Cold sore vs. zit (gross, sorry)

February 2, 2013 9:55 PM

How do I tell the difference between a cold sore and a zit?

My husband has been affected by cold sores lately. He said that they hurt and generally happen near your lips. He bought some Abreva and has been using it.

I get zits near my lips - or at least I thought they were zits? I get my upper lip waxed on a regular basis so I have had ingrown hairs and I thought other red bumps near my lip line were zits but maybe they were cold sores?

The current one is just a red bump. I can't tell if it's a zit or a future cold sore. I've been putting Abreva on it, fearing the worst, but I don't know if that's the right thing to do. Before it was a little sensitive but I touched it when I got out of the shower just now and it didn't feel like anything.

My dermatologist prescribed Acanya for my acne and I use that regularly. If i hadn't been using the Abreva on the ambiguous cold zit, I would be putting Acanya on it, which I imagine would just dry it out, whatever it is.

So how do you tell the difference between a zit and a cold sore? If you're not sure, is it a bad idea to put Abreva on it? Is there a better way to deal with cold sores? I saw someone suggest putting a used tea bag on your face but when I mentioned that to my husband, he made an inappropriate joke.

posted by kat518 to health & fitness (8 answers total)

For me, a cold sore starts out as something that looks like a little blister. Then the blister pops and it turns into a full-on cold sore. With a zit I usually have some swelling and a knot under the skin (if it's cystic acne) or a whitehead on the top.

Also, cold sores usually don't happen outside of my lipline while a zit may be near the lipline but not within the pink/red colored area of my lip.
posted by joan_holloway at 10:06 PM on February 2

They are very different, though sometimes you can't tell at first. If it's been more than a couple days and you're still not sure, it's probably just a zit. But, if you're thinking it might be a cold sore, ice the hell out of it, like until your lip is numb. You can kill it that way if you catch it fast enough. And be careful about using chapstick with a cold sore as you can spread the infection.
posted by Jess the Mess at 10:06 PM on February 2

A cold sore looks like a blistered section of skin, and it normally happens right on the edge of the lip line but can happen around the lips and on the chin or upper lip. You can good a google search for cold sore and get a pretty good idea. Zits look like zits. :/

Another thing: I spent a lot of time searching "cold sores" and herpes and eventually found out (from my doctor) that I don't have herpes, but that I do get canker sores, which happen inside your mouth on fully on the lip. So if you get them inside your mouth, they might be canker sores, which are different altogether. If you really concerned about herpes, you can talk to your doctor! It's pretty common, though; I had to convince my doc to actually do the tests for non-genital herpes.
posted by two lights above the sea at 10:10 PM on February 2

I get cold sores on my lip line and I can assure you the amount of time between thinking I have a zit and realizing it's actually a cold sore is very small! They just feel different, cold sores being much more tender. Also, the pain from my cold sores tends to radiate out into the bottom of my jaw. Then of course there is the inevitable blister. And the protracted healing process. Once you have experienced these symptoms, you may become hyper vigilant to every tender spot on your lip. IMHO, you'll know when you have a cold sore.
posted by secrethandshake at 11:02 PM on February 2

When you first get exposed to a herpes strain that causes cold sores, the resulting cold sores burn. The more years you've been hosting the virus, the less frequent the outbreaks become and the less they hurt.

The usual sequence for an untreated cold sore goes: redness and a tingle, redness with tenderness and swelling and itching, redness with tenderness and swelling and a bunch of tiny transparent blisters that itch fiercely, redness with intense itching and broken blisters, an open sore that burns and burns and burns, redness and flaky dry skin, gone.

Cold sores also start in nerve endings rather than pores. If what you're seeing definitely has a single inflamed pore right in the middle, it's more likely a zit than a cold sore.

I personally had very little luck with antivirals. Vitamin B, on the other hand, worked really well if taken at the tingle stage. Some people have good results with lysine supplements. I'm sure you'll find something that works for you.

They do get better. I've not had an outbreak for years; the last one happened after I allowed my face to get sunburned.
posted by flabdablet at 8:15 AM on February 3

I get the tiny lip-line zits as well, sometimes inflaming into larger ones, and I don't have HSV1 or HSV2 (two blood tests, long story). I think they're more painful than zits elsewhere because of the high density of nerves in the lip area. I'm not familiar with Acanya and use salicylic acid (most nights) or benzoyl peroxide for acne; the salicylic acid is non-drying enough for use on the lip line in my opinion.
posted by ecsh at 8:16 AM on February 3

When I feel a cold sore coming on it is a very distinct feeling, like the area is being pricked with a needle. A developing zit is more of an ache. A cold sore will have multiple little bubbles of puss which weep liquid and eventually form a golden yellow crust. A zit, if it comes to a head, will have just one white pustule. Nothing will come out unless you pop it.

As soon as I get that pin prick feeling I apply the CVS brand version of this stuff. The cold sore won't develop if I get it soon enough. It also helps me to wear lip balm regularly, being sure to also apply it on the regular skin just around my lip line. I have had success with Whole Foods store brand of lip balm in vanilla honey.
posted by fozzie_bear at 8:47 AM on February 3

For me cold sores never have a head, they're quite rough and settle in the corners of my lips. Zits have heads and, although I'm sure the can, I've never had one in the corners of my lips. Also, the feeling is quite different between the two; much like fozzie_bear describes it.
posted by deborah at 10:34 PM on February 3