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, Spotty lips. These are labial melanotic macules, kinda like freckles on the lips. They are mostly due to age and sun exposure, but sometimes they run in families and are associated with Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics