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Is That a Herpes Cold Sore—Or Just a Zit?

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You’re brushing your teeth or slicking on some gloss when you notice a tender spot on your lip. A closer look reveals the beginnings of an angry-looking sore—and immediately you start to stress: Is it a pimple? Out-of-control chapping? Or—oh please, no—a cold sore?

Cold sores, which are caused by the herpes simplex 1 virus (a cousin of the herpes simplex 2, the genital kind) affect as many as 90 percent of adults, and are easy to confuse with other lip issues, like zits and canker sores. But the last thing you want to do when you're sporting a distracting, potentially painful bump on your face is waste time on the wrong treatment.

The best way to get the right diagnosis is to visit your doctor or a pharmacist. But to save you from having to perform endless online searches (and weed through some brutal Google image results) right this minute, we asked the experts how to identify a cold sore—and how to treat it, or whatever else you might be obsessing over in the mirror.

Cold Sore
ID it: The first thing you’ll notice is pain or burning in your lip. Next, small groups of fluid-filled blisters will form, usually on the outer border of one of your lips. Eventually these will pop, crust up, or form a yellowish scab, says Joshua Zeicher, M.D., a dermatologist at the Mount Sinai Hospital. The herpes simplex 1 virus is passed through direct contact, he says, so if you’ve never had a cold sore before, think back—have you recently kissed or shared a drink with someone with suspicious spots on their mouth?
Treat it: Applying an over-the-counter treatment like Abreva ($21; walgreens.com) at the first sign of symptoms can shorten healing time and ease issues like pain. If your outbreaks are severe or very frequent, though, Zeicher suggests asking your doctor about prescription antiviral creams or oral meds, which can ward off future flare-ups. (Until it heals, learn How To Conceal Cold Sores.)

Pimple
ID it: The first sign of a zit is general minor soreness or tenderness, rather than the shooting pain or burning that comes with a cold sore. As anyone who’s made it through puberty knows, they can appear anywhere on your face, not just your lip. They also tend to be firmer than cold sores since they’re filled with skin oils and dead skin (not the clear fluid in cold sores), and often appear solo, rather than in clusters.
Treat it: Slather on an over-the-counter acne treatment (Zeicher recommends benzoyl peroxide). If there’s swelling, an over-the-counter hydrocortisone cream can also help, he adds. Try to keep your hands away from the spot, and try these other tricks to Get Rid of Zits Fast.

Canker Sore
ID it: These usually form on the inside of the lip, not the outside, says Zeicher. Instead of small, grouped blisters, you’ll notice one sore or tender white or yellow patch under your tongue, inside your cheeks or lips, on your gums, or on the roof of your mouth. The area surrounding the sore may be redder than usual. Doctor’s aren’t totally sure what causes these spots, though injuries (from biting your cheek, say), stress, and nutritional deficiencies may play a role.
Treat it: “The best treatment is a tincture of timewait for it to heal on it’s own,” says Zeicher. If the area hurts, an oral numbing gel from the drugstore can help ease the pain.

Chapping
ID it: Dry winter air and cold winds can suck all the moisture from your lips. Super-intense dryness can extend beyond the outer border of your lips, leading to some extreme peeling, irritation, pain, and even splitting or bleeding. If you have redness that’s not centered around any specific spot or doesn’t appear to have a locus (like a whitehead), it’s probably just chapping.
Treat it: Smooth on your favorite lip balm as often as necessary, applying an extra-thick layer before bed. (You can't over-apply; the idea that you can get addicted to lip balm is a myth.) Also avoid licking your lips or picking at dry skin, which can worsen symptoms. (Still dry? Learn how to Cure Chapped Lips in 3 Quick And Easy Steps.)

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