Perioral or Lips
Hyperpigmentation

What is Perioral Hyperpigmentation?

Melanin is the pigment that gives colour to the skin. Sometimes hyperpigmentation can appear around the mouth (perioral) and lips. “Peri” is a prefix from Greek meaning “around” or “surrounding”; oral relates to the mouth. Perioral or lips hyperpigmentation are usually benign. Change in the colour of the lip itself can be caused by medications or certain illnesses and should be assessed by a physician.

Why are lips differently colored than regular skin?

Normally, skin is composed of numerous layers of cells, however, the lips only have 3 to 5 cell layers. This means that skin over lips is thinner. Lips are also richly supplied by blood capillaries. Due to this, lips show the color of blood capillaries beneath them, owing to their crimson or pinkish color.

Why are some lips darker than the others?

Race

Those who are fair-complexioned tend to have rosy lips whereas those with darker skin have purplish lips.

Smoking

People who smoke regularly have hyperpigmented lips. Nicotine is the main culprit.

Pan chewing

Pan contains betel leaf and betel nut. Chewing pan for a long time can cause hyperpigmentation of the lips.

Coffee, tea and other staining liquids

Liquid beverages can also stain lips and teeth.

Prolonged sun exposure

Increased UV exposure can cause the melanocytes to overproduce melanin

Hyperchromatosis

An abundance of iron in the body can also lead to lip hyperpigmentation.

Melanin-making medication

  • People who take too many painkillers, especially NSAIDS (non-steroidal anti-inflammatory drugs)
  • Antimicrobial drugs like sulphonamides, cyclophosphamide, doxorubicin are taken by cancer patients during cancer therapy.
  • Escitalopram and barbiturates for anxiety patients
  • Levodopa taken by patients who have Parkinson’s disease.
  • Antifungal drugs like ketoconazole
  • Colchicine taken by gout patients.

Various clinical diseases

Some people can also have lip hyperpigmentation due to some diseases, like:

  • Post-inflammatory hyperpigmentation
  • Lichen planus
  • Lupus erythematosus
  • Lentigines
  • Nevus
  • Peutz-Jeghers syndrome
  • Bandler syndrome
  • LEOPARD syndrome
  • Endocrine and metabolic disorders
  • Addison’s disease
  • Cushing’s disease
  • Nelson’s syndrome
  • Acromegaly
  • Hyperthyroidism
  • Heavy metal poisoning

Cancer

Various benign and malignant cancers can cause lip hyperpigmentation. These include:

  • Kaposi’s sarcoma
  • Malignant melanoma
  • Cavernous haemangioma
  • Benign pigmented lesions
  • Malignant pigmented lesions

How can I prevent lip hyperpigmentation?

Quit smoking

Limit your sun exposure

Always wear sunscreen. There are various lip balms and lip products that come with SPF.

Hats are good to make a fashion statement as well as keep your face and lips protected from harsh UV rays if they are wide-brimmed.

Hemochromatosis (excess iron in blood)

Malignancy

How do I treat lip hyperpigmentation?

  • Laser therapy
  • Cryotherapy
  • Surgery
  • Intense Pulse Light (IPL)
  • Photodynamic therapy
  • Topical bleaching agents
  • Cyspera®, intensive pigment corrector, reduce 67% melanin index in pigmented lesions