Does anyone know what this black mark on my lip is? Started last August so it's I've had it nearly a year, was living in Spain at the time for 6 months An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth. An oral melanotic Labial melanotic macule Oral Mucosal Melanosis IntechOpen Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 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.