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 Figure 7 from Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management. Semantic Scholar Labial melanotic macule Citalopram Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature Cureus