Is It a Cold Sore or Pimple?

How to tell the difference and effectively treat each

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When you wake up with a sore, red bump next to your lip, you may be wondering if it's a cold sore or a pimple. Even though these are completely different skin problems, they can start off looking very similar.

How do you know the difference? This article looks at the clues that can help distinguish between the two and the best way to treat each.

Cold Sores vs. Pimples
Verywell / Jessica Olah

How to Spot a Cold Sore

Cold sores around the mouth.
Avatar_023 / Getty Images

Cold sores are caused by a virus, specifically the herpes simplex virus (HSV-1 or HSV-2). This is a common virus. It's estimated that approximately 70% of people have it, although it doesn't always cause breakouts. Signs the bump on your face is a cold sore include:

  • Cold sores form clusters of blisters. A good way to determine the difference between a pimple and a cold sore is by its appearance. Cold sores cause tiny, red blisters. Eventually, the blisters burst and can ooze fluid.
  • Cold sores develop around the lips, nose and nostrils, chin, and (less commonly) eyes. Cold sores typically appear in the area around your mouth, just below the lip on the chin, or between your mouth and nose. They may also form directly on your lip.
  • Cold sores tingle or burn. In the days or hours before a cold sore appears, you may notice that your skin itches or tingles. However, as it grows, a cold sore can become painful and might throb or burn.
  • Cold sore blisters crust over after several days. As it dries, a cold sore may crack and ooze.
  • Cold sores are contagious. HSV-1 is spread from one person to another through kissing, sharing utensils, or drinking from the same cup. HSV-2 is more frequently sexually transmitted, but it can also spread to the face.

How to Spot a Pimple

Zits around mouth

Bunlue Nantaprom / EyeEm / Getty Images

Pimples develop when a pore becomes blocked. Pores are openings in the skin where oil and sweat are released. When pores are blocked, normal skin bacteria can get into the pore, causing a red, raised blemish.

You might feel a pimple before you actually see it. For example, an area just under the skin may be tender, or you might feel a small lump under the skin. Quite often, however, pimples appear without any warning. You can go to sleep one night and wake up with a big zit. Some things that distinguish a pimple from a cold sore include:

  • Pimples can develop over the entire face, including the border 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.
  • Acne is not contagious. 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 blister or cluster of blisters

  • Is contagious

Pimple
  • Never occurs directly on the lip itself, but can be on the border of the lip

  • Forms a raised, red bump, which may develop a whitehead, but not a blister

  • Is not contagious

How to Treat a Cold Sore

Woman putting lip balm on

Jamie Grill / Getty Images

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.
  • Don't pop the blisters. It 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 can help shorten this healing time.
  • See your doctor for prescription medication. If you're prone to cold sore breakouts, your doctor can prescribe medications. These prescription antiviral medications need to be taken at the very start of a breakout. They can drastically reduce 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.
  • Avoid contamination. Always use a fresh cotton swab (no "double-dipping") to avoid contaminating your product. For the same reason, always wash your hands before touching the balm again to avoid contaminating it and prolonging the problem.

How to Treat and Prevent Pimples

Woman with face cream

ExtremePhotographer / E+ / Getty Images 

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.

Avoid all the odd things that are supposed to be "miracle" acne cures. This includes toothpaste, Windex, and garlic. They won't heal the pimple and may actually irritate it more.

Summary

Cold sores and pimples may look similar, but there are some ways to tell them apart. Cold sores are contagious and cause clusters of blisters. These often occur on and around the lips. On the other hand, pimples are not contagious and cause raised, red bumps. While they may also appear around the lips, they do not ever occur directly on the lip.

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

For both cold sores and pimples, the best treatment is simply time. They will eventually go away, but it can take several days to a few weeks to fully heal.

Of course, if you're not sure exactly what is happening on your skin, or if the lesion isn't healing or is getting worse, you should see your doctor.

With a simple exam, your doctor can tell you whether you have a cold sore, pimple, or something entirely different. Even better, your doctor can help you treat that pesky thing so you'll be well on your way to healing.

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Article 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. Updated May 1, 2020.

  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. Updated August 2020.

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