What Does a Black Spot on Your Lip Mean?

What is the dark spot on the lip called?

There’s no one term for a dark spot on your lip—according to 2019 research published in Head and Neck Pathology, this lip discoloration can be a normal physiological occurrence, an abnormal growth (that can be either serious or completely harmless), a reaction to something external, or a sign of an underlying condition or disease. But it’s important to understand the underlying cause, says Susan Massick, MD, a board-certified dermatologist at The Ohio State University Wexner Medical Center. “Dark spots on the lips can be benign and harmless, but there are more serious causes that are critical to recognize when signs can be as subtle as a new discoloration of the lip.”

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What causes a dark spot on the lip?

A spot on your lip could be a simple freckle that you never noticed or the blood vessels in your mouth. These spots grow more visible with age as the skin thins and becomes more subdued, says Tricia Quartey-Sagaille, DMD, FAGD, a practicing general and cosmetic dentist.

“We also see normal moles on the lips, which usually present as uniform brown spots,” adds Catherine Baker, MD, Director of Cutaneous Oncology at Tufts Medical Center. But our experts explain that there’s a range of other possibilities, too. 

Venous lakes

“One of the most common causes of dark spots on the lip that we see are dark, purple-blue spots called venous lakes,” says Dr. Baker. “These are not dangerous and usually occur in older individuals.” According to research published in the International Journal of Surgery, venous lakes typically appear on the lower lip and are associated with sun damage. 

Melanotic macule

“Another common dark spot on the lip we see is a labial melanotic macule, which presents as a dark grey-brown flat spot on the lip,” Dr. Baker says. They’re harmless, caused by hyperpigmentation—an increase in the skin’s melanin production, which produces darker patches. 

Hyperpigmentation

While melanotic macules are one result of hyperpigmentation, there are a few other avenues through which this excess melanin can cause dark spots on the lips. 

Hormonal changes in women, generally related to pregnancy or oral contraceptives, can trigger melasma that may affect the lips, Dr. Massick says. She adds that sun exposure and UV damage are common causes of lentigines or lenitgos, which are hyperpigmentation spots that typically develop on sun-exposed skin areas like your hands, face and lips. 

Irritation

Dr. Quartey-Sagaille says that another common cause of dark-colored spots on the lips is irritation that will go away on its own. This could result from a burn or chapped lips that leave a scar as your lips heal.

You could also experience lip discoloration due to irritant contact or allergic reaction to a product you’re using (or even from a dental filling), according to Dr. Massick. This pigmented contact, cheilitis, is most commonly associated with lip products—which is why it’s a good idea to patch test when using a new product—but research has also shown that some people experience a reaction from green tea due to its nickel content. 

Medications

Change in skin color is a side effect of certain medications—and for some, this can result in a dark spot on your lip, according to Dr. Massick. These medications include chemotherapy drugs, anti-seizure medications, antipsychotics, and some others. Ask your pharmacist if you have questions about the potential side effects of medications you take. 

Smoking

Smoking can cause dark spots on your lips, too, says Dr. Massick. Research has shown that this tobacco-related pigmentation affects about 22% of smokers, and it occurs because the nicotine in tobacco products can activate the cells that produce melanin, potentially as a protective measure against the chemicals in tobacco products. 

Skin cancers

“Melanoma, as well as other skin cancers, can present as dark spots on the lip—or as pink or red spots,” Dr. Baker says. According to the Cleveland Clinic, 86% of melanomas are caused by excessive sun exposure. They’re also the most dangerous type of skin cancer but have a 99% cure rate if they’re caught and treated early. 

Other skin cancers, such as squamous cell carcinoma, can also turn up as a dark spot on your lip. Like melanomas, this is often related to UV damage and chronic sun exposure or a history of blistering sunburns, explains Dr. Massick. 

Peutz-Jeghers syndrome

“Multiple dark spots on the lip and in the mouth—particularly those that occur starting at a young age—can be associated with a genetic syndrome called Peutz-Jeghers syndrome,” says Dr. Baker. This disorder causes polyps to form inside your body, typically in your gastrointestinal (GI) tract, as well as dark spots in areas like your lips, face, hands, and feet. While the spots themselves are benign, Peutz-Jeghers syndrome is associated with a greater risk of cancer.

Certain systemic diseases

“When acquired later in life, multiple new brown spots on the lips and in the mouth can be associated with other systemic conditions,” Dr. Baker explains. She points to Addison’s disease as one example, a rare disorder in which the adrenal glands don’t produce enough of certain hormones. And according to the Cleveland Clinic Journal of Medicine, hyperpigmentation on the lips and gums may be an early sign of the disease. Thyroid diseases—both hypo and hyperthyroidism—can also lead to skin pigment changes on the face, including the lips, adds Dr. Massick.  

Nutrient imbalances

“Vitamin deficiencies, such as vitamin B12, may lead to skin hyperpigmentation, including on the lips,” Dr. Massick says. On the other hand, getting too much of a nutrient—especially iron—can cause dark spots on the lips. Hemochromatosis is a condition that causes the body to absorb and store too much iron, and this excess can turn up as dark splotches on the skin. 

When should I be worried about a dark spot on my lip?

“In general, it’s always a good idea to have any new dark spot that occurs on your lip evaluated by a doctor,” says Dr. Baker. This is especially true for any spots that have an irregular shape, multiple colors, large size, or are painful or bleeding. “In addition, anyone with numerous dark spots on the lip should be evaluated.”

Dr. Massick adds to keep an eye on the changing appearance of a dark spot, especially those that are painful, bleeding, crusting, or not healing. She says to think about these ABCDEs: Asymmetric in appearance, borders that are notched or irregular, color irregularity, darkening in color, and [expanding] size or appearance. “Be aware of these changes and be sure to inform and discuss with a primary care physician or board-certified dermatologist,” she says. “Your dentist may call attention to these oral/lip lesions as well.” 

How to get rid of a dark spot on the lip?

Treatment for a dark spot on your lip depends on its cause. Benign spots like venous lakes are often removed for cosmetic purposes with laser therapy—and hyperpigmentation spots may respond well to laser therapy, too. But in mild cases, the dark spots might just go away on their own. For instance, if the dark spots occur in reaction to an irritant or medication, they should resolve once you stop using that product or taking the medicine (though never stop a medication without your doctor’s guidance). Skincare products like discoloration-correcting serums can also help reduce the appearance of hyperpigmentation spots. 

2022 research published in the Indian Journal of Dermatology also suggests that sun protection can help reverse mild hyperpigmentation spots, including those caused by melasma. Most medications linked with dark spots also cause sun sensitivity, so protecting your skin can reduce the likelihood of darker patches. 

What’s more, even if SPF doesn’t fully remove a dark spot, unprotected sun exposure is known to make hyperpigmentation worse—while also increasing your risk of skin cancer.  “Protect your lips from UV sun exposure like you should with the rest of your skin,” advises Dr. Massick. But keep in mind: “Because we lick our lips and eat and drink throughout the day, you will need to apply and reapply SPF products to the lips.” Keeping your lips hydrated by drinking enough water and using an SPF lip balm can also reduce the appearance of spots and help limit post-inflammatory hyperpigmentation. 

If a dark spot on your lip is a sign of a more serious condition—such as cancer, a genetic syndrome, systemic disease, or nutrient imbalance—you’ll need to work with your doctor to treat the underlying cause itself. While these potentially serious dark spots aren’t as common, you should always have a healthcare professional check out any new or changing spot, Dr. Massick says. 

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