A dot on the lip can be concerning, but is often harmless. This article clarifies the different appearances of lip dots and outlines when professional medical advice should be sought.
Common Benign Lip Dots
Fordyce spots are a common type of benign lip dot, appearing as enlarged, slightly raised sebaceous (oil) glands on the lips. These spots, typically 1 to 3 millimeters, can be white, yellowish, pale red, or skin-colored. They are usually painless, affect many adults, and are not contagious or associated with any underlying disease.
Freckles or moles can appear on the lips. A freckle on the lip, known as a labial melanotic macule, is a flat, brown to black patch, usually on the central third of the lower lip. These pigmented spots are harmless and result from melanin accumulation due to sun exposure. While typically solitary and stable, any changes should be monitored.
A venous lake is a benign lip dot, appearing as a soft, compressible, dark blue or purple spot, most commonly on the lower lip. These lesions are enlarged veins caused by dilated blood vessels, often linked to long-term sun exposure and more common in individuals over 50. While usually asymptomatic, they may occasionally bleed if injured.
Small blood spots from minor trauma, such as accidentally biting the lip, can appear as temporary dots. When the lip is damaged, tiny blood vessels beneath the skin can break, forming a bruise or small blood blister. These spots appear purple or dark red and usually resolve within a few days as the bruise heals.
Other Appearances of Lip Dots
Cold sores, caused by the herpes simplex virus (HSV), often begin with a tingling, itching, or burning sensation around the lips. A day or two later, a small, painful spot appears. This spot then develops into fluid-filled blisters, often grouped along the lip border, which may merge, burst, and crust over. They typically heal within 7 to 10 days.
Milia are small, white, dome-shaped bumps that form when keratin, a skin protein, becomes trapped beneath the skin’s surface. While most commonly found on the face, milia can appear on the lips, usually measuring 1 to 2 millimeters. These cysts are painless and not itchy, often resolving on their own, though they can persist for months or years.
Mucoceles, also known as oral mucous cysts, are fluid-filled sacs that appear as transparent, bluish, or pink lumps on the inner surface of the mouth, especially the lower lip. These cysts result from trauma, such as lip biting, which damages or blocks a minor salivary gland duct, causing mucus to accumulate. They can range in size from a few millimeters to 3 centimeters and may rupture spontaneously, but can recur if the trauma continues.
Pustules or small pimples can develop on or around the lip line. These blemishes form when hair follicles become clogged with oil, dead skin cells, and bacteria, leading to inflammation. They can appear as small, inflamed red bumps or pus-filled lesions. While similar to acne elsewhere, lip pimples can be particularly painful due to the delicate skin and numerous nerve endings. Factors such as hormonal fluctuations, certain lip care products, poor hygiene, and stress can contribute to their formation.
When to Seek Professional Medical Advice
While many lip dots are harmless, certain signs warrant professional medical evaluation. Consult a healthcare provider if a lip dot changes in size, shape, or color, especially if it darkens or develops irregular borders. Persistent bleeding, oozing, or crusting from the spot should also prompt a medical visit.
Any new or unusual dot on the lip should be assessed by a doctor. This includes spots that cause pain, tenderness, or itching that does not resolve, or open sores that fail to heal within a few weeks. Numbness or tingling sensations in the lip area, particularly if sudden or accompanied by other neurological symptoms, necessitate immediate medical attention. Rapid growth of a lip dot is another warning sign that requires prompt professional assessment.
Diagnostic Steps and Treatment Options
When a lip dot raises concern, a healthcare professional will begin with a physical examination and visual inspection of the lip and surrounding areas. In some cases, a dermoscopy, which involves examining the lesion with a magnified scope, may be used to observe details not visible to the naked eye. If a more serious condition is suspected, a biopsy may be performed, where a small tissue sample is removed for laboratory testing.
Treatment approaches vary widely depending on the diagnosis. For benign conditions like Fordyce spots or small venous lakes, no treatment may be necessary, though cosmetic removal is an option using laser therapy, cryotherapy, or electrosurgery. Cold sores are managed with antiviral medications to shorten outbreaks, while mucoceles often resolve on their own but may require surgical removal, laser treatment, or cryotherapy if persistent or large. If a lip dot is diagnosed as cancerous, treatment typically involves surgical excision, which may be followed by radiation therapy or chemotherapy, depending on the cancer’s type and stage. Seeking professional advice for any concerning changes ensures an accurate diagnosis and appropriate management.