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Cold sores and pimples can look similar, and both can appear around the mouth. However, they have very different causes and treatments.

Cold sores occur due to a viral infection, whereas pimples are a symptom of acne and result from clogged hair follicles.

Both these skin conditions are common. In the United States, approximately 48% of people aged 14–49 years have the virus that causes cold sores, while around 80% of people aged 11–30 years will have a breakout of acne at some point.

This article looks at the differences and similarities between cold sores and pimples, along with their causes, treatment, and prevention.

Cold sores result from infection with the herpes simplex virus (HSV). Pimples are a symptom of a skin condition called acne, which occurs when hair follicles in the skin become clogged.

Cold sores primarily develop on and around the lips. By contrast, pimples can form on any part of the body that has hair follicles, including the face.

There are no hair follicles directly on the lips, but pimples may appear on the outer edges of the lips, where hair follicles are present. When pimples become large or swollen, their outer edges may seem to be on the lips.

The key differences between cold sores and pimples include the following:

  • Cold sores may cause a tingling or burning sensation before they appear. Pimples usually occur without warning.
  • Cold sores can be painful. Although pimples can feel uncomfortable, they do not usually hurt unless they become large or swollen.
  • Cold sores may begin to look more like blisters after a few days. Pimples typically develop a white, yellow, or black head.
  • Cold sores can last for 2–3 weeks. Large or swollen pimples can last for several weeks, while smaller pimples can often resolve within a few days.

Pimples are common, and most people will get them at some point in their lives. They are a symptom of acne.

Hair follicles contain a tiny gland that makes an oily substance, or sebum. Acne occurs when pores become clogged with a combination of oil, dead skin cells, and bacteria. Clogged pores can become inflamed, which leads to the development of pimples.

Acne can occur anywhere on the body where there are hair follicles. However, it commonly affects the face, chest, and back. In mild cases of acne, pimples typically appear as small, closed spots with a white, yellow, or black head.

When acne is more severe, pimples can become large and painful and change color. Very large pimples, or cysts, may contain pus.

Larger pimples can sometimes cause scarring, especially when a person picks or forcibly pops them. However, having pimples does not mean that a person has poor hygiene, according to reviews.

Causes

Research is yet to identify a singular cause of acne. However, overproduction of oil on the skin, bacterial infection, and inflammation mechanisms are known to all play a part in its formation.

Acne commonly occurs during puberty, when hormonal changes can often cause a person’s skin to become oily.

Other possible causes of acne and pimples include:

Treatment

People with mild acne can often manage their pimples at home by:

  • choosing oil-free cosmetics and skin care products
  • gently washing the face twice per day and properly removing any makeup before going to bed
  • shampooing the hair regularly, especially if it is oily
  • using an acne treatment containing salicylic acid or benzoyl peroxide

While it can be tempting to pop a pimple, this can make acne worse and increase the risk of scarring. It is best to let pimples heal on their own.

It is advisable to contact a doctor or dermatologist for more severe acne or acne that does not clear up with over-the-counter medication. They may prescribe one of the following treatments:

A doctor may also examine an individual for factors that could be making the acne worse, such as an underlying inflammatory condition or a hormonal issue, such as PCOS. Treating these health problems may also help with acne.

A range of acne treatment products are available for purchase online.

Prevention

Many people with acne find that specific factors, such as stress, makeup, or sweating, can trigger a breakout of pimples.

Keeping a diary can help a person identify any acne triggers and make lifestyle changes that may prove effective.

Some simple strategies to prevent or reduce pimples include:

  • avoiding touching or rubbing pimples
  • avoiding wearing tight clothes, hats, or backpacks
  • limiting exposure to potential irritants, such as pollution and high humidity
  • washing the face regularly, especially if the skin is very oily, but not scrubbing the skin too hard
  • applying minimal makeup or switching to acne-friendly products, such as noncomedogenic products, which do not clog pores

Cold sores are small, fluid-filled blisters that typically appear on or around the lips. They are also known as oral herpes, fever blisters, and Herpes labialis. Cold sores result from infection with HSV.

Cold sores usually begin with a tingling or burning sensation in the skin. The sores may appear a few hours to a few days later. Some people may only develop a single sore, but it is common to have several blisters at once.

The blisters may change over several days and eventually crust over. Cold sores may cause pain and irritation.

Causes

There are two main types of HSV.

HSV type 1 is the main cause of cold sores but can also cause genital herpes. HSV type 2, on the other hand, is the main cause of genital herpes, but it can also cause oral herpes.

It is possible to get an HSV infection by coming into direct contact with another person’s cold sore or infected area of their skin.

It is also possible to pass on the virus through bodily fluids, such as saliva. However, transmission of HSV is more likely during a cold sore outbreak.

Once a person has contracted the virus, it remains in their body for life. Many people find that the first outbreak is the worst. Other individuals only ever have one outbreak.

For some people, specific factors seem to trigger a cold sore outbreak, such as:

  • stress
  • illness
  • tiredness
  • hormonal changes, such as those during menstruation
  • changes in weather or strong sunlight

Treatment

Cold sores tend to resolve without treatment after 1–2 weeks.

While there is no cure for cold sores, research has shown that prescription antiviral medications help in treatment. These drugs may also lower the risk of another outbreak and reduce the likelihood of the virus spreading.

Antiviral creams for cold sores are widely available over the counter. A doctor can prescribe a stronger antiviral medication for more severe outbreaks.

A range of antiviral creams are available for purchase online.

Warm compresses and pain relievers, such as ibuprofen and acetaminophen, may help alleviate pain and discomfort.

Ibuprofen is available for purchase online.

Prevention

A person can reduce the risk of contracting or transmitting HSV by:

  • avoiding kissing anyone with sores on or around their mouth
  • avoiding touching the lips of someone with a cold sore
  • refraining from sharing beverages and food with people who have cold sores
  • abstaining from oral sex with people who have sores around the mouth or genitals
  • using a condom if a person has genital herpes
  • talking to sexual partners about herpes, cold sores, and any other infections

People with HSV can reduce outbreaks by identifying and avoiding triggers, such as overexposure to sunlight. It is also essential to follow the directions of a doctor or pharmacist when taking antiviral drugs.

Studies have shown that certain herbal treatments may also have preventive properties.

It is advisable to contact a doctor for outbreaks of cold sores or pimples that are severe or long-lasting or occur alongside high fever or swollen glands.

A doctor can also provide advice on acne or cold sores that are causing significant emotional distress. In addition, they will be able to explain the different treatment options and how to reduce or prevent outbreaks.

If the cause of a pimple or sore is unclear or if the doctor is concerned that there may be a more severe underlying cause, they may take a sample of the lesion for further testing.

Although cold sores and pimples can sometimes be similar in appearance, they have very different causes and treatments.

Cold sores result from infection with HSV, and treatment options include antiviral creams and pills. Pimples form due to clogged hair follicles, and treatment may consist of face washes, retinoid creams, and antibiotics.

Cold sores are contagious, but pimples are not. It is vital for people without HSV to avoid direct contact with a person’s cold sores or genital herpes sores and take precautions during sex.

A person should contact a doctor for severe, long-lasting, or distressing outbreaks of cold sores or pimples.