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

Updated on June 28, 2018
prodriver08 profile image

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

Herpes
Pimples
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
Summary of the main differences between cold sores and pimples.

Pictures of Herpes Blisters

Click thumbnail to view full-size
Herpes blisters are clear, white, or yellow and are filled with clear liquid. They lie right on the surface of the skin.Herpes labialis (oral herpes) on the lips.Herpes labialis (oral herpes) around the mouth..HSV-1 under the eyes.Cold sore on the lips crusting over.
Herpes blisters are clear, white, or yellow and are filled with clear liquid. They lie right on the surface of the skin.
Herpes blisters are clear, white, or yellow and are filled with clear liquid. They lie right on the surface of the skin. | Source
Herpes labialis (oral herpes) on the lips.
Herpes labialis (oral herpes) on the lips. | Source
Herpes labialis (oral herpes) around the mouth..
Herpes labialis (oral herpes) around the mouth.. | Source
HSV-1 under the eyes.
HSV-1 under the eyes.
Cold sore on the lips crusting over.
Cold sore on the lips crusting over. | Source

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.

How a cold sore develops.
How a cold sore develops.

Causes of Oral and Genital Herpes

Herpes is very infectious and also very common. Two studies published in PLOS ONE estimated that in 2012, 67% of people worldwide who are under 50 are infected with HSV-1, and 11.3% of people ages 14-49 are infected by HSV-2. Some people may not be aware that they are infected because it is possible for the virus to stay dormant and not cause any symptoms until an outbreak is triggered. People with herpes sores often confuse them with common skin problems such as rashes, pimples, bug bites, razor burns, ingrown hairs, or yeast infections.

Herpes sores are caused by one of two subtypes of the herpes simplex virus (HSV):

  1. HSV-1: Usually causes oral herpes (herpes labialis), including cold sores and fever blisters
  2. HSV-2: Usually causes genital herpes (herpes genitalis) and sores in other areas of the body

It should be noted that either subtype of the herpes simplex virus can infect any part of the body, usually through oral sex. That is, HSV-1 can cause genital herpes, and HSV-2 can cause an oral infection.

Herpes Symptoms

For some people, the first outbreak after a herpes infection is the worst, although others may have little to no symptoms at all. The first episode is generally accompanied by flu-like symptoms:

  • Fever
  • Swollen lymph nodes
  • Joint pain
  • Headaches
  • Fatigue

What Does Herpes Look Like?

  • Itchy rash
  • Sensitive, reddish, inflamed skin
  • Clusters of small, blisters filled with clear fluid

The first occurrence of herpes is usually the most painful and lasts about two weeks. Subsequent episodes are less likely to occur, although some people may have recurrent episodes. It is estimated that about 40% of American adults get reoccurring cold sores. Those infected with HSV-2 are more likely to experience recurring herpes outbreaks. These subsequent outbreaks are generally milder than the first and last about a week. This is because the body has created antibodies against the virus and is therefore more prepared to fight off the infection. Those infected with HSV-2 are more likely to experience recurring herpes outbreaks than those infected with HSV-1.

Herpes tend to form in irregular clusters of blisters.

How Do You Catch Herpes?

Herpes is spread through direct contact with a person or the bodily fluids of a person that is infected with the virus—such as contact with blisters and ulcers—but most commonly occurs through kissing and sex (oral, vaginal, and anal). Herpes cannot be spread through contact with objects touched by an infected person, since the virus cannot survive long outside of the body. However, avoid contact with objects that may have the infected person’s bodily fluids on them, such as eating utensils, straws, cups, towels, and lip balm.

Once you are infected, you will always carry the virus—even when symptoms do not appear. The virus will stay dormant until common triggers, like stress, illness, and UVB rays from the sun, cause an outbreak to occur.

How Do You Know If You Have Herpes?

Often times, you can tell the difference between herpes sores and pimples just by looking at them. However, for a definitive answer, it is best to seek out a licensed healthcare provider, who can find out if you are infected with herpes using one or a combination of three possible diagnostic tests:

  1. Culture test: A fluid sample from a blister or ulcer—preferably a new one—is cultured to detect whether the herpes virus is present. This test is most sensitive within 48 hours of initial symptoms and is usually done during the first episode.
  2. Blood test: This tests for presence of antibodies for the two types of herpes viruses (HSV-1 and HSV-2). Therefore, it is usually done weeks after the first episode, since it takes time for the body to create antibodies to fight a virus. Because this test detects antibodies specific to the virus, it can tell you what type of herpes simplex virus you are infected with and can be useful in determining the likelihood of future episodes.
  3. Polymerase chain reaction (PCR) test: This test is used to detect the presence of genetic material from the herpes virus. It is the most sensitive test but also the most expensive test, so it is not generally ordered, except in extreme cases.

Can You Pop Herpes Blisters?

Like pimples, you may be tempted to pop a cold sore or a herpes blister, but by popping, you are only doing more harm. Popping a cold sore, a genital herpes blister, or a pimple increases the risk that you will worsen the existing infection, introduce a secondary infection, or irritate your skin further. Popping can also make it more likely to form a scar.

It is best to leave the pimples or blisters alone to heal on their own, but if they are too uncomfortable or painful, talk to your doctor.

Don't Risk It!

Although you can likely tell herpes sores and pimples apart just by looking at them, a medical diagnosis will let you know for sure.

Pictures of Pimples

Click thumbnail to view full-size
Pimples may appear alone or as an outbreak and are filled with white pus. Pimple sink deeper into the skin than herpes blisters.Beginning stages of pimple formation near the mouth.Pimples can occur singularly or in clusters.The later stages of pimple development in which they begin to dry out and heal. There may still be some discoloration where the pimple used to be.Severe acne on the face, resulting in papules and pustules on the cheeks.
Pimples may appear alone or as an outbreak and are filled with white pus. Pimple sink deeper into the skin than herpes blisters.
Pimples may appear alone or as an outbreak and are filled with white pus. Pimple sink deeper into the skin than herpes blisters.
Beginning stages of pimple formation near the mouth.
Beginning stages of pimple formation near the mouth. | Source
Pimples can occur singularly or in clusters.
Pimples can occur singularly or in clusters.
Source
The later stages of pimple development in which they begin to dry out and heal. There may still be some discoloration where the pimple used to be.
The later stages of pimple development in which they begin to dry out and heal. There may still be some discoloration where the pimple used to be. | Source
Severe acne on the face, resulting in papules and pustules on the cheeks.
Severe acne on the face, resulting in papules and pustules on the cheeks. | Source

What Do Pimples Look Like?

There are many types of acne, including blackheads (open comedones), whiteheads (closed comedones), papules, pustules, nodules, and cysts. The ones most often confused with cold sores are papules and pustules, which are bumps filled with white or yellow pus. Papules appear as small pink or red bumps, while pustules are similar with a white or yellow cap.

Acne Symptoms

  • Pink or red bumps
  • Appear alone or in clusters
  • Firm and sensitive to the touch
  • Can be itchy or irritate the skin
  • Can be painful if pressure is applied

How Long Do Pimples Usually Last?

Depending on the type of pimple you get, each pimple can last from a couple days to about two weeks. Pimples with a lot of pus may take longer to heal. They will likely heal faster when kept clean and undisturbed. Constantly touching—especially popping—a pimple can make it larger, more uncomfortable, and delay the healing process.

Pimples have a regular, round shape and can appear as a single pimple.

How Do Pimples Form?

Papules and pustules are caused by inflammation of clogged hair follicles. Buildup of oil (sebum) and dead skin can trap bacteria in the follicle, leading to an infection. To combat this infection, the immune system starts an inflammatory response that increases blood flow to the area—causing the redness you see—and recruits cells to trap and fight the bacteria. This process forms pus—the collection of dead cells and tissue, bacteria, white blood cells, blood serum, and other debris.

What Triggers Pimple Formation?

  • Excess oil on the skin: This can come from excess sebum production or from contact with oily products like greasy foods or oily lotions and creams.
  • Puberty: Increases in androgen production, which leads to increased sebum production.
  • Genetics: If you have a family history of acne, you are more likely to develop it yourself.
  • Diet: Contrary to popular belief, eating greasy foods like chips and burgers has not been found to affect acne. That being said, the relationship between diet and acne still needs further exploration, but some studies do suggest that certain foods can exacerbate acne, including high glycemic foods (i.e. foods that contain simple sugars like soda and candy), chocolate, and dairy.

Types of Pimples: How Acne Progresses
Types of Pimples: How Acne Progresses

Stages of Pimple Development

Stage 1: Clogged Pore (Day 1)

A pimple generally starts with a clogged hair follicle. This may be seen as a blackhead (may also be dark yellow), if it is an open comedo, or a whitehead, if it is a closed comedo. At this stage, the skin may or may not be raised, and there may be some redness around the head as inflammation begins.

Stage 2: Papule (Day 2)

The sebaceous glands around the hair follicle continue to produce sebum, but because the follicle is now plugged, the sebum builds up, pressing on the skin above and against the walls of the follicle. This can be seen as a raised bump that makes the skin feel tight and can be painful to the touch. A bacterial infection is also possible, which would increase inflammation and may lead to the formation of a cyst.

Stage 3: Pustule (Days 2-6)

If the sebum bursts the walls of the hair follicle, the papule may become a pustule. A pustule is filled with a mixture of sebum, cellular debris, white blood cells, and bacteria. The pustule might feel a bit looser than the papule, and it may be tempting to pop the pimple, but resist the urge to do so. Popping a pustule might make the infection worse and actually make the pimple last longer.

Stage 4: Nodule or Cyst (Days 3-7)

If there is a bacterial infection, the pimple may extend deeper into the skin and form a nodule or cyst. These cover a larger area of the skin and can be very painful.

Stage 5: Complete Healing (Days 3-10)

Depending on the severity and the individual, pimples can last anywhere from a few days to over a week. As long as the pimple was left alone, it will rarely result in a scar. The pus will simply drain into the body's filtration system to be discarded, and the pimple will disappear, possibly leaving a bit of discoloration. However, scars can easily form if cysts break the surface of the skin.

Is It Pimples, Herpes, or Razor Burns?

Razor burns also have the symptoms of red skin and itchiness and can also create small bumps that resemble pimples or herpes blisters. Small cuts when shaving the face or the genital region can irritate the skin increase the risk of an infection. This is made worse by the possibility of ingrown hairs. To combat the irritation or infection, the body may respond with inflammation and recruitment of white blood cells, resulting in the formation of small, pus-filled bumps. If you notice these bumps, and you recently shaved, that's most likely what caused them.

As mentioned, the small cuts increase the risk of an infection. Practice good hygiene and disinfect the area immediately after shaving help reduce skin irritation and prevent an infection from occurring.

If You Still Can't Tell

When in doubt, it’s generally best to see your physician. Don't be ashamed. Genital herpes is extremely common. If you have herpes, it is possible to keep it in check, and understanding your options can help you live with the virus.

Other Helpful Tips

  • Time will tell. Herpes occurs in cycles. Take some time to notice what your body is showing you. Pay attention to the herpes blister life cycle and continue to look for any additional symptoms, such as fever or muscle tenderness. If "pimples" with a burning sensation occur in the same area after a period of time, it is probably herpes.
  • Evaluate the location. Do the "pimples" occur near your genitals, rectum, or mouth? Those are all common areas for herpes. Herpes symptoms are usually the same no matter where the virus is found on the body, although the location may impact the seriousness of the symptoms.

Disclaimer

This article is for informational purposes only and is not meant to be used to diagnose. When in doubt, it’s best to see your physician. Don't be ashamed. Genital herpes is extremely common.

References

Albrecht, Mary A, MD. (5 July, 2017). Patient education: Genital herpes (Beyond the Basics). UpToDate.

Bowe, Whitney P., MD, Joshi, Smita S., MD, Shalita, Alan R., MD. (2010). Diet and acne. Journal of the American Academy of Dermatology 63(1): 124-141. https://doi.org/10.1016/j.jaad.2009.07.043

CDC Fact Sheet. (9 Feb, 2017). Genital Herpes.

Craine, Esther. (5 Feb, 2015). Are Those Razor Bumps...Or an STD? Women'sHealth.

Grinde, Bjorn. (2013). Herpesviruses: latency and reactivation — viral strategies and host response. Journal of Oral Microbiology 5(1). doi: 10.3402/jom.v5i0.22766

Looker, K.J., Magaret, A.S., May, M.T., Turner, K.M.E., Vickerman, P., Gottlieb, S.L., Newman, L.M. (2015). Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLOS ONE. https://doi.org/10.1371/journal.pone.0140765

Looker KJ, Magaret AS, Turner KME, Vickerman P, Gottlieb SL, et al. (2015). Global Estimates of Prevalent and Incident Herpes Simplex Virus Type 2 Infections in 2012. PLOS ONE 10(5): e0128615. https://doi.org/10.1371/journal.pone.0128615

Melnik, Bodo C. and Schmitz, Gerd. (2009). Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogensis of acne vulgaris. Experimental Dermatology 18(10): 833-841. https://doi.org/10.1111/j.1600-0625.2009.00924.x

Stanford Children's Health. (n.d.). Acne in Children.

WebMD Staff. (21 September, 2017). What Are Cold Sores? WebMD.

Comments

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    • profile image

      Angel 

      6 months ago

      I have a rash in a cluster with inflammation and it's red but it's not filled with puss also I never had it before it started 1 week ago also I shaved when it started to pop up please help im afraid to let my parents know

    • profile image

      Maria2 

      9 months ago

      My son is 30 years old and got hsv-2 and he dosen't want to live anymore. I am really worrie about it. Please i need an advice.

    • profile image

      Noone 

      13 months ago

      Do any medical professionals answer these

    • profile image

      anon 

      13 months ago

      I'm getting small like pimples in clusters and it has white puss is it for sure a pimple and not herpes

    • profile image

      Anon 

      13 months ago

      Glad to know I don't have herpes

      WITH these descriptions and images, it's definitely acne due to shaving

    • profile image

      Unknown 

      14 months ago

      I had unprotected sex about 12 hours ago. It was in a pool, and I went home and showered afterwards, however about 4 hours ago, before bed, i itched. And about an hour or two after it itched, I noticed a pimple. It's hard to tell if it's a herpes blister. It doesn't burn, just itch. I've tired looking to check for clear liquid stuff as said in the chart above. But still it's hard to tell. Should I be worried? Please help..

    • profile image

      jones 

      14 months ago

      Great article.While many other sites have described the same thing again and again,this article has provided the most important and clarifying information.thanks.

    • profile image

      IDJFIONSDFNJOSDNFJ 

      14 months ago

      DAB ON THE HATERS!!

    • profile image

      nisha 

      14 months ago

      Can I get hsv2 first outbreak after 10 year of infection?

    • profile image

      Gaby1980 

      15 months ago

      Question? I was diagnose with HSV2 and HSV1 and I have noticed i have a pimple in my outer lips (vagina) and I'm so confused because It looks like a pimple and it does not itch or hurt. But i dont know if it can be an outbreak. Can someone help me to answer my question?

    • profile image

      Guest1 

      15 months ago

      The most informative article and described exactly what I've been searching all over the internet for

    • profile image

      vikensh grice 

      16 months ago

      i think i might have herpes but the bisters are all clustered inside my left nostril

    • profile image

      Dee 

      17 months ago

      I have hsv2. Had one sore on my lip they didn't spread or hurt it was just uncomfortable. Doc have mw acyclovir n i take it daily as a suppressive medicine that was last August. I started on acyclovir to avoid the 2 pills a day. Monday I felt a raise under my skin that was slightly tender but not to tgw point I cant touch it. I'm the cuff of my butt. It is now ednesday and it has popped open, the raise under the skin is gone. I have acyclovir cream and i put organic are vinegar on it. I know herpes comes in clusters but my 1st discovery was 1 sore over a year ago and now this. I'm wondering if it's another for its red now that it's busted open, was blood on a napkin when I patted it. Is this an outbreak or?

    • profile image

      bob white 

      20 months ago

      how long does it take to clear up?? Can I take meds to clear it up??

    • profile image

      Sandra 

      20 months ago

      Okay so I shave the vaginal hair because in my mind I want to see if I'm getting an outbreak. Can this cause an outbreak? There's red bumps but it doesn't hurt to pee. Should I wait and see if it's an outbreak or just razor burn/in-grown hair?

    • profile image

      Joyce 

      22 months ago

      Just wondering usually after my periods I get I think pimples they come to a white head I pop them then they are gone by the next day is that herpes or just pimples?

    • prodriver08 profile imageAUTHOR

      prodriver08 

      23 months ago from Houston, TX

      I for one would like no more than to provide a formal answer but how can I based on words alone. It would be totally irresponsible for me to answer this question any further than I have already. If I agree that they are herpes blisters...and they turn out NOT to be then that's bad. If I say...nope...they are not herpes blisters and this person goes out and kisses a baby and spread the virus then that's REALLY bad.

      If you want a definitive answer then you'll need to take decisive steps to find those answers...such as visiting a doctor for a formal test. This article is simply a starting point. Use it and decide for yourself whether or not to seek out a professional opinion and testing.

    • profile image

      Josh Rivers 

      23 months ago

      Hi, I have read Sooooo question above. I have an identical situation, it's IDENTICAL. Will someone please provide a good answer? HSV-2 diagnosed 6 months ago... but the new concern are some pretty questionable oral (wild zits/cold sores) right at the edge of the lip... the pain woke me up last night, it was a pressure type of pain, and it's the second time in a month or so. Never seen these before- really, never... They look red and big, but they pop like regular zits. Very clearly, the content is puss. Much more dense than a liquid- they don't look like oral herpes, they're singular. What is it? What advise is out there for us?

    • profile image

      Soooo 

      23 months ago

      The question above posed by Soooo is identical, I mean, IDENTICAL to what I'm experiencing. Can we get a formal answer?

    • profile image

      anony 

      23 months ago

      You shaved your weiner? Or the pubes around? Likely razor burn. When I shave my neck I sometimes get razor burn and It gets red and rashy looking. Sometimes they'll be an odd larger bump or two on my neck. By product of shaving.

    • profile image

      John 

      23 months ago

      Darker my guess would be that you are safe

    • profile image

      Dareke 

      23 months ago

      I just had sex for the first time and I had asked her if she had anything and she said no cause she had only do e it once before and the dude she did it with I'm pretty sure he didn't get any thing from her or he would of let her know . well a couple of days after I had sex was fine then I shaved the base of my penis a little to hard and the next day I had these little bumps where I did so the looked like pimples so I popes um and there slowly fading away and I also have a few bumped on my but but I usually do get a few pimples on my butt sometimes but I'm still worried there not bunched up or any thing its just 3 small red bumps and their not real close together so does anybody think I have anything?

    • profile image

      In known 

      23 months ago

      I'm not for sure what's these things on my arms it's just on my right arm upper arm so what could that be

    • prodriver08 profile imageAUTHOR

      prodriver08 

      2 years ago from Houston, TX

      Can they be popped? Yes they can. Should they be popped? No they should not. Popping a herpes blister releases a clear liquid that is highly contagious which can easily be spread around the affected area, hands, mouth, etc. It's best to leave them alone and let them heal.

      You don't have to have a cluster of blisters. Many people only experience one blister and sometimes they are so small that they are hard to see.

      I hope that I answered your questions.

      Best of Luck!

    • profile image

      Soooo 

      2 years ago

      Ok so I've tested positive for hsv2 and experienced a mild outbreak in my genital region. Its confirmed. But Lately (last 6 months) I've noticed frequent pimples around my lower lip. Sometimes 1-3 cm away. My question is, can herpes blisters be "popped?" Because they act like pimples but seem to recur more often then I rmemeber. The best i can benignly attribute them to is the fact I'm sitting in front of my computer cupping my mouth my hand for many hours a day. These pimples are red for a few days before clearing. But never develop into "clusters" of a terrible outbreak. Just one at a time month by month....thanks

    • ladyguitarpicker profile image

      stella vadakin 

      2 years ago from 3460NW 50 St Bell, Fl32619

      Great article with lots of important information about herpes and pimples. Thanks, Stella

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