Cold sores and pimples are two common skin conditions that can appear on or around your lips. While both can cause redness, bumps, and discomfort, they have different causes and aren’t treated the same way. Being able to distinguish between a cold sore and pimple can help you effectively treat these unique conditions.

Here, we’ll discuss the differences between cold sores and pimples, and examine their causes, symptoms, and treatment options, so you’re better informed on how to manage these common skin conditions.

Here at Curology, we currently focus on the diagnosis and treatment of acne, rosacea, and anti-aging concerns. We do not treat many of the conditions mentioned in this article. This article is for information purposes.

Cold sore vs. pimple — why you should know the difference 

Cold sores and pimples may look similar at first glance, but they’re quite distinct from one another. Pimples are caused by clogged pores and bacteria and are not contagious, while cold sores are caused by the herpes simplex virus and are highly contagious.¹ 

Failing to treat a cold sore effectively or treating a cold sore like a pimple may end up making it worse. The right treatment will help you to better tackle your skin concerns, no matter which condition you’re dealing with!

What is a cold sore? 

Cold sores are small blisters that develop on the lips or around the mouth. They're caused by the herpes simplex virus, which is highly contagious. The good news is that these visible bumps usually clear up within 7 to 14 days without treatment.²

Symptoms 

You may experience the following symptoms if you have a cold sore:³

• Painful blisters on one side of your mouth

• Bumps that are oozing fluid

• Fever 

• Swollen lymph nodes

Causes

When the nerve cells in your lips are afflicted with a virus, you develop cold sores. The main triggers of cold sores include:⁴

• Sun exposure or UV rays

• Common colds

• Fever

• Injury or cracks in lips

• Stress

• Weakened immune system (such as during chemotherapy, bone marrow transplants, and taking certain steroid medications)

• Hormonal changes

What are pimples? 

Acne may appear as visible bumps (sometimes full of pus), commonly on your face, shoulders, chest, and back. This common skin condition affects between 81 and 95% of young men, and 79 and 82% of young women during adolescence.⁵

Causes

When your pores get clogged, this can lead to inflammation and the formation of pimples.⁶ You may develop pimples for several different reasons, including:⁷

• Excess production of oil. 

• A buildup of dead skin cells in your pores.

• Growth of bacteria in your pores.

• Hormonal imbalances (like an increase in androgens or hormonal changes during pregnancy).

Diet, stress, certain skin and haircare products, and smoking may also contribute to acne breakouts.⁸

Differences between cold sores and pimples 

There are several ways to tell if the bump on your lip is a cold sore or pimple.

Cold Sores:

• Appear directly on your lip.

• Usually appear as a cluster of fluid-filled blisters.

• May cause an itching and burning sensation.

• Are contagious.

Whereas pimples on/around your lip:

• Do not usually grow directly on your lip.

• Appear as a red bump that may have a whitehead.

• May be painful to touch.

• Are not contagious.

Treatment Options for Cold Sores 

If all goes well, your cold sores will go away on their own without intervention. However, there are some home remedies and medical treatment options available to speed up the healing process.

Honey

Honey has potent wound healing and antiviral properties. Researchers have found that medical-grade honey is effective in treating cold sores. In fact, in one study, medical-grade honey outperformed conventional treatments for healing cold sores.⁹ 

Antiviral drugs

Antiviral drugs like acyclovir or penciclovir can help cold sores heal a little bit faster.¹⁰ Another antiviral drug, valacyclovir, was found to reduce a cold sore episode with one-day treatment when taken as instructed.¹¹ If you have a cold sore starting to form, you should speak with your medical provider and see if antiviral medications are a good option for you. 

Preventing cold sores

To help prevent cold sores, avoid triggers that are known to activate the virus, such as sun or wind exposure. If your cold sores are triggered by sun exposure, using sunscreen can significantly reduce the recurrence of cold sores.¹²

Treatment Options for Pimples

If you have acne, you may want to consider the following treatment options:

Topical retinoids

Topical retinoids are the drugs of choice for treating and preventing mild to moderate acne. Doctors may prescribe them alone or in combination with benzoyl peroxide and antibiotics.¹³ Oral antibiotics are an important part of treatment for inflammatory acne that does not respond to topical retinoids.

Doxycycline

Doxycycline is a drug used to treat acne by controlling the secretion of free fatty acids and thus reducing inflammation.¹⁴ Minocycline capsules are also used to treat acne. Other antibiotics such as amoxicillin, erythromycin, and trimethoprim/sulfamethoxazole may be used in some cases, but it's important to consult with a dermatology provider before taking any medications.¹⁵

Good Hygiene

To keep your skin healthy and acne-free, it's important to remove dirt, excess oil and makeup at the end of the day. A simple soap or face wash may not be enough to clear up acne. Proper use of medicated acne cleansers can help.

Tea tree oil and aloe vera

Tea tree oil is another effective remedy for pimples. It’s especially helpful in fighting against C. acnes, the bacteria that causes acne.¹⁶ Aloe vera may also help as it contains six antiseptic agents.¹⁷ They all can help inhibit bacterial growth.

Curology offers customized formulations that treat acne. The formulations may contain a combination of active ingredients, such as tretinoin, azelaic acid, and clindamycin, which can help unclog pores and decrease inflammation. 

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Distinguishing between cold sores and pimples can be tricky, but with the proper knowledge, it's possible to manage and treat them effectively.

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P.S. We did the homework so you don’t have to:

1. Institute for Quality and Efficiency in Health Care (IQWiG). Cold Sores: Overview. National Library of Medicine. (2018, July 12).

2. Institute for Quality and Efficiency in Health Care (IQWiG). Cold Sores: Overview. National Library of Medicine. Ibid.

3. Fatahzadeh, M. and Schwartz, R.A. Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol. (November 2007).

4. Institute for Quality and Efficiency in Health Care (IQWiG). Can Cold Sores Be Prevented? National Library of Medicine. (2018, July 12).

5. Skroza, N., et al. Adult Acne Versus Adolescent Acne: A Retrospective Study of 1,167 Patients. The Journal of Clinical and Aesthetic Dermatology. (2018, January 1).

6. Leyden, J.J. A review of the use of combination therapies for the treatment of acne vulgaris. J Am Acad Dermatol. (September 2003).

7. Leyden, J.J. A review of the use of combination therapies for the treatment of acne vulgaris. J Am Acad Dermatol. Ibid.

8. American Academy of Dermatology Association. Acne: Who Gets and Causes. (n.d.).

9. Naik, P.P., et al. Medical-Grade Honey Outperforms Conventional Treatments for Healing Cold Sores-A Clinical Study. Pharmaceuticals (Basel). (2021, December 4).

10. Institute for Quality and Efficiency in Health Care (IQWiG). How effective are creams and tablets for the treatment of cold sores?. National Library of Medicine. (2018, July 12).

11. Spruance, S.L., et al. High-Dose, Short-Duration, Early Valacyclovir Therapy for Episodic Treatment of Cold Sores: Results of Two Randomized, Placebo-Controlled, Multicenter Studies. Antimicrob Agents Chemother. (March 2003).

12. Mazzarello, V., et al. Do sunscreen prevent recurrent Herpes labialis in summer?. J Dermatolog Treat. (March 2019).

13. Leung, A.K.C., et al. Dermatology: how to manage acne vulgaris. Drugs in Context. (2021, October 11).

14. Sutaria, A.H., et al. Acne Vulgaris. StatPearls Publishing. National Library of Medicine. (2023, February 16).

15. Sutaria, A.H., et al. Acne Vulgaris. StatPearls Publishing. National Library of Medicine. Ibid.

16. Ossa-Tabares, J.C., et al. Evaluation of tea tree oil physicochemical features and its antimicrobial activity against Cutibacterium acnes (Propionibacterium acnes) ATCC 6919. Biomedica. (2020, December 2).

17. Surjusche, A., et al. Aloe Vera: A Short Review. Indian Journal of Dermatology. (2008, n.d.).

Donna McIntyre is a board-certified nurse practitioner at Curology. She obtained her Master of Science in Nursing at MGH Institute of Health Professions in Boston, MA. *Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Donna McIntyre, NP-BC