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How to Tell the Difference Between Herpes and Pimples (With Photos)

My name is Ed, and my passion is helping people overcome the stigma of living with genital herpes. I speak from personal experience.

How to distinguish between herpes and pimples.

How to distinguish between herpes and pimples.

Herpes vs. Pimples

Both herpes and pimples can occur in various areas on the body, most commonly on the face (around the mouth) and in the genital region. Although this article will focus more on the mouth region, occurrences are similar anywhere on the body. Herpes and pimples may have a similar appearance and be equally uncomfortable or painful, but there are a few key differences that can help you easily tell them apart.

Differences Between Herpes Blisters and Pimples

Summary of the main differences between cold sores and pimples.

HerpesPimples

Sensitive, itching sensation

Only hurts when touched

Usually forms in clusters

Pimples can form individually

Caused by a viral infection

Caused by bacterial infection and inflammation

Filled with a clear liquid and will break to form scabs

Filled with white pus

Lie on the surface of the skin

Can extend into deeper layers of the skin

Stages of Herpes Development

Once you get infected by the herpes virus, you may start to develop symptoms (enter stage 1), or the virus may enter a latent phase in which it lies dormant until something triggers an outbreak. At this time, it is unclear why this is and what the exact triggers are.

Stage 1: Prodrome or Viral Shedding (Days 1-2)

This is the beginning of the replicative phase of the herpes virus lifecycle. Within the first few days of an outbreak, the virus will make contact with the skin and begin replicating as it prepares to break out and infect other hosts. This initiates an inflammatory response that causes you to feel tightness, tingling, itchiness, burning sensation, and possibly some swelling. You may or may not be able to see physical symptoms (i.e. small reddish bumps) at this stage.

You are considered contagious during this period and should avoid physical contact with other people or shared objects (e.g. eating utensils, cups, straws, phones, etc.).

Stage 2: Blister Formation (Days 2-7)

Depending on the severity and the person, the infection can lead to the formation of blisters within a few days. Blisters are seen as clusters of fluid-filled sacs that are clear, yellowish, or white (pus). The fluid in a herpes sore is generally a mixture of plasma, interstitial fluid, cellular debris, and the virus itself. The blisters can be itchy and painful and usually last around two days before they burst on their own.

You are the most contagious during this stage since the concentration of the virus on the surface of the body is at its highest.

Stage 3: Bursting and Crusting (Days 5-10)

A few days after the blisters form, they will burst on their own, releasing the fluid along with the virus. This may also cause some bleeding and subsequent scabbing. The sore will then dry out and begin to heal. As new skin starts to form over the next few days, the affected area may be very itchy.

Stage 4: Complete Healing (Days 7-14)

Once the scab falls off—you should let it fall off naturally to minimize scarring—and the new skin covers the old blisters, the virus will move back into the dormancy phase of its infection. During this phase, the virus will continue to live in your body—in the nerve roots in your spinal cord—without causing any symptoms until it is once again triggered.