The vermillion of the lips — which is the part that most people refer to when talking about the lips — can range in color from very light pink to brown.

Unlike the rest of your skin, which is made of multiple cellular layers, your lips are only made up of three to five. This makes the tissue thinner and more delicate and allows color from the underlying blood vessels to show through.

The color of your skin also plays a role in the color of your lips. The lighter your skin color, the lighter your lips and the more prominent the blood vessels will appear.

Discolored lips can be the result of a few things that range from harmless, like staining from certain foods or drinks, to an underlying medical condition.

Lips that turn blue may be a sign that there’s not enough oxygen available from the blood stream. Low blood oxygen levels are a medical emergency.

There are several possible causes of lip discoloration and each one can cause your lips to turn a different color. Here’s what certain colors or appearances may indicate:

Blue lips

Poor oxygen circulation in the blood can cause blueish discoloration in the skin, called cyanosis. This can be easily noticed in the tips of the fingers and toes, along with the lips.

Blood changes color depending on the presence of oxygen. Blood rich in oxygen is bright red, while blood with low levels of oxygen is dark red or purple, which shows through your skin and mucus membranes.

Blue lips can be an indicator of decreased oxygen in the blood which can be caused by several conditions affecting the heart, circulatory system, and lungs. Possible causes of blue lips include:

Call 911 or seek emergency medical assistance if you have blue lips that don’t improve after warming up or that are accompanied by gasping for air, chest pain, or dizziness.

White lips

White or pale lips are often accompanied by general paleness affecting the face, lining of the eyes, inside of the mouth, and the nails.

This is usually caused by anemia, which is a low red blood cell count. Anemia that causes pale or white lips is severe and requires immediate medical attention. Any of the following may lead to anemia:

  • a diet low in iron
  • a diet low in vitamin B-12 or folate
  • blood loss from heavy menstrual periods
  • bleeding in the intestinal tract

Another common cause of white lips is oral thrush (oral candidiasis). Candida is an organism that usually exists in low numbers in your mouth.

If an overgrowth of Candida occurs, you end up with oral thrush, which can cause white lesions. Though the lesions usually grow on the tongue or inner cheeks, they can also appear on your inner lips, as well as the roof of your mouth, tonsils, and gums.

Other conditions that may cause pale or white lips include:

Black lips

The following are possible causes of black lips, or hyperpigmentation of the lips:

  • Smoking. Smoking can cause your lips and gums to darken. A 2013 study of smokers found that all of the smokers in the study had lip and gingival pigmentation.
  • Trauma or injury. A bruise can form on one or both lips following an injury. This can cause your lips to be partly or entirely purple or black. Dry, cracked, and severely damaged lips, including burns, can also turn lips dark.
  • Addison’s disease. Addison’s disease occurs when your adrenal gland doesn’t produce enough cortisol and, sometimes, aldosterone. It can cause hyperpigmentation of the skin and lips, causing them to look dark or black on the inside and sometimes the outside.

Spotted lips

Discolored lips can include spotting, too. The causes of spotted lips range from harmless sunspots to spots that are a symptom of a medical condition.

The possible causes include:

Sunspots

Sunspots are dark spots that develop on parts of the body that get the most sun exposure, such as the face and hands.

These spots can also form on the lips and range in color from beige to dark brown. However, it’s important to have any new lip spots checked because there are other conditions, such as skin cancer, that can look similar.

Medications

Certain medications can cause dark spots on your lips, such as cytotoxic drugs used to treat cancer, antipsychotic drugs, such as chlorpromazine, and others.

Hemochromatosis

Hemochromatosis is a disorder in which the body stores too much iron. It affects over 1 million Americans.

Hyperpigmentation of the skin is also a common sign, and some people develop dark gray or brown patches on the skin and lips.

Laugier-Hunziker syndrome

This is a benign skin condition that involves the oral cavity, mainly the lower lip.

It causes brown or black macules on the lips that can range from 1 to 5 millimeters in size. The condition often causes black lines on the nails, as well.

Peutz-Jeghers syndrome

This inherited disorder causes a number of noncancerous growths in the gastrointestinal tract and increases the risk of certain types of cancer.

These spots can affect the lips and mouth, along with the skin around the eyes, nose, hands, and feet. Children with the condition can develop tiny dark spots that may fade with age.

Carney complex

This is a rare disorder, also called LAMB syndrome, which is characterized by an increased risk of different types of tumors. The condition often causes changes in skin pigmentation.

People with the condition have a higher risk of developing noncancerous tumors in the heart and other parts of the body, including the skin around the eyes and lips.

Cancer

Sometimes, a dark spot on the lip can be a cancerous growth, particularly melanoma.

Spots that are new, have an irregular shape or color, increase in size rapidly, bleed, or have a scar-like appearance are considered suspicious and should be evaluated by a doctor.

A sore that doesn’t heal or a growth that appears shiny should also be looked at by a doctor.

Medical treatment for discolored lips may involve treating the underlying condition causing your lip discoloration. If caused by a medication, speak to your doctor about changing to another medication.

Medical treatment for some skin discoloration may include:

Depending on the cause, lip discoloration may be prevented by using at-home skincare solutions. Other tips include:

  • Quit smoking. Quitting is difficult but possible. Speak with a doctor to come up with a smoking cessation plan that’s right for you.
  • Limit sun exposure and wear a lip balm that contains sunscreen.
  • Protect your face and lips from sun exposure with a wide brimmed hat.

It’s a good idea to see your doctor or dentist for any new discoloration or lesions on your lips.

If you or someone else develops blue lips and trouble breathing, call 911 right away.

Discolored lips aren’t always a cause for concern, but any changes to the color of your lips or new spots should be evaluated by your doctor to rule out an underlying medical condition.