Is this cause for concern?
Whether you’re dealing with slight discoloration, flaky patches, or dark, raised moles, you shouldn’t ignore spots on your lips. After all, the health of your skin reflects the health of your body.
Although dark spots usually aren’t cause for concern, it’s important to get a diagnosis from your doctor. They can check for any underlying conditions and ensure that nothing is amiss.
Keep reading to learn more about what may be causing these spots and what you can expect from treatment.
1. Angiokeratoma of Fordyce
Dark or black spots on lips are often caused by angiokeratoma of Fordyce. Although they can vary in color, size, and shape, they’re usually dark red to black and wart-like.
These spots are typically harmless. They can be found on any mucous-producing skin, not just lips. Angiokeratomas usually occur in older people.
Angiokeratomas can usually be left alone. However, they may look similar to cancerous growths, so you should visit your doctor or dermatologist to get a diagnosis. They can confirm whether these spots are angiokeratomas and advise you on any next steps.
2. Allergic reaction
If you’ve used a new product lately, an allergic reaction may be to blame for your spots. This type of reaction is known as pigmented contact cheilitis.
The most common causes of cheilitis are:
- lipstick or lip balm
- hair dye, if applied to facial hair
- green tea, which may contain nickel, an irritant
If you think an allergic reaction has caused your dark spots, throw the product away. Make sure your beauty products are fresh and have been kept in a cool, dark place. Old products can break down or grow bacteria or mold — and be more likely to cause a reaction.
Melasma is a common condition that can cause brownish patches to appear on your face.
These spots usually form on the following areas:
- nose bridge
- area above your upper lip
You can also get them on other places exposed to the sun, like your forearms and shoulders.
Melasma is more common in women than men, and hormones play a role in its development. In fact, these patches are so common during pregnancy that the condition is called “mask of pregnancy.”
You can prevent melasma from getting worse by protecting yourself from the sun. Wear sunscreen and a wide-brimmed hat.
Melasma may fade with time. Your dermatologist can also prescribe medicines that you smooth on your skin to help lighten the spots.
- hydroquinone (Obagi Elastiderm)
- tretinoin (Refissa)
- azelaic acid
- kojic acid
If the spots on your lips feel scaly or crusty, you may have what’s called actinic keratosis, or sunspots.
These spots can have the following characteristics:
- tiny or more than an inch across
- the same color as your skin or tan, pink, red, or brown
- dry, rough, and crusty
- flat or raised
You may feel the spots more than you can see them.
In addition to your lips, you’re most likely to get keratoses on sun-exposed areas like your:
Because actinic keratoses are considered a precancer, it’s important to have your doctor look at the spots. Not all keratoses are active, so they don’t all need to be removed. Your doctor will decide how best to treat them based on their exam of the lesions.
Treatment may include:
- freezing spots off (cryosurgery)
- scraping or cutting spots off (curettage)
- chemical peels
- topical creams
Not drinking enough liquids or being out in the sun and wind can leave your lips dry and chapped. Chapped lips can start to peel, and you may bite off little pieces of skin. These injuries can lead to scabs, scars, and dark spots on your lips.
Make sure to drink at least eight glasses of water every day. If you’re out in the sun or wind, protect your lips with lip balm that contains sunscreen, and avoid licking your lips. Once you’ve rehydrated yourself, your lips should heal and the dark spots fade with time.
6. Too much iron
If you have a condition called hereditary hemochromatosis, your body absorbs too much iron from the food you eat and stores it in your organs. This can result in symptoms like discolored skin.
Your body can also be overloaded with iron if you:
- have received numerous blood transfusions
- get iron shots
- take a lot of iron supplements
This type of iron overload can also cause your skin to take on a bronze or gray-green tone.
To reduce the iron in your blood and organs, your doctor may drain some of your blood (a procedure known as a phlebotomy) or have you donate blood on a regular basis. They may also prescribe medication to help remove the iron.
7. Vitamin B-12 deficiency
If you don’t get enough vitamin B-12 in your diet or through supplements, your skin may become dark. This could potentially show up as dark spots on your lips.
A mild B-12 deficiency can be corrected with a daily multivitamin or by eating foods that contain a lot of this vitamin. A severe B-12 deficiency may be treated with weekly injections or daily high-dose pills.
8. Certain medications
Some medicines you take can cause changes to the color of your skin, including the skin on your lips.
These medicine types include:
- antipsychotics, including chlorpromazine and related phenothiazines
- anticonvulsants, such as phenytoin (Phenytek)
- cytotoxic drugs
- amiodarone (Nexterone)
You can check with your pharmacist if you have questions about a specific drug you take.
Most medicine-related changes to skin color are harmless. If you and your doctor decide you can stop taking the drug, the spots will probably fade — but not in all cases.
Many drugs that cause skin pigment problems also cause sun sensitivity, so make sure you apply sunscreen daily.
9. Dental treatments or fixtures
If your braces, mouth guard, or dentures don’t fit well, you may get pressure sores on your gums or lips. These sores can cause what’s called post-inflammatory pigmentation — dark spots left behind after the sore has healed.
These usually occur in people with darker skin types. The patches can get darker if exposed to sunlight.
If your braces or dentures don’t fit well, go to your dentist or orthodontist. Your dental fixtures shouldn’t cause sores.
Wear lip balm with sunscreen so the spots won’t get darker. Your dermatologist can also prescribe creams or lotions to lighten the lesions.
10. Hormone disorders
Low levels of circulating thyroid hormone (hypothyroidism) can cause melasma, which is a blotchy brown pigmentation on the face. High levels of thyroid hormone (hyperthyroidism) can also cause your skin to darken.
To treat the skin discoloration caused by imbalanced hormones, you’ll need to fix the root problem. Your doctor will be able to talk through your symptoms and advise you on next steps.
The heat from cigarettes can directly burn the skin on your lips. And because smoking delays wound healing, these burns could form scars. The burns may also lead to post-inflammatory pigmentation, which are dark spots left behind after the sore has healed.
Quitting smoking is the only way to allow your lips to heal properly. Talk to your doctor about your options for cessation, as well as any lightening creams that you may be able to use.
Is it cancer?
The lips are an often overlooked site for skin cancers. The two most common skin cancers are basal cell carcinoma and squamous cell carcinoma. These are usually seen in fair-skinned men over the age of 50. Men are 3 to 13 times more likely to develop lip cancers than women, and the lower lip is about 12 times more likely to be affected.
Here’s what to look for if you think the spots on your lips may be cancer:
With basal cell carcinoma:
- an open sore
- a reddish patch or irritated area
- a shiny bump
- a pink growth
- a scar-like area
With squamous cell carcinoma:
- a scaly red patch
- an elevated growth
- an open sore
- a wart-like growth, which may or may not bleed
Most lip cancers are easily noticed and treated. The most common treatments include surgery, radiation, and cryotherapy. When found early, nearly 100 percent of lip cancers are cured.
When to see your doctor
If you’re not sure how you got a black, discolored, or scaly spot on your lip, do see your doctor. It may be nothing, but it doesn’t hurt to check.
You should definitely see your doctor if the spot:
- is spreading rapidly
- is itchy, red, tender, or bleeds
- has an irregular border
- has an unusual combination of colors