Does anyone know what this black mark on my lip is? Started last August so it's I've had it nearly a year, was living in Spain at the time for 6 months Citalopram Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature Cureus 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. Pigmented macular lip lesion Clinical Advisor