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Melanotic Macule

Last reviewed by Dr. Raj MD on January 12th, 2022.

What is Melanotic Macule?

This medical condition is a dark spot that is usually found on your lips, usually the bottom one but can appear on the top lip also. It can even be found on the inside of your mouth, gums, called gingiva, the roof your mouth on the soft or hard palate, or inner cheek called buccal mucosa. It has also been found on the genital areas. A melanotic macule is normally benign, which means it is not cancerous. Another name for this medical condition is labial melanotic macule and it is sometimes referred to as a freckle on the lip. Although it can appear at any age in either sex, race, or gender, it is most commonly found in people who are dark skinned and in their middle ages and are female. It occurs in approximately three percent of the population of the world.

Melanotic Macule Symptoms

Having a melanotic macule does not cause any symptoms but when you see one it is usually smaller than seven millimeters in diameter. The lesions will usually appear as a flat non-itchy rash on the lip with a color that is uniform and has a border that is well-defined. Although most of the time they are solitary lesions there can be more than one. The color of the lesion is normally darker than the tissue that surrounds it.

Melanotic Macule Causes

There is a variety of causes for a person to have a melanotic macule. Some of those causes can include:

  • Being born with one or having it appear in early childhood, which is common for people who have dark skin.
  • A response to environmental stress such as persistent exposure to the sun, smoking, or taking a medication that can cause your skin to darken or spot, called hyperpigmentation.
  • It could be an indicator of an underlying medical condition like Addison’s disease.
  • If a child has one it is usually because of their race.
  • It may be caused by acne.


If the melanotic macule begins to change in texture, color, or shape it may be a cause for concern and should be check by either your physician or dermatologist. To make sure what type of treatment is needed, if any, they will usually do a skin biopsy to confirm if it is melanotic macule or another medical condition that could be precancerous or cancerous. If the melanotic macule is removed it can create a small scar or depression in the tissue which may or may not be noticeable. If it is irregular in shape or big it could be noticeable if removed. In some people, if they opt to have it removed the tissue may heal well and leave little or no depression or scar.

As most melanotic macule is benign for women they may be able to hide them under makeup if they are light in color and small enough so they do not attract any attention. For most of the melanotic macule your dermatologist or physician will observe it over time to make sure that it does not change in shape, color, or texture and will not remove it and it will not need any treatment. If a person decides that they do want them removed this can be done by:

  • Cryotherapy – this is when the dermatologist or physician uses liquid nitrogen and sprays it on the melanotic macule to freeze it.
  • Intense pulsed light therapy which is a form of laser therapy
  • Excision but using this form of removal will leave you a scar.

Melanotic Macule Pictures

Pictures collection of the condition Melanotic Macule…

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