An oral melanotic macule is a benign hyperpigmented macule that may be found on the lips or oral mucosa in approximately 3% of the general population. It is caused by an increase in focal melanin deposition that is occasionally associated with an increased number of melanocytes.

Melanotic macules are most commonly found on the vermillion border of the lip, lower more often than upper. Lesions can also be found on the gingiva or palate, and they may be multiple. Some experts refer to lip lesions as labial melanotic macules, although histopathology is identical to that at any other mucosal site.

Oral melanotic macules are common in individuals with darker skin colors and are seen more frequently in women than men. The average age at time of presentation is approximately 40 years, although these macules may appear at any age. In patients with darker skin colors, onset typically occurs in adolescence. Lesions on the lips are generally diagnosed earlier than those in the intraoral mucosa.