A dark discoloration around the mouth or lips  is a result of increased pigmentation of the skin (hyperpigmentation) which may arise for a number of reasons. This common cosmetic problem is characterized by the darkening of the skin around the mouth area, particularly at the corner of the lips,  as a result of the over activity of the melanocytes, which are the skin cells that are responsible for the production of melanin. Melanin is a natural pigment responsible for the color of our skin and provides protection against the sun. Discoloration around the mouth is more common in females and occurs more commonly in persons with a darker skin.

Causes of Skin Discoloration Around the Mouth

Skin discoloration around the mouth or corner of the lips may be due to :

• Medical conditions such as Addison’s disease, Cushing’s syndrome, digestive disorders ( biliary cirrhosis, porphyria) and iron-deficiency anemia.
• Injury or trauma to the area from fungal infections, chemical irritants, certain cosmetics, long term use of skin lightening creams and incorrectly performed skin procedures like dermabrasion.
• Excessive sun exposure that leads to sun burn can result in pigmentation around the mouth. This is more common in lighter skin complexions or those with sun sensitivity.
• Prolonged exposure to heat, common in beauty treatments with the use of procedures like long periods of facial steaming.
• Beauty treatments involving facial hair removal, such as waxing, threading or depilatory creams, can often leave the skin bruised and irritated, if performed incorrectly, done repeatedly in short periods or in more sensitive skin types. This can cause repeated trauma to the area resulting in the darkening of the skin.
• Hormonal changes such as menopause, puberty and pregnancy can contribute to dark skin discoloration around the mouth
• Melasma, which is a skin condition commonly occurring in females, results in the appearance of brown patches. This is occurs due to hormonal imbalances during pregnancy and menopause. Excessive sun exposure can aggravate melasma but does not usually cause the condition.
• Drug-induced pigmentation is hyperpigmentation that occurs as a side effect of certain drugs, like antimalaria drugs, antibiotics and certain oral contraceptives. However this is not a common side effect and occurs in only a small percentage of patients.
• Nutritional conditions such as carotenanemia (orange tinge of the skin due to over consumption of yellow food), malnutrition, malabsorption of food and pellagra may lead to hyperpigmentation of the skin.
• Hyperpigmentation can occur due to inflammatory conditions of eczema, systemic sclerosis, burns, healing of acne scars, blisters and photodermatosis.

Treatment and Management

• Avoid excessive sun exposure, especially if your skin is sensitive to the sun. Sun exposure aggravates most skin conditions, particularly when hyperpigmentation is a symptom of the specific condition. The use of a sunscreen  will assist with protection from the sun and it is advisable to use a protective cream with SPF 30 on a daily basis.
• Beauty procedures such as chemical peels, iontophoresis, intense pulse light therapy and laser surgery can help in the treatment of hyperpigmentation. However these procedures should be conducted by a reputable skin care professional as incorrectly performed procedures may aggravate the dark skin discoloration further.
• Topical cosmetic creams such as alpha hydroxy acid and hydroquinone are effective in treating hyperpigmentation but hydroquinone should be used cautiously as incorrect use can cause furthering darkening.
• Camouflage make up is often used in the concealment of pigmentation but this is not a solution to the problem.