Melanotic macule refers to a well-defined, pigmented, black or brown, oval, and flat spot or patch on the lips. It is non-malignant and usually appears on the lower lip, but can also form on the upper lip. Melanotic macule can also occur inside the oral cavity; on the roof of mouth, the gums, inner cheeks, or on the hard or soft palate. Sometimes, it may appear in the genital region. Other names for melanotic macule are freckle on lip and labial melanotic macule.
Melanotic macule can affect people of all ages, genders, and races. However, it is more common in females, dark-skinned people, and middle-aged individuals. The global incidence rate of the condition is about 3 percent of world population.
Melanotic macule is harmless and treatment is not required as long as the macule remains stable in shape, size, and color. Some patients may have the macule removed for cosmetic reasons.
Symptoms of melanotic macule
Some of the signs and symptoms of melanotic maculae are listed below:
- Melanotic macule usually appears as a single, non-itching, flat, dark spot on the lower lip. It is constant and does not come and go; nor does it change color or fade with time.
- The border of the dark patch on lips is well-defined.
- It has a dark brown or black hue; the color of the macule is usually darker than the surrounding adjacent tissue.
- There is no pain
- Melanotic macule may also appear on the upper lip, gums, roof of mouth, inner cheeks, penis of men (also called penile lentigo or penile melanotic macule), and vulva of women (also called vulval melanosis or vulval labial melanotic macules)
- The macule size is small and is usually never bigger than 7 mm diametrically
- It usually occurs as a solitary skin defect, but may also occur in multiples
- It is more common in adult women, but can also appear in younger people and males.
Causes of melanotic macule
Melanotic macule may occur due to a variety of causes. A few common causes are listed below:
- A newborn may be born with a melanotic macule. It can also occur later in early infancy. Melanotic macule during early childhood is common in dark-skinned people.
- Development of the lesion in children is often due to their race
- Response or reactions to smoking, chronic exposure to sunlight, certain medicines, or other environmental factors can trigger hyperpigmentation of skin and result in development of darkened patch or spot.
- The lesion may also be an adverse effect of acne
- Melanotic macule may be indicative of preexisting disorders such as Addison’s disease
Treatment of melanotic macule
Melanotic macule is a harmless benign condition. It is usually asymptomatic and does not cause any severe signs or symptoms. Hence, treatment is not required.
- If there are any changes in the color, texture, size, or shape of the lesion, then it can be a cause of worry. In such cases, patients need to immediately consult a doctor. A skin biopsy is then ordered by the doctor to verify whether the dark spot is melanotic macule or a symptom of some other type of precancerous or malignant medical disorder.
- If melanotic macule on a woman’s lips is small and light hued, then it can be easily covered by application of lipstick.
- Removal of the lesion may cause a depression in tissue or leave a tiny scar which may or may not be easily visible.
- If the melanotic macule is big or irregularly shaped, then removing it can leave noticeable signs.
- Removal of the dark patch may heal well in some patients and there may be minimal or nil scarring or depression on tissue.
Patients who want to remove a melanotic macule for cosmetic purposes may do so in the following ways:
- Cryotherapy, wherein liquid nitrogen is used to freeze and remove the lesion
- Excision, wherein the dark spot is surgically removed. It usually causes scarring
- Intense pulsed light therapy; it is a type of laser therapy but is rarely used for removal of melanotic macule
Prevention of melanotic macule
If melanotic macule is not a congenital condition, then the below listed self-care guidelines can help prevent development of the lesion:
- Use lip balm with SPF of at least 30, especially before venturing outdoors. Lip balm will be of no help after the formation of melanotic macule; it will neither reduce the color or size nor make the macule disappear.
- Avoid going outside between 10 am to 2 pm, when the sun is at its brightest.
- Wear/use other sun-protective measures like sunglasses, hats, long-sleeved shirts or tops, pants, etc.
- Eat a healthy balanced diet full of nutrients, quit smoking, and exercise regularly
