Pimples and cold sores are two types of lesions that can blight your complexion. Pimples, also known as acne vulgaris or "zits," are caused by a conflagration of excess oil, dead skin cells and bacteria. But a cold sore, which goes by the more ominous name of oral herpes, is caused by a contagious virus.
Cold Sores & HSV-1
A cold sore appears when you've been infected with the herpes simplex virus type 1, according to Scott & White Health. If you're infected with HSV-1, you may not notice any initial signs or symptoms, as the virus retreats into nerves closest to your face, where it remains dormant until something causes it to activate. Cold sores may only occur once and never again, although in some cases, HSV-1 is triggered again and again, resulting in repeated outbreaks. The first cold sore may be preceded by a sore throat, fever and swollen glands in the neck for up to five days before the lesions erupt. Cold sores are synonymous with fever blisters and may also go by the name herpes labialis. Scott & White Health states that most Americans are infected with HSV-1 by the time they reach the age of 20.
What Causes Pimples
As noted above, excess oil, dead skin cells and bacteria are the three ingredients necessary for a pimple to form. Pimples and teenagers typically go hand in hand, as this is the stage of life when hormones called androgens are at high levels. These hormones cause the sebaceous glands to produce too much oil, which blocks pores and causes a plug to form. A pimple can be one of many types of acne lesions, including comedones (whiteheads and blackheads), papules, pustules, nodules and cysts. Scott & White Health states that even adults in their 30s and 40s may get pimples.
Presentation
Scott & White Health states that cold sore lesions may appear on the gums, in the mouth or throat or on the face. Most of the time, cold sores appear on or around the lips. But the American Social Health Association (ASHA) indicates that some cold sores may erupt inside the nose or on the chin or cheek, in which case the lesions are referred to as oral-facial herpes. Pimples can also appear anywhere on the face, but may also occur on the shoulders, chest, arms, legs and buttocks. Cold sores appear as a cluster of small, translucent blisters (vesicles) that are filled with a yellowish liquid that eventually rupture, crust over and heal; the skin around them is red and inflamed and extremely sensitive to the touch. Pimples are often inflamed, but lack the characteristic cluster of blisters associated with cold sores. To see how these types of lesions differ, see the Resources link below.
More Differences
Scott & White Health notes that cold sores are most likely to be seen in children between the ages of 1 and 5. As noted, pimples typically occur at the onset of puberty. Although there may be times when acne get worse, it is generally a constant feature on the face of the person who has it. Cold sores, on the other hand, affect a specific area of the face. Although there may be protracted periods of time before another cold sore appears, the ASHA notes that only around 25 percent of people with oral herpes experience recurrent outbreaks.
Treatment
Cold sores generally heal over a period of one to two weeks, but oral antiviral medications can reduce symptoms and shorten the outbreak. Scott & White Health states that ongoing use of antivirals may be necessary if outbreaks are frequent. Pimples, on the other hand, require different treatment. Washing the face twice a day with a mild cleanser can help prevent acne formation, as can applying over-the-counter acne medications. However, prescription topical or oral medications and other methods of treatment provided by a dermatologist may be required before pimples resolve.
Cautions
Unlike pimples, which are not contagious, HSV-1 can be passed from one person to another, especially when a cold sore is active. Scott & White Health advises refraining from touching a cold sore and washing anything that touches the lesion (such as towels) in very hot water. If you have a cold sore, you shouldn't share personal items (such as razors, cups and eating utensils) with others. It's particularly important to not engage in oral sex when a cold sore is present, as you can give your partner genital herpes. Only your doctor can determine if you have acne or if you suffer from repeated cold sores. Scott & White Health advises contacting a health-care professional if you suspect you have a cold sore and symptoms are extremely severe, do not resolve after two weeks or if lesions erupt near the eyes.
