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 Mystery behind labial and oral melanotic macules: Clinical, dermoscopic and pathological aspects of Laugier Hunziker syndrome