How to Tell Eczema On the Lips from a Cold Sore

Although eczema and cold sores are different conditions, you should see a physician or dermatologist if this is your first experience with either.

One of the most sensitive parts of our bodies is our lips, as you probably already know if you've ever had chapped lips from the bitter cold or from licking them too much. Furthermore, not much needs to happen for them to get chapped, irritated, inflamed, or worse.

These symptoms are also frequently brought on by certain medical diseases; eczema and cold sores are two examples. Lip sores and inflammation can be caused by both eczema and cold sores; however, despite their similar appearances, each condition has different symptoms and treatments.

We'll talk about how to tell if you have a cold sore or eczema on your lips, what treatments you can try for each, and when visiting a doctor is necessary.

The difference between eczema on the lips and a cold sore

Atopic dermatitis, another name for eczema, is a widespread, long-lasting, inflammatory skin disease that can affect both adults and children. Patches of dry, itchy, inflammatory, and discoloured skin are the usual appearance of eczema; occasionally, it can result in cracked skin, fluid-filled bumps, and open sores.

When someone has eczema or is reacting to allergies or irritants, they may develop eczematous cheilitis, or eczema on the lips:
  • Irritant contact cheilitis is the term used to describe eczematous cheilitis brought on by an irritant, such as lip-licking, cosmetics, or other materials that irritate the lips.
  • Allergy contact cheilitis is the term used to describe eczematous cheilitis caused by an allergic reaction to allergen exposure.
The herpes simplex virus (HSV) is the source of painful, fluid-filled blisters on the lips that are referred to as cold sores or herpes labialis. Although HSV type 2 can sometimes produce cold sores, HSV type 1 is the most frequent cause of them.

Symptoms of eczema vs. cold sores

Both lip eczema and cold sores, particularly in cases of severe eczema, are characterised by red, discoloured, itchy skin and lip sores. However, these illnesses differ slightly in how they seem and feel.
  • Your lips can have eczema if they have dry, scaly, cracked, itchy, red, or discoloured skin. In rare instances, lip eczema may also penetrate your mouth, however, it usually affects the skin that surrounds or borders your lips.
  • The first signs of a cold sore on your lips or mouth are closed blisters filled with fluid that is encircled by skin that is itchy, red, or discoloured. The cold sores eventually break open and start to leak fluid, which eventually dries up and scabs over before healing completely.
An important distinction between these two illnesses that can aid in diagnosis is the nature of the initial symptoms.

A tingling, burning feeling is frequently experienced in the lip's afflicted area approximately 24 hours before the blistering. Even with therapy, a blister usually develops soon after a cold sore onset, however, certain drugs can lessen its intensity.

Even in the absence of a blister or sore, eczema causes simultaneous itching, drying, and discolouration. Cold sores almost invariably result in blisters or sores, even in cases of eczematous cheilitis that are not treated.

When to see a doctor

See a doctor to discuss your concerns if you've seen any new sores or rashes, or any other changes to the skin around your lips and mouth.

These symptoms can occasionally be signs of an underlying disease, even if they can also be caused by eczema or cold sores. A physician can provide you with an accurate diagnosis and immediate treatment by using appropriate testing.

Treating eczema vs. a cold sore

Although there is no known treatment for cold sores or eczema, it is possible to manage symptoms and stop breakouts and flare-ups.

Lip eczema treatment

Eczema is typically treated with a variety of methods to assist manage the condition's current symptoms and lower the likelihood of relapses in the future.

Topical and prescription drugs can help keep the symptoms of eczematous cheilitis from getting worse. Corticosteroids, emollients and moisturisers, and injectable or oral anti-inflammatory drugs are some of the best solutions.

Wet wrapping and phototherapy are two further therapeutic options that may help lessen the symptoms of severe eczema flare-ups. Another critical step in preventing flare-ups of eczema or eczematous cheilitis is identifying and avoiding triggers.

Cold sore treatment

It needs a multifaceted approach to treat and manage cold sores, beginning with treating the symptoms as soon as they start to tingle:
  • Stage 1: Certain oral and topical treatments can help lessen the length and intensity of an outbreak during the tingling phase. Daily use of oral antiviral drugs can also lessen the likelihood that outbreaks will occur in the future.
  • Stage 2: Analgesic drugs may be useful in easing the discomfort and swelling associated with a cold sore blister. It's also critical to drink plenty of water, wash your hands frequently, and refrain from oral sex and kissing.
  • Stage 3: Medication and cool or warm compresses can help relieve pain as the blister opens and starts to drip. It's critical to wash your hands frequently and steer clear of close contact at this stage of the sore because it's the most infectious.
  • Stage 4: The cold sore starts to crust over and start to heal not long after the weeping period. Remind yourself not to pick at or exacerbate the freshly developed crust, and keep applying compresses and painkillers as needed.
  • Stage 5: The yellow or brown crust eventually solidifies and forms a scab that peels off on its own as the cold sore heals. Picking or pealing off this scab could cause damage to your skin and create a scar, so avoid doing so.

Other possibilities

Other illnesses besides eczema and cold sores can alter the skin around your mouth or result in lip sores. Other illnesses that could also present with the same symptoms include:
  • eczema herpeticum
  • oral candidiasis
  • hand, foot, and mouth disease
  • infectious mononucleosis
  • sexually transmitted infections
  • severe acne breakouts


Cold sores and eczema on the lips might resemble one other first, creating blisters, lesions, and red, stinging, and irritated skin.

But whereas cold sores might take several days to appear and worsen, the earliest signs of eczema usually appear all at once. Furthermore, cold sores almost usually result in painful, fluid-filled blisters, although eczema does not necessarily present with blisters and sores.

See a doctor if you experience any new symptoms that you haven't had previously, even if you already have eczema and cold sores.

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