Finding a black dot on your lip can be concerning. While many are harmless, some indicate conditions requiring medical attention. This article provides general information about causes of black dots on the lip and is not a substitute for professional medical advice.
Common Benign Causes
Many black dots on the lip are benign. A common type is a labial melanotic macule, a freckle-like spot on the lip. These are typically flat, brown to black, oval-shaped patches that remain stable in size and color. They are thought to be provoked by sun exposure.
Blood blisters can also appear as dark spots. These form when blood vessels rupture, trapping blood. Minor trauma, such as biting the lip or consuming hot food, can cause them. Venous lakes, vascular lesions, are soft, compressible dark blue to purple spots, often on the lower lip, associated with sun damage.
Fordyce spots are small, visible sebaceous glands on the lips. While typically yellowish or white, they can sometimes appear darker. These are normal variations. Post-inflammatory hyperpigmentation can also result in dark spots after skin irritation, injury, or inflammation, such as from chapped lips or cold sores.
Amalgam tattoos are benign discolorations from dental filling material embedded in tissue. They appear as blue, black, or gray spots.
Potential Serious Causes
Some dark spots on the lip can signal serious conditions. Melanoma, a type of skin cancer, can affect the lips. Oral melanoma can manifest as dark spots or irregular areas in the mouth and lips.
The ABCDE criteria are used to evaluate pigmented lesions for melanoma:
Asymmetry: One half of the spot does not match the other.
Border irregularity: Edges are ragged, notched, or blurred.
Color variation: Uneven colors or shades of brown, black, tan, white, red, or blue within the same spot.
Diameter: Melanomas are typically larger than 6 millimeters.
Evolving: The mole is changing in size, shape, color, or elevation, or if it starts to bleed, itch, or scab.
Other oral cancers, such as squamous cell carcinoma and basal cell carcinoma, can also affect the lips. Squamous cell carcinoma is the most common type of lip cancer, often appearing as a non-healing sore or discolored patch. Basal cell carcinoma can appear as a crusty spot that does not heal, sometimes mistaken for chapped lips or cold sores. While these cancers may not always present as a distinct black dot, pigmented variants or associated changes like bleeding can make them appear dark.
When to Consult a Doctor
Consult a healthcare professional for any new black spot on the lip or any existing spot that causes concern. A spot that changes in size, shape, color, or elevation warrants medical evaluation.
Seek medical attention if a lip spot bleeds, scabs, itches, or causes pain. Spots with irregular borders, asymmetry, or multiple colors require prompt assessment. Early diagnosis of lip cancers is important as they are often curable when detected and treated early.
How a Doctor Diagnoses and Manages
A healthcare professional will visually examine the black dot on the lip. A dermatoscope may be used for a detailed, non-invasive examination, revealing features not visible to the naked eye.
For a definitive diagnosis, especially for suspicious lesions, a biopsy is often performed. This involves removing a tissue sample for microscopic examination. Depending on the lesion, an excisional biopsy (removing the entire lesion) or an incisional biopsy (removing a portion) may be chosen.
Management depends on the diagnosis. For benign and stable lesions, observation may be sufficient. Removal might be an option if the lesion causes symptoms or for cosmetic reasons.
Cancerous lesions typically require surgical excision. Additional treatments like radiation therapy or chemotherapy may be necessary if the cancer is advanced or has spread. Cryotherapy might be used for certain benign lesions.