Oral pigmented lesions: a pragmatic approach to diagnosis and management Faculty Dental Journal 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. In the process of removing a Labial Melanotic Macule. A Labial Melanotic Macule is a well defined, oval, brown to black, flat patch on the central third of the lower lip, as seen Melanotic Macule Lip TikTok