Dark Spot on Lip

I am trying to determine if this dark spot on my lip is a venous lake, melantonic macule, or some other lesion. I am 25, not a smoker, and occasionally take B vitamin supplements.

The spot is right above the vermillian border of my lower lip, dead in the center on the line where the mucosa begins, approximately 2 mm. The discoloration appears to be below the epidermis. It certain lighting it appears bluish, but under ordinary indoor lighting it appears greyish. When my lip is stretched and up close, the spot does not appear at all. Please advise, could this be a venous lake?

[Bhupinder Kaur, MD]

Hello,
From your symptoms it can be a venous lake. It is a dark blue compressible papule caused by dilation of venules and lips are very commonly affected. Treatment is by cryosurgery, electrosurgery, sclerotherapy, excision and laser treatment. Please discuss these options with a cosmetologist in detail.

I sincerely hope it helps. Take care and please do keep us posted on how you are doing. Warm regards.