015 Dec;42(4):517-67. doi:10.1016/j.pop.2015.08.006

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.