Pimple vs. Cold Sore

A pimple is a small, inflamed spot on the skin. It is also known as a zit, bleb, boil, carbuncle, and more. Some pimples can be large. Pimples are inflamed areas of skin with pus formation in the center. They result from a bacterial infection of the oil gland that produces sebum.

What is a cold sore? What does it look like?

Cold sores, also known as fever blisters or oral herpes, are inflamed blisters on the lips and/or near the mouth. They are caused by infection with herpes simplex viruses (HSV-1 and HSV-2).

What are the similarities and differences between pimples and cold sores?

Both pimples and cold sores can heal without treatment. They have stages of development, usually appear on the face, and may cause embarrassment and social stigma.

The following table highlights the differences between pimples and cold sores:

What are the causes and risk factors for pimples and cold sores?

Cold Sores

Cold sores are caused by HSV-1 and HSV-2 viruses, with the majority caused by HSV-1 (about 80%).

Risk factors include:

• Person-to-person transmission by direct skin contact
• Sharing eating utensils and personal items such as razors or towels
• Kissing can transmit viruses through saliva

It is also possible to transmit the disease with oral sex.

Pimples

Pimples are caused by inflammation and bacterial overgrowth in the sebaceous glands of the skin. They are not caused by person-to-person contact.

Risk factors include:

• Clogged sebaceous glands (whitehead and/or blackhead formation)
• Hormonal changes, especially during puberty
• Chemical irritants placed on the skin

Breakouts of pimples can occur due to hormonal changes, such as during menstruation.

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What are the signs and symptoms of pimples and cold sores?

The signs and symptoms of pimples and cold sores can be summarized by the five stages of development.

Pimples

The signs and symptoms of pimples are:

• No visible lesions; possible tingling
• Reddish, flat small area of skin
• Possible whitehead or blackhead development
• Pus develops and eventually drains
• Inflammation decreases and the skin heals

Cold Sores

The signs and symptoms of cold sores are:

• No visible lesions; possible tingling
• Fluid-filled blisters begin to appear
• Blisters ooze clear fluid and form painful sores
• Sores dry and form scabs
• Scabs fall off and the skin heals

The process of pimple formation and healing often takes longer than the process with cold sores (two to four weeks). The longer period is due to the time it takes to form whiteheads and/or blackheads. Additionally, it takes about a month after pus develops and drains for the inflammation to decrease and the skin to heal. In some individuals with pimples and large areas of pus, the skin may form a scar.

What tests do doctors use to diagnose pimples and cold sores?

Most individuals do not require tests to diagnose pimples and/or cold sores. These two problems are almost always diagnosed with the patient’s history and physical exam. Severe infections may require specialized tests conducted by a dermatologist and/or an infectious disease specialist.

What are treatments and medications for pimples and cold sores?

Treatments and medications for pimples and cold sores differ.

Pimples

The most common treatment for pimples is over-the-counter medications containing benzoyl peroxide. These come in lotions, gels, cleansers, creams, and skin washes. Benzoyl peroxide can kill bacteria and remove some of the oil and dead skin cells associated with whiteheads and blackheads. Another common treatment is salicylic acid, which helps to open pores. Severe pimple formation may require antibiotics and consultation with a dermatologist. Picking at or popping pimples can make the infection worse and result in scar formation.

Alternative medicine for pimples includes lemon juice, tea tree oil, green tea, honey, mint, echinacea, and others. Consult your primary care physician before using alternative medicine treatments.

Cold Sores

Treatment for cold sores does not cure the disease, but it may speed up the healing process. Many antiviral drugs are used to treat cold sores, including acyclovir, docosanol, famciclovir, penciclovir, and valacyclovir. These antivirals can be administered in various forms such as pills, creams, and injections for severe infections.

Alternative medicine treatments for cold sores include lysine as an oral supplement or cream, sage plus rhubarb in a cream, propolis (synthetic beeswax), and stress reduction.

What is the prognosis of pimples and cold sores?

The prognosis for pimples and cold sores is usually good. For many individuals, pimples and cold sores may require little or no treatment and have few complications. However, in patients with severe pimple formation or frequent outbreaks of cold sores, the prognosis is somewhat less favorable. These individuals may require frequent treatments and experience many recurrences even with appropriate treatments.

Is it possible to prevent pimples and cold sores?

To reduce the chance of developing pimples, dermatologists suggest washing your face twice a day with warm water using a mild cleanser. Avoid scrubbing the skin hard. Remove makeup before going to bed. For some individuals, regular use of benzoyl peroxide-containing medication may be required to help prevent pimple formation. Severe pimple formation may require antibiotics.

To reduce the chance of getting cold sores, avoid sharing items such as utensils and towels. Avoid person-to-person contact to reduce and prevent the transfer of the viruses that cause cold sores. Additionally, people with cold sores can help stop the spread by avoiding touching the cold sore and washing their hands frequently.

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