Common Causes and Treatment of Black Spots on the Lips

Despite their prominent position on the face, lips often get overlooked when it comes to personal care and grooming. This is why the appearance of black spots on the lips can cause consternation for someone who has never experienced the problem before. This comprehensive guide looks at risk factors that can make you more likely to experience the problem, its likeliest causes and whether it is necessary to see a doctor for treatment.

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What are black spots on the lips?

The term black spots on the lips encompass a whole range of different types of lesions, discolouration or swellings with a dark appearance on the lips.

Risk factors for darkening of the lips

There is no consistent evidence that people fitting a certain demographic class are at a greater risk of developing black spots on the lips. That said, dermatologists have found out that people with certain genetic characteristics or who are exposed to certain occupational or climactic conditions may be at greater risk of developing dark spots on the lips. Of these, variations in the production of melanin and exposure to sun rays are the most common factors.

Variations in melanin production

Melanin is the biological compound responsible for the colour of our skin. It is produced by cells known as melanocytes present in the skin tissue. Sometimes melanocytes end up producing more melanin than normal, and this can lead to the darkening of certain areas on the skin, including your lips.

Exposure to sun rays

Getting the skin of your lips exposed to the rays of the sun for an extended period can cause actual damage to the underlying cells. The damaged cells can then turn black, blue or brown, appearing as spots on the skin. Some of the dark spots on your lips resulting from sun exposure may result from excess melanin production as the skin tries to protect the underlying tissue from sun rays’ damage. It is known that fishermen, for example, are at an increased risk of developing cancer of the skin of the lips due to their prolonged exposure to the sun on repeated days out at sea.

Common causes of black spots on the lips and their treatment options

Common causes of black spots on the lips and their treatment options

Dental treatments or fixtures

Certain forms of dental treatment and fixtures can cause lesions or injury to the lips, leading to the appearance of unsightly dark spots known as Post-Inflammatory Hyperpigmentation (PIH), when skin cells react to damage or irritation by making extra melanin. The most common culprits are dentures, braces and mouthguards. PIH may fade on its own without treatment. However, if necessary, medication and treatment options are available.

Venous lake

The dark spots on your lip may result from a venous lake, a sole, dark compressible papule on the skin surface usually caused by sun exposure. A venous lake may appear ominous at first, but they are not associated with cancer.

It is possible to remove a venous lake using laser therapy. However, it is better to protect your lips and other open areas of your skin from direct sun exposure to avoid the problem altogether.

Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome is a rare disorder related to stomach cancer. It has been traced to a specific gene mutation leading to abnormal cellular growth. Other than the dark spots appearing on the lips and mouth, an individual with Peutz-Jeghers syndrome will exhibit dark spots around the eyes, nose, hands, feet and lower digestive system.

Laugier-Hunziker Syndrome

Laugier-Hunziker Syndrome is a rare skin disorder characterized by the appearance of flat, brown spots on the mucous membranes of the mouth as well as on the lips.

As Laugier-Hunziker Syndrome is not well understood, only a specialist medical practitioner can diagnose it and recommend a workable course of treatment.


Injury to the lips, even what may seem like an innocuous, harmless knock may cause the injured tissue to turn bluish/black. How dark or extensive the black spots end up depends on the extent of the injury as well as how much of the underlying tissue has been damaged.

Vitamin deficiency

Vitamins are essential for healthy spotless skin. The most important vitamin for skin health is vitamin B-12 which ensures you have an even skin tone. Only a qualified doctor or clinician can diagnose the cause of your dark spots as vitamin deficiency. Once that has been confirmed, a diet change to incorporate more vitamin-rich foods may be necessary. Your doctor may also recommend taking multivitamin supplements.

Too much iron

Discolouration of the skin, including on the lips, can result from too much iron intake. The problem can also be a result of a hereditary condition known as hemochromatosis, where the body ends up retaining too much of the iron content in food. Whichever the actual cause of the excess iron, a doctor will recommend the best remedy, whether that is prescription medication or regular blood donation.

Hormone disorder

Certain hormonal deficiencies or imbalances can lead to skin pigmentation, including on the lips. When the levels of thyroid hormone are either too low or too high, hyperpigmentation and dark spots around the mouth can appear. Contact your doctor if you suspect hormonal disorders are to blame for your dark spots on the skin.

Allergic reaction

Certain skincare and cosmetic products may cause the skin on your lips to develop dark pigmentation or lesions as a form of allergic reaction. This may be true even if the products are only applied to the rest of the face and not necessarily on the lips themselves. If you can’t tell which of the products you are using are causing the allergic reaction, start limiting each, and gradually you will identify the culprit.


If your body is starved of hydration, the most adverse effects will be seen on the skin. The skin on your lips will dry up, harden and even crack if you don’t have enough moisture in your body. To reverse the negative effects of dehydration, take adequate amounts of water and avoid too much exposure to sunlight and heat.

When to see a medical professional?

While plenty of instances of dark spots on the lips are nothing to worry about, you should consult a doctor if you witness any unusual or persistent dark spots on the lips. It is only with a proper diagnosis that an effective course of treatment can be prescribed.

Many people are affected by the appearance of dark spots on their lips. While it is usually a problem that has no long-term complications, you should consult your doctor to have it diagnosed and treated as early as possible. Even better, you should take precautions such as a proper diet and adequate water intake to prevent the problem from occurring in the first place.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at its disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.