If that black spot on your lower lip is scaring you, a dermatologist explains four possible causes including cancer.

Keep in mind that what appears to be black may actually be a deep dark purple, or, if the speck is small enough, you may notice upon very close inspection that it’s actually medium brown.

The benign melanocytic macule can be medium brown, but so can the dangerous melanoma.

Dr. Janet Prystowsky is a board certified dermatologist in New York, NY, with 30+ years’ experience.

Dr. Prystowsky explains, “A black spot on the lower lip could be a freckle, a mole, a melanoma, or a blood vessel lesion such as a venous lake.”

Melanoma is the most serious form of skin cancer. Lips are part of the skin.

A “freckle” or “mole” that starts appearing on your lower (or upper) lip in later adulthood is more concerning than if it begins appearing if you’re under age 25, and especially under age 18.

“It is worth getting a professional’s opinion of the spot because a melanoma would be important to diagnose and treat,” says Dr. Prystowsky.

“Even though it is uncommon for a black spot on the lower lip to turn out to be melanoma, lip cancers metastasize more readily than other skin cancers.

“That means a melanoma on your lip has a much higher risk of causing death.

“An experienced dermatologic surgeon can do a lip biopsy without leaving you with a terrible mark/scar.”

Are there tell-tale signs of a black spot on your upper or lower lip that are more indicative of cancer (melanoma) vs. a benign lesion?

Dr. Prystowsky says, “Things to make you worry about having a melanoma on your lip include:

1)   is it a new lesion?

2)   has it been growing or changing in some way?

3)   does it bleed readily? 4) does it have an irregular appearance or border?

4)   is it large – over a few millimeters in diameter?

5)   does it have multiple colors in it? i.e., white, blue, black, red.”

Scab on Lip that Won’t Go Away

This can be a type of cancer called squamous cell carcinoma.

Though it may not look like a “black spot” in the true sense, it can still be dark and appear like a scab or tiny smudge, as shown below.

Squamous cell carcinoma cancer on the lip. Coronation Dental Specialty Group, CC BY-SA 4.0/creativecommons.org

What about this venous lake?

“For the lesions that are caused by a blood vessel, removal usually improves your appearance significantly,” says Dr. Prystowsky.

The venous lake is a benign cause of what appears to be a black spot on the lip.

If a dermatologist identifies the black speck as a freckle, be sure to keep an eye on it, says Dr. Prystowsky, in case it begins getting bigger, changing in size, shape, color or texture.

In combination with her focus on early skin cancer detection and removal, Dr. Prystowsky provides a wide range of revitalizing and rejuvenating treatments.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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