It all begins with an inflamed red bump on your face dangerously close to your lips--or sometimes on your chin or in your nostril. If you've never had this problem before, you may wonder, "Is it a pimple or a cold sore?" There are very big differences between the two.
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Pimples and cold sores have very disparate causes. Cold sores erupt because you've been infected with the herpes simplex virus type 1, or HSV-1, which is passed along to you unknowingly through a kiss from a relative or friend--or sometimes by touching an infected personal item, such as an eating utensil or towel. Pimples, on the other hand, are synonymous with acne. Mayo Clinic experts note that acne occurs when excess oil production in your skin, along with dead skin cells, form a plug in your pores. Factor in the bacteria that normally reside on your skin's surface, and this can cause the inflamed lesion you call a pimple.
Who Gets Them?
Any person of any age can get a pimple or a cold sore. But generally speaking, teenagers are more prone to getting pimples due to hormonal changes that cause their skin to produce more oil, the Mayo Clinic says. Children are more likely to initially become infected with HSV-1, says the American Social Health Society. You may get only one cold sore in your life, but you may also experience intermittent outbreaks of these lesions. The HSV-1 virus remains in your body forever, laying dormant in the ganglia closest to the base of your skull until something happens to cause the virus to awaken. If you get pimples, this skin condition is more likely to be a persistent, ongoing problem–especially during the teen years.
The American Academy of Dermatology says that only 10 percent of people infected with HSV-1 actually get a cold sore. Cold sores typically erupt between 2 and 20 days after an initial HSV-1 infection. Before getting a cold sore, you may notice that your skin is extremely tender or experience a strange burning or tingling sensation on the prospective area of infection. Cold sores may present in the form of numerous watery blisters or a single blister, generally very close to the mouth, the AAD says. These blisters eventually rupture, ooze, scab over and heal without scarring within a couple of weeks. The classic acne pustule–the pimple that rises from the skin in a half-dome shape with a pus-filled tip–may be mistaken for a cold sore if you're not used to seeing either lesion on your skin. Pimples can also be painful, especially cysts that develop deep under your skin. But cold sores are generally associated with more physical discomfort–pain, burning and itching–until they heal.
Whether it's a pimple or a cold sore, the primary rule is not to squeeze the lesion or pick at it manually. This causes your skin to scar. If you have a pimple, squeezing it can force bacteria deeper into the skin, resulting in a more pronounced infection, the Mayo Clinic says. But picking at cold sores is even far more dangerous; the watery substance inside the blister(s) contains live HSV-1. If you touch or pop a cold sore, you may transfer the virus to other parts of your body. Mayo Clinic experts note that unless you get frequent cold sores, or unless cold sores erupt around the area of your eyes, these lesions generally need no medical treatment other than self-care (see "Resources"). But pimples may require ongoing home treatment by using topical acne medication purchased over the counter. If pimples are persistent, it may be necessary to see a dermatologist for a stronger prescription medication.
Get Medical Advice
If you have a cold sore, you can infect others with HSV-1 as well. If you suspect a cold sore, the AAD warns you not to kiss others or share cups, utensils or lip balms. If you aren't sure and the inflamed lesion causes you pain and distress, see a doctor to get an accurate diagnosis.