Can oral herpes start out underneath your skin above the upper lip , like a little cystic pimple?

Yes: Most lesion on edge if lip are cold sores. They a vesicles(fluid filled bumps) that will rupture to open ulcers. However, you can have them in or near nose and other skin lesions. There are several other skin lesions from causes other than herpes virus. See dentist or dermatologist.

Yes: Herpes has what is called a prodrome period or a period of mild discomfort before a full outbreak occurs. This is when prescription Acyclovir is most effective and can prevent the full outbreak. If you see your dentist or physician right away, they will generally give you a prescription to take now with refills to use during future onsets - but they need to see it to diagnose it correctly.