Lip pigmentation Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review Removal of lip pigmentation with our Alma Q laser. Such lip spots (aka labial melanotic macules) appear for no apparent reason. Similar spots can appear due to smoking, sun damage, drug reactions, Melanotic macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight in single basal melanocytes; NO nests. More info like this in A collection of resources for RACGP exams Next Gen GP Text Book live webinars AKT and KFP questions