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 Mucosal melanocytic macules Oral Malignant Melanoma Oral Cancer Foundation Information and Resources about Oral Head and Neck Cancer Lingual melanotic macule the first case report in an adult patient* Anais Brasileiros de Dermatologia Melanocytic Lesions A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions Continuing Education Course dentalcare.com 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.