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 Oral Mucosal Melanosis IntechOpen Pigmented (Purple or Brown) Lesions in the Mouth Pigmented (Purple or Brown) Lesions in the Mouth Kazemi Oral Surgery Facialart.com This lovely patient was thrilled with her beautiful result after laser treatment of oral melanotic macules. I share this case to educate: laser treatment requires accurate diagnosis, an understanding Pigmented macular lip lesion Clinical Advisor What Caused These Multiple Hyperpigmented Macules of the Mouth?