Dark spots on the lips can often cause concern. Among these, labial lentigo is a common type of pigmented spot. While any new or changing mark on the skin, especially on the lips, warrants careful attention, labial lentigo is generally a benign condition. This article explores the characteristics of labial lentigo and how it differs from more concerning lesions, such as melanoma.
Understanding Labial Lentigo
Labial lentigo is a flat, benign pigmented spot typically appearing on the lips. It is often described as a “freckle of the lip” because it results from increased melanin production rather than an increase in melanocytes. These spots are usually well-defined, with an oval or round shape, and their color can vary from light brown to dark brown, black, or even blue.
They are generally small, often measuring less than 6 millimeters, though sizes can range from 1 to 8 millimeters. While most commonly appearing on the central lower lip, they can also be found on the upper lip. Once developed, these lesions typically remain stable in size and color.
Distinguishing Labial Lentigo from Melanoma
A primary concern with any new or changing pigmented spot on the lips is the possibility of melanoma, a serious skin cancer. While labial lentigo is a benign lesion, mucosal melanoma can occur on the lips, although rare. Understanding the differences in appearance is helpful, using criteria summarized by the “ABCDEs” for pigmented lesions.
Labial lentigos typically contrast with melanoma. They are usually symmetrical, with one half mirroring the other. Their borders are generally regular and well-defined, and the color within the spot is uniform.
In contrast, melanoma lesions often display asymmetry, where one half does not match the other. Melanoma borders can be irregular, notched, or poorly defined. Color variability is another warning sign, with melanoma often showing multiple shades of brown, black, red, white, or blue within a single lesion. While melanomas can be smaller, they are often larger than 6 millimeters when diagnosed. Melanoma lesions tend to evolve, changing in size, shape, color, or texture over time.
When to Seek Medical Evaluation
While labial lentigos are generally harmless, any pigmented spot on the lip that changes or causes concern should be evaluated by a dermatologist. Seek medical advice if a lip spot exhibits any ABCDE warning signs, including changes in symmetry, border regularity, or color uniformity. Other indications for evaluation include rapid growth or a significant change in size. New symptoms associated with the spot, such as bleeding, itching, pain, or the appearance of a lump or bump, also warrant prompt medical attention. Early detection of melanoma improves treatment outcomes, underscoring the importance of professional assessment for any suspicious or evolving lesion.
Diagnosis and Management
When a pigmented spot on the lip is evaluated, a dermatologist typically begins with a visual examination. They may use a dermatoscope, a handheld magnifying device, for a more detailed view of the lesion’s structure and pigment patterns. If malignancy is suspected based on clinical or dermoscopic findings, a biopsy is often performed.
A biopsy involves taking a small tissue sample from the lesion, sent to a laboratory for microscopic examination by a dermatopathologist. This histological analysis definitively diagnoses the spot, confirming whether it is a benign labial lentigo or a melanoma. For confirmed labial lentigo, no medical treatment is usually necessary. However, if cosmetic concerns arise, removal options like laser therapy or cryotherapy may be considered. If the biopsy reveals melanoma, treatment typically involves surgical removal of the cancerous tissue, with further interventions depending on the stage and type.