Medically reviewed by Michele Emery, DNP
Written by Our Editorial Team
Last updated 2/1/2019
If you've had an outbreak before, cold sore vs. pimple doesn't really seem like a difficult question to answer. However, if this is your first outbreak — or what you suspect might be your first outbreak — cold sore vs. pimple is a pretty understandable comparison to question.
Superficially speaking, cold sores and pimples have quite a bit in common. Both tend to develop on the face, often around the mouth and nose. Both are aesthetically displeasing, both can take days or weeks to disappear and both, for most people, are things we’d rather not have to deal with.
However, cold sores and pimples are very different, each requiring a unique approach for optimal healing. In this guide, we’ll explain how you can settle your inner cold sore vs. pimple debate, as well as the best treatments for each common skin problem.
Pimples are small, sensitive bumps that can develop on your skin. They form for a few different reasons, which may include things like excessive sebum oil production, certain bacteria, dead skin cells and even hormone fluctuations.
While pimples are common in places like your face, neck and jawline, they can develop all over the body — including your back, shoulders and elsewhere
Pimples, no matter how severe, aren’t contagious, meaning there’s no reason to worry about kissing your partner if you have a pimple or two around your mouth or face.
Cold sores, on the other hand, are small blisters that develop around the mouth, cheeks and nose. For most people, cold sores start as itchy, uncomfortable spots on the face, before developing into visible, fluid-filled blisters caused by the herpes virus.
There are several cold sore stages to be aware of, and our what to expect during herpes outbreaks guide goes into more detail about the stages of an outbreak, how cold sores develop and what symptoms might signal the beginning of an outbreak.
Unlike pimples, which are caused by clogged hair follicles, cold sores are caused by the HSV-1 or HSV-2 virus. Most cases of cold sores are the result of HSV-1, although cold sores can also develop on the face if you’re infected with HSV-2.
Although it’s not exactly known what triggers a cold sore outbreak, things like stress, fatigue, hormonal changes, illness or even too much sun exposure are thought to contribute.
On average, people with HSV-1 may experience less than one outbreak per year, although this can vary significantly between people.
Cold sores also spread easily. Since they’re filled with fluid, often all it takes to infect another person with HSV-1 or HSV-2 is a kiss or even shared use of a glass or utensil. Herpes can also spread easily if you share a razor with another person.
Even without a cold sore on your lip and without experiencing any symptoms or any of the cold sore stages, you can still transmit the virus to someone or have it transmitted to you through a process called asymptomatic viral shedding, which makes things even more troubling.
In general, you have a variety of ways to deal with pimples, ranging from home remedies to full skin care regimens. For severe acne, there are also pharmaceutical options such as , that can provide lasting and effective relief.
If you have severe or recurring acne, it’s best to talk to a dermatologist. They’ll be able to offer expert advice to help you control or eliminate your acne and prevent further outbreaks.
Cold sores, on the other hand, require a more focused approach. Because cold sores are the result of a viral infection, there’s no one-off solution that will prevent you from developing cold sores in the future.
Currently, the most effective way to treat cold sores is through the use of medications such as valacyclovir (Valtrex®). This antiviral medication is effective against both HSV-1 and HSV-2 and can provide faster healing in the event that you suffer a cold sore outbreak.
You can learn more about valacyclovir and its effects for treating cold sores in our Valacyclovir 101 guide, which covers everything from benefits to side effects, dosages and more.
It’s especially important that you don’t “pop” a cold sore like you might a pimple, since this just makes it easier for the infectious fluid inside the blister to spread to other parts of your body. In some cases, this spreading of the virus can lead to the development of other types of herpes, like genital or even ocular (eye) herpes.
It’s also important to make sure your hands are clean after touching a cold sore, since it’s easy for the fluid to transfer from your fingertips or nails to other parts of your body or other people.
Finally, it’s important not to have oral sex if you have visible cold sores, as there’s a risk of the cold sores spreading to your partner’s genitals and causing genital herpes. While condoms do reduce the risk of herpes transmission, there’s still a risk.
Most cold sore outbreaks eventually resolve on their own, meaning you’ll likely notice your cold sores starting to heal and disappear over the course of two to four weeks, even if you don’t use antiviral medication. However, research suggests that drugs like valacyclovir can significantly speed up the process.
As you can see, the cold sore vs. pimple debate is actually a lot more simple than you'd first think. Pimples and cold sores might look similar, but they’re different issues that need to be treated very differently. While pimples can usually be solved using topical creams, facial washes and retinoid medication, cold sores are the result of a virus and can be treated using valacyclovir.
If you’ve noticed a cold sore developing around your mouth, the best option is to talk to your doctor. If they can't give you a visual confirmation, they'll be able to tell you about all the different testing options available to you. letting you learn whether or not you have an active HSV-1 or HSV-2 infection.