This patient has multiple labial melanotic macules. These are essentially freckles of the lips. These most commonly involve the lower lip. This patient had involvement of both the upper and lower lips. Oral pathology: Noting a pigmented macule that often presents a diagnostic dilemma Registered Dental Hygienists Simple cryosurgical treatment of the oral melanotic macule Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics Mara Ever wondered what those little brown spots are that are often found on the lip? Many refer to them as a freckle but the medical term is melanotic macules.