Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics Are Freckles on Lips a Cause for Concern? Causes, Remedies 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 ORAL MELANOTIC MACULE (OMM) (Also called focal melanosis labial melanotic macule) A benign, localized, flat pigmented lesion of the oral mucosa Caused by a focal increase in melanin production Labial melanotic macule