Oral Melanotic Macule: Symptoms and Treatment Skinsight What Caused These Multiple Hyperpigmented Macules of the Mouth? Oral Melanotic Macule: Symptoms and Treatment Skinsight Clinical Challenge: Dark Lesion on Lower Lip MPR Pigmentation Document Gale Academic OneFile 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,