A word on the virus: HSV is incredibly contagious, and it’s caused by skin-to-skin contact—things like kissing or drinking after a person who has active lesions, touching the person’s skin, or sharing objects like silverware, lip balms, or razors. And while there’s a certain stigma around them (“They can affect a person’s confidence and self-esteem, especially for those who get them several times a year,” says board-certified dermatologist Zenovia Gabriel, M.D., FAAD), cold sores are actually more common than you think: In fact, the World Health Organization reports that an estimated 3.7 billion people under age 50 have HSV-11, which translates to 67% of the global population—well over half. And for some, the virus may lay dormant entirely; for example, you might have contracted the virus as a child or drinking after a friend and not even know it. It’s important to note that some people can be contagious even without an active outbreak, a condition known as “asymptomatic viral shedding,” says board-certified dermatologist Hadley King, M.D. That’s not meant to scare you from kissing or sharing gloss ever again (after all, you may already have the dormant virus yourself), but an important word of caution nonetheless. Unfortunately, everyone faces pimples, and they can happen anywhere on your body you have hair follicles (aka, everywhere except the palms of your hands and bottoms of your feet). Which, as it turns out, includes the lip area. While pimples can also crop up due to stress, sun, and trauma, they aren’t caused by a viral infection, like cold sores. While they might look similar in the beginning, cold sores usually take on the appearance of a cloudy blister, says Patel. That’s because they’re typically mixed with a clear fluid, which gives them that “cloudiness.” Of course, “If you have a lip skin lesion that is not healing, see a board-certified dermatologist,” she adds. Cold sores can also come with flu-like symptoms (some to note are headaches, achiness, fever, and swollen lymph nodes, especially along the neck) as well as what’s known as a prodrome—a tingling or burning sensation on the skin before any actual lesions appear. People who experience cold sores may recognize this pain and treat the virus before any lesions even arise (more on that later). On the other hand, “pimples do not have this sensation, as they do not involve the nerves under the skin,” says Patel. While zits themselves can become rather sore (ever had a cystic pimple that’s painful to the touch?), it’s the burning sensation before that’s a tell-all sign. In terms of topicals, zinc oxide and essential oils have shown effective: One study showed that patients who applied a zinc-oxide-based cream experienced less severe symptoms3, even shaving one and half days off their healing time. It makes sense, as zinc oxide has a rather soothing effect on the skin. Another study found that applying lemon balm essential oil to lesions can help reduce the size of blisters2 and allow patients to heal faster. Without any sort of treatment, topical or oral, the flare-up should heal on its own in about one to two weeks, says King. Now, onto the topicals. For lip pimples in particular, retinoids, salicylic acid, and benzoyl peroxide can be super helpful: Gabriel recommends using benzoyl peroxide or salicylic acid in the morning and retinol at night to reduce inflammation fast. Also be sure you’re not using any comedogenic makeup products, as those could be causing that buildup around the lip area.
