Clinical Challenge: Dark Lesion on Lower Lip MPR What Caused These Multiple Hyperpigmented Macules of the Mouth? A Fast Growing Black Patch on the Upper Front Gum: Malignant Melanoma Springer Nature Link Lip Pigmentation Treatment in Singapore Spotty lips. These are labial melanotic macules, kinda like freckles on the lips. They are mostly due to age and sun exposure, but sometimes they run in families and are associated with Labial Macules: Dark Spots on the Lip Dermatology Advisor