UGLY BLACK SPOTS APPEARING ON LIPS :(

Hello. I'm in my teen years. about 3-4 weeks ago, my doctor told me to start taking iron tablets because appearantly i have a very mild iron deficiancy. each tablet is 65 mg. I had been taken the tablets a week before my doctor told me to(so i started taking them about 5 weeks ago), but instead of one tablet, i was taking two. Then about a week ago, i noticed a dark spot appear on my bottom lip. I didn't pay it any attention. I thought maybe i un-knowingly bruised it or something. But then throughout the week, the spots started to spread all through out my bottom lip. So i stopped taking the iron tablets. Now the spots on my lip are VERY noticeable and VERY ugly. I have no pain, no cracks on my lip. Im pretty diligent in keeping my lips moist so it's not like they are dry or anything. I haven't done anything out of the ordinary or put any foreign thing to my skin. But i am worried about my lips. It seems now the spots are starting to spread to my upper lip as well. PLEASE HELP.

[Bhupinder Kaur, MD]

Hello,
Oral iron supplements can cause staining of teeth especially if taken in the syrup form but it is less likely to cause black spots on lips. These black spots can be due to oral melanotic macule. It can be an oral pigmented macule but if  you are a smoker, smoker’s melanosis and any serious pathology need to be ruled out. Smoker’s melanosis is due to long-term tobacco smoking. Smoking cessation is the treatment of choice. The hyperpigmentation then disappears in a few months.

Cryosurgery using liquid nitrogen and laser are the other main treatment modalities for oral melanotic macule. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.