Darkness around the mouth, medically termed perioral hyperpigmentation, is a common skin concern involving increased pigment in the skin surrounding the lips. This discoloration can appear as patches or a distinct shadow, impacting an individual’s appearance. It arises from an overproduction of melanin, the natural pigment that determines skin color. While generally not harmful, it can be a source of self-consciousness for many.
Common Causes of Darkness Around the Mouth
Excess melanin production is a primary factor in perioral hyperpigmentation, manifesting in several ways. Post-inflammatory hyperpigmentation (PIH) frequently causes darkened skin after an injury or inflammation, such as from acne, eczema, or perioral dermatitis. This type of discoloration can also result from irritation due to constant lip licking or contact dermatitis from lip balms and toothpastes.
Melasma, another form of hyperpigmentation, often presents as brown or grayish patches, commonly triggered by hormonal fluctuations, particularly during pregnancy or with the use of birth control pills. Sun exposure significantly worsens melasma and other forms of hyperpigmentation, as ultraviolet (UV) radiation stimulates melanocytes, the cells responsible for melanin production, to produce more pigment.
Dryness and dehydration can also contribute to a darker, duller appearance of the skin around the mouth. When the skin lacks moisture, it can become flaky and rough, making existing pigmentation more noticeable. Environmental factors, insufficient water intake, or a compromised skin barrier can lead to this dryness.
Irritation and allergic reactions in the perioral region are additional causes. The skin around the mouth is susceptible to allergens from food, saliva, cosmetics, and certain toothpastes. For instance, ingredients like sodium lauryl sulfate (SLS) and flavorings such as spearmint or peppermint in toothpaste can cause irritant or allergic contact dermatitis, leading to inflammation and subsequent darkening.
Underlying medical conditions can also manifest as perioral darkening. Acanthosis nigricans, characterized by dark, velvety, and thickened skin, often appears in body folds but can affect the perioral region and is frequently associated with insulin resistance or diabetes. Addison’s disease, a rare adrenal gland disorder, can cause diffuse skin hyperpigmentation, including around the mouth, due to increased levels of adrenocorticotropic hormone (ACTH) stimulating melanin production. Certain vitamin deficiencies, particularly low levels of vitamins B12 and D, have also been linked to hyperpigmentation.
Lifestyle factors, such as smoking, contribute to perioral darkness. Nicotine in tobacco products can constrict blood vessels, reducing oxygen and nutrient flow to the skin, while also stimulating melanin production in the lips and gums. Additionally, some medications, including certain antibiotics (like minocycline), antimalarials (like chloroquine), and chemotherapy agents, can induce pigmentation changes in the skin and oral mucosa.
When to Consult a Doctor
Seeking professional medical evaluation is advisable if darkness around the mouth appears suddenly or changes rapidly. If the discoloration is accompanied by other symptoms, such as itching, pain, rashes, unusual fatigue, or unexplained weight changes, it could indicate an underlying medical condition requiring diagnosis and treatment.
Consulting a healthcare provider is also recommended if the perioral darkening does not improve with over-the-counter remedies or lifestyle adjustments. A doctor or dermatologist can accurately diagnose the cause of the hyperpigmentation, which is a necessary first step for effective management.
Approaches to Management
Managing darkness around the mouth often involves a combination of consistent skincare practices and targeted treatments. Sun protection is an important step, requiring daily application of broad-spectrum sunscreen with an SPF of 30 or greater to shield against UVA and UVB rays, which can trigger and worsen pigmentation. Gentle cleansing and consistent moisturizing help maintain a healthy skin barrier, reducing irritation and dryness that can exacerbate darkening.
Topical treatments can help reduce hyperpigmentation. Over-the-counter ingredients like niacinamide, vitamin C, alpha arbutin, and azelaic acid work by inhibiting melanin production or promoting cell turnover. Stronger agents, such as hydroquinone and retinoids (e.g., tretinoin), are also used to lighten dark patches and promote skin renewal, but these require a prescription due to their potency and potential for irritation.
Addressing any identified underlying causes is important for long-term improvement. For example, managing insulin resistance if acanthosis nigricans is present, identifying and avoiding irritating products (like certain toothpastes or cosmetics), or quitting smoking can significantly improve skin appearance. These measures help to stop the source of inflammation or pigment stimulation.
For more stubborn cases, dermatologists may recommend professional procedures. Chemical peels, using acids like glycolic or salicylic acid, exfoliate the top layers of the skin to reduce discoloration and promote cell turnover. Laser therapy can precisely target melanin particles in the skin, breaking them down to lighten dark spots and improve skin texture. These professional treatments are performed by dermatologists and are tailored to the specific type and severity of pigmentation.