Melanotic macules of the tongue in a newborn Journal of the American Academy of Dermatology Lip pigmentation Oral Melanotic Macule: Symptoms and Treatment Skinsight Simple cryosurgical treatment of the oral melanotic macule ScienceDirect This patient has multiple labial melanotic macules. These are essentially freckles of the lips. These most commonly involve the lower lip. This patient had involvement of both the upper and lower lips.