While not usually serious, hyperpigmentation may be attributed to underlying medical conditions, lifestyle habits, and medications.
Dark patches donâ€™t necessarily require treatment, but some people may find the skin discoloration bothersome depending on the size of the patches. Hereâ€™s what you need to know about the causes and treatment options for discoloration around the mouth.
What causes dark spots around the mouth?
Your skin gets its natural color from a pigment called melanin. Sun exposure, hormone fluctuations, medications, and certain underlying conditions may all create changes in melanin production, particularly on the face. This can cause spots of hyperpigmentation that may appear as discoloration around your mouth.
Nicknamed â€œthe mask of pregnancy,â€ melasma consists of dark brown and grayish brown patches on the forehead, cheeks, and upper lip. Theyâ€™re typically caused by hormonal changes in women. These can occur during pregnancy, as well as while taking birth control pills (oral contraceptives) or hormone replacement therapy.
Melasma tends to occur most often on the face, in areas such as the upper lip and chin, as well as the cheeks, nose, and forehead. Sun exposure can make the patches more noticeable.
The condition is less common in men, making up an estimated 10 percent of all melasma cases.
Medication side effects
While oral contraceptives may cause melasma, there are other medications that can increase the risk of hyperpigmentation. These include:
- hormone replacements, especially estrogen
- doxycycline, a type of antibiotic that can increase sun sensitivity
- chemotherapy drugs
Ultraviolet (UV) rays from sun exposure and tanning beds can increase your risk for dark spots as you age. These include age spots, also known as sun spots or liver spots. These are most common on the face, chest, and arms. Sun exposure can also worsen melasma.
Youâ€™re at an increased risk if you tend to skip the mouth area and lips when applying sunscreen.
There is new evidence that visible light also contributes to the development of melasma.
Trauma to the skin
If you had a serious injury, acne breakout, burn, or infection around your mouth, itâ€™s possible you may develop hyperpigmentation in brown or black spots after the skin has healed. Also called post-inflammatory hyperpigmentation, the associated discoloration usually fades after several months.
This type of discoloration can also be caused by lip lickerâ€™s dermatitis or contact dermatitis from lip balms and toothpastes.
Skin pigment changes may also be associated with vitamin deficiencies, including vitamin B12 and vitamin D. A 2018 study found that vitamin D deficiencies were also prominent in people with melasma.
The vitamin D deficiency is most likely secondary to sun avoidance, as sun exacerbates melasma.
Who is more prone to have discoloration around the mouth?
People with dark skin are more prone to hyperpigmentation overall. This is because of a higher rate of melanin production compared to light skin.
As you age, you may notice more spots around your face, chest, and other areas that are most exposed to UV rays. Your risk for skin discoloration around the mouth from sun damage is higher if you donâ€™t wear sunscreen in this area.
You might notice that any spots of discoloration around the mouth are worse during the summer months. This is likely due to more sun exposure, which can stimulate more melanin and make hyperpigmentation more noticeable.
Treatment for hyperpigmentation around the mouth
Hyperpigmentation around the mouth may be more difficult to treat compared to other areas of your face, due to the delicate nature of the skin in this area. However, effective treatment options include home remedies and medical treatment from a dermatologist.
Dark spots may fade if you take sun protection measures, including wearing sunscreen every day. The mouth area is often missed when applying sunscreen, so be sure to do so daily and reapply as needed.
Exfoliation and skin brightening serums containing antioxidants like vitamin C may also help reduce the appearance of hyperpigmentation. However, the spots may return soon after you stop using these methods.
Retinoids and hydroquinone may also help to lighten your skin. Use these products gradually, starting with every other day as your skin gets used to them.
These products are not without risks. Before using vitamin E for your skin, do a patch test to ensure youâ€™re not allergic to it. Place some inside your elbow and wait 48 to 72 hours before proceeding.
Retinoids commonly cause dry and irritated skin. Other side effects may include redness, itchiness, and peeling skin. Hydroquinone may cause initial redness or dryness.
If youâ€™re seeking permanent removal of skin discoloration around your mouth, a dermatologist may recommend one of the following options:
- prescription-strength retinoids or hydroquinone
- azelaic acid to reduce discoloration and inflammation
- kojic acid for melasma and age spots
- laser therapy for dark spots
- chemical peels to help exfoliate the skin and reduce appearance of pigmentation
When to see a doctor
Some forms of discoloration around the mouth may fade with time or once you stop taking certain medications. Other causes like sunspots and melasma may be more chronic and require treatment from a dermatologist.
You should also see a dermatologist if home remedies fail to decrease the appearance of discoloration.
A primary care doctor can help address pigmentation issues related to underlying medical issues as well as medication side effects.
If you donâ€™t currently have a primary care doctor or a dermatologist, you can search for one using the ishonest FindCare tool.
Preventing pigmentation around the mouth
Depending on the underlying cause, you may be able to help prevent dark spots around the mouth by:
- switching medications, if recommended by a doctor
- wearing sunscreen every day containing iron oxide, which can prevent hyperpigmentation or melasma caused by visible light exposure
- avoiding tanning beds as well as peak sun hours (late morning through early afternoon)
- wearing a wide-brimmed hat to protect your face
- addressing diagnosed underlying nutritional deficiencies
Skin discoloration around the mouth is caused by excess melanin production in your skin.
Hormonal changes, medications, and sun exposure are related to hyperpigmentation. Nutritional deficiencies, skin trauma, and other medical conditions may also cause skin discoloration.
In most cases, dark spots around the mouth arenâ€™t harmful, and they only need treatment if the appearance bothers you. See a doctor if you suspect hyperpigmentation may be related to an underlying medical condition.
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