Spot on the lip: acne or cold sore?

A spot on the lip can be confusing. How can you tell whether it is a spot, a cold sore or another skin irritation? Why has this spot appeared in the centre (or on the edge) of the lip? Should you be concerned if it is red, painful or filled with fluid? How long will it last? 

First and foremost, it is important to correctly identify the cause of this spot. It is best to seek advice from a healthcare professional, but in the meantime, here is some information to help you tell the difference between a spot and a cold sore. 

In this article, discover all the essential information about acne spots on the lips.

In terms of appearance:  

• A spot on the lip can be a whitehead or a red spot, often located around the mouth⁽¹⁾. 
• A cold sore (or herpes labialis), on the other hand, looks like small blisters filled with fluid, often clustered around the edge of the lips⁽²⁾. 

In terms of sensations:

• A spot on the lip can be painful, but without warning signs.
• A cold sore, on the other hand, begins with tingling, burning or itching.

In terms of the development of acne or cold sores:  

• A spot on the lip remains localised and may develop into a pustule (red spot with white pus). It may last a few days, but the spot usually disappears without leaving a mark if you do not touch it⁽¹⁾.
• A cold sore, on the other hand, follows a specific cycle⁽²⁾: appearance of blisters filled with clear fluid, bursting of the blisters, formation of a scab, then healing. This develops over several days, with frequent recurrences during periods of stress, exposure to sunlight or severe fatigue (with a decrease in the body's defences). Be careful, cold sores are highly contagious!

Recognising a spot on your lip

A spot on the lip may look like a whitehead (closed comedone) or a red spot that may be painful.
These acne spots on the lip may appear around the mouth, on the lip contour. However, unlike cold sores, they do not itch before they appear and do not form blisters. 
If you have acne spots on your lips, it is likely that you also have acne spots on other areas of your face (forehead, nose, chin, etc.)⁽¹⁾.

• A spot on the lip forms due to the blockage of a pore located at the edge of the lips, mainly due to excess sebum and a build-up of dead skin cells. Several factors contribute to this condition, including a hormonal imbalance and genetic predisposition⁽¹⁾...
• A cold sore⁽²⁾ is caused by the herpes simplex virus (HSV-1). Once contracted, this virus remains dormant in the body and is reactivated by several triggers, such as stress, fatigue, prolonged exposure to the sun, or direct contact with a person carrying the virus⁽³⁾. Indeed, cold sores are highly contagious!

Certain ingredients contained in cosmetic products can also cause skin reactions with the rapid appearance (after contact) of spots on the lip, accompanied by swelling and/or itching. This may be due to fragrances, preservatives, or colourings present in make-up products, lipsticks, toothpastes, or foodstuffs. 

If you develop spots on your lip, always seek medical advice to obtain the correct diagnosis and appropriate treatment.

Treatments and advice for acne spots on the lip

While waiting to consult with your dermatologist, here are some initial tips on the skincare routine to adopt if you have acne spots on your lips⁽⁴⁾:

1. Thoroughly cleanse your face and the area around your lips, morning and evening, with a purifying foaming gel suitable for acne-prone skin (soap-free and non-comedogenic).
2. Apply a moisturising anti-blemish serum that contains keratolytic and sebum-regulating active ingredients (glycolic acid, azelaic acid, etc.) to the entire face and the acne spot (lip).
3. If you wear make-up, ensure that the products are non-comedogenic, suitable for sensitive skin, and formulated with a minimum of ingredients.
4. Avoid touching or squeezing the spot.
5. Protect your skin from the sun throughout the healing process. 

In the event of a cold sore (herpes labialis), it is recommended to use a local antiviral treatment as soon as the first tingling sensation appears and to avoid direct contact to limit contagion. Ask your pharmacist for advice.