Pimple vs. Cold Sore

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Get Rid of Adult Acne

Pimple vs. cold sore facts

  • Pimples contain pus, while cold sores contain clear fluid in blisters.
  • Both pimples and cold sores can spontaneously heal.
  • Pimples are caused by bacteria, while cold sores are caused by herpes viruses.
  • Symptoms and signs differ between pimples and cold sores. Significant differences are that pimples produce pus and occur mainly on the face and back, while cold sores produce blisters on the lips and in the mouth.
  • Pimples and cold sores are usually diagnosed clinically by a primary health caregiver without any testing.
  • Treatments for pimples include benzoyl peroxide and/or antibiotics, while treatments for cold sores include antiviral medication. Alternative medicines may be helpful.
  • The prognosis for pimples and cold sores is usually good.
  • It is possible to prevent or reduce the development of pimples and cold sores.

What is a pimple?

A pimple is usually a small, firm inflamed spot on the skin and has many other names such as zit, bleb, boil, carbuncle, and others. Some pimples may become large. A pimple is an inflamed area of skin with pus formation in the center, resulting from a bacterial infection of the oil gland that produces sebum.

Picture of a pimple
Picture of a pimple

What is a cold sore?

A cold sore is an inflamed blister (also termed a fever blister or oral herpes) on the lips and/or near the mouth, caused by infection with herpes simplex viruses (HSV-1 and HSV-2).

Picture of cold sores
Picture of cold sores

What are similarities and differences between pimples and cold sores?

Similarities between pimples and cold sores include that they both can heal without treatment, both have stages of development, both usually appear on the face, and both may cause embarrassment and/or social stigma.

The following table highlights differences between pimples and cold sores:

PimplesCold Sores
CausesLocalized bacterial overgrowthHerpes viruses
LocationsMainly on the face, chest, and backMainly on the lips and in the mouth
Symptoms & SignsPus in the center of the lesionBlisters contain clear fluid
TransmissionMainly noninfectious person to personInfectious person to person
PrognosisSome pimples heal with scar formationNo scar formation with healing

Quick GuideAdult Acne (Pimples) Causes and Treatments

Adult Acne (Pimples) Causes and Treatments
Hormonal changes that occur during puberty may cause acne.

Home Remedies for Acne

  • Cosmetics: Don't be afraid to hide blemishes with flesh-tinted cover-ups or even foundation, as long as it is water-based (which makes it noncomedogenic). There are many quality products available.
  • Facials: While not absolutely essential, steaming and "deep-cleaning" pores is useful, both alone and in addition to medical treatment, especially for people with "whiteheads" or "blackheads." Having these pores unclogged by a professional also reduces the temptation to do it oneself.
  • Pore strips: Pharmacies now carry, under a variety of brand names, strips which one applies to the nose, forehead, chin, etc., to "pull out" oil from pores. These are, in effect, a do-it-yourself facial. They are inexpensive, safe, and work reasonably well if used properly.
  • Toothpaste: One popular home remedy is to put toothpaste on zits. There is no medical basis for this. The same applies to vinegar.

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

Cold sores are caused by HSV-1 and HSV-2 viruses, with the majority of facial cold sores caused by HSV-1 (about 80%). Risk factors include person-to-person transmission by direct skin contact, sharing eating utensils and other personal items (such as razors or towels), and even kissing can transmit viruses through saliva. It is also possible to transmit the disease with oral sex.

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 that indicates clogging of sebaceous glands), hormonal changes (especially in individuals undergoing puberty), and/or chemical irritants placed on the skin. Breakouts of pimples sometimes occur due to hormonal changes, for example during menstruation.

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 by which both pimples and cold sores develop.

The following are the signs and symptoms of pimples:

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

The following are the signs and symptoms of cold sores:

  • 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 skin and skin heals

The process for pimple formation and healing often occurs over a longer time span than the process with cold sores (two to four weeks). The longer time span 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 have the skin heal. In some individuals who have pimples with large areas of pus, the skin may form a scar.

What tests do health care professionals use to diagnose pimples and cold sores?

Your primary health caregiver, for most individuals, does 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. Patients with severe infections may be referred to a dermatologist and/or an infectious disease specialist who may order specialized tests.

What are treatments and medications for pimples and cold sores?

The treatments and medications for pimples and cold sores are different.

The most common treatment for pimples is an over-the-counter medication that comes in lotions, gels, cleansers, creams, and skin washes; it is benzoyl peroxide. It can kill bacteria and also 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. Individuals with severe pimple formation may require antibiotics (for example, minocycline [Minocin] and doxycycline [Oracea, Monodox, Vibra-Tabs]) and consultation with a dermatologist. Do not pick at or pop pimples. This 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 many others. For alternative medicine treatments, you should discuss them with your primary care physician before use.

Treatment for cold sores does not cure the disease, but it may speed up the healing process. There are many antiviral drugs that are used to treat cold sores. These antivirals may be administered as pills, creams, and more severe infections, even injected. Some of the drugs used for treatment of cold sores are as follows:

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.

Quick GuideAdult Acne (Pimples) Causes and Treatments

Adult Acne (Pimples) Causes and Treatments

What is the prognosis of pimples and cold sores?

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

Is it possible to prevent pimples and cold sores?

To reduce the chance of developing pimples, dermatologists suggest that you wash your face twice a day with warm water using a mild cleanser. Do not scrub the skin hard. If you use makeup, it should be removed every day before going to bed. For some individuals (for example, teenagers), use of benzoyl peroxide-containing medication with a fairly regular basis may be required to help prevent pimple formation. For those individuals who have severe problems with pimple formation, the use of antibiotics may be warranted.

To reduce the chance of getting cold sores, individuals need to avoid sharing items such as utensils, towels, and other items. Individuals should avoid person-to-person contact (for example, kissing or other physical contact) to reduce and/or prevent the transfer of the viruses that cause cold sores. In addition, people with cold sores can help stop the spread by avoiding touching the cold sore and/or by washing their hands frequently.

REFERENCE:

"Treating Pimples." American Academy of Dermatology. <https://www.aad.org/public/kids/skin/acne-pimples-zits/treating-pimples>.

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Reviewed on 5/24/2017
References
REFERENCE:

"Treating Pimples." American Academy of Dermatology. <https://www.aad.org/public/kids/skin/acne-pimples-zits/treating-pimples>.

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