Hyperpigmentation around mouth

Pigmentation around the mouth area is termed perioral hyperpigmentation. Though complex in origin, our specialists can lighten most types of pigment with prescriptive skin care, lasers & chemical peels. Understanding the cause of pigmentation forms the basis of effective treatment. 




8 weeks, variable

Treatment Time

1 minutes



Treatment science score

The science of treating dark areas / hyperpigmentation around the mouth

  • Causes of pigment include genetics & inflammation. 
  • Stopping the cause of inflammation is the first step.
  • Inflammation can be due to skin care, dermatitis, food allergies or internal. 
  • Once inflammation subsides, lasers are used to remove excess pigment.
  • Azelaic acid & glycolic acid toners are our preferences to remove perioral pigment. 
  • Genetic causes respond poorly to lasers.

Understanding the cause of hyperpigmentation around the mouth areas is the first step of management. 

Why do dark areas around the mouth appear?

Darkening of the mouth area can be due to genetics (more common in darker skin types), or secondary to inflammation, a term known as post inflammatory hyperpigmentation. In most cases it is multifactorial, ie. more than one cause. 

The list is exhaustive & follows a super complex diagnostic algorithm. Read more to understand. Once we have identified the cause, we can then focus on treatments.

What are the most common causes of post-inflammatory hyperpigmentation around the mouth area?

PIH or post-inflammatory hyperpigmentation can occur around the mouth areas. Inflammation irritates the sensitive skin in this region leading to increased pigment. The most common causes are-

  • Allergic contact dermatitis: due to foods, preservatives, toothpaste
  • Irritant dermatitis; due to saliva, foods, & skincare products
  • After laser or waxing: especially if the settings and laser device is incorrect.
  • Inflammatory skin conditions: such as seborrhoeic dermatitis, eczema & others

Our clinicians at The Melasma Clinic are procedural dermatologists, though we understand the causes, investigations & medical management of perioral hyperpigmentation, our work is entirely procedural, namely we treat with lasers & peels. A medical dermatologist can help find the cause/s of inflammation & provide solutions to treat the primary rash. This step precedes laser pigment removal if the cause is unknown or if active inflammation is noted.  Most cases can be diagnosed clinically, whilst some cases may require a biopsy or skin allergy testing.

How to treat dark patches/ skin around the mouth?

Treatments can be a combination of the following –

Skin care at home: this is for mild cases of pigmentation in the absence of inflammation. Read more about how to, outline below. 

Prescriptive skin care by a medical dermatologist if there is inflammation. 

Laser treatment by procedural dermatologists for some cases of perioral pigmentation. 

Combination treatment provides the best results. The ideal treatment depends on the cause. 

What skin care ingredients can be used to treat perioral hyperpigmentation / hyperpigmentation around the mouth?

Several skincare ingredients can be used to treat patches around the mouth; however you should be mindful that if used incorrectly, they can make pigmentation worse (adds to post inflammatory hyperpigmentation). 

Alpha Hydroxy Acids (AHAs): AHAs such as glycolic acid and lactic acid can help exfoliate dead skin cells, lighten dark patches, and promote skin cell turnover, resulting in a brighter and more even skin tone. We recommend using a wash off exfoliating toner that contains 7% glycolic acid, read more for instructions on how to. 

Hydroquinone (2-8%) can be considered in some, but not all cases of perioral pigmentation. The exact percentage & duration of treatment depends on the cause, & skin type/sensitivities. 

Vitamin C: Vitamin C is a potent antioxidant that can help reduce the appearance of hyperpigmentation by inhibiting melanin production, leading to brighter and more radiant skin. It should not be used if there is background inflammation, for example eczema or dermatitis as it could worsen pigmentation.

Retinol & retinoids: much like vitamin C, they can be irritating to the perioral areas. 

Niacinamide:  Also known as vitamin B3, niacinamide can help lighten dark spots and hyperpigmentation by inhibiting melanin transfer to the skin’s surface and reducing inflammation. It also supports the skin’s natural barrier function, resulting in improved overall skin health. It is much safer to use compared to vitamin C.

When using skincare ingredients to treat perioral hyperpigmentation, it’s essential to use them consistently but most importantly as tolerated. If your pigment around the mouth is due to post inflammatory hyperpigmentation & your skin is still inflamed, chances are, active skin care ingredients may flare up this condition. A medical dermatologist can guide you. 

*The Melasma Clinic employs a procedural dermatologist, one who performs laser procedures. For cases that require prescription medications & further investigations, you will be referred to a medical dermatologist at Cutis Dermatology in Brisbane or the Skin Hospital in Westmead or Darnlinghurst in Sydney.

The Melasma Clinic difference

Our specialist clinic is overseen by dermatologists who have extensive experience in the treatment of all forms of pigmentation, including perioral pigmentation. 

What results can I expect from lasers?

Lasers work best for cases of post inflammatory hyperpigmentation once the source of inflammation has subsided. Most patients can expect a reduction of pigmentation by up to 50-80% within a few sessions, spaced 4 weeks apart. 

The Melasma Clinic has the most advanced lasers for pigment, including the Picoway & Picosure Pro.

*Genetic cases may require 10 sessions with a success rate of only 20%.

What is laser treatment like?

Treatments are comfortable & fast, taking less than 2 minutes to perform. On a pain scale of 1 to 10, it rates as a 1. Results are seen within the first 4 to 8 weeks. 

Side effects following pico lasers are exceptionally rare. 

What does genetic causes of hyperpigmentation around the mouth imply?

Genetic causes are seen in darker skin patients. If you really look carefully at your relatives, chances are they have 3-4 shades of brown or black. The skin around the mouth, eyes & sides of the forehead are darker than the rest of the face. This is normal. Another type of pigment is the PDL or pigmentary demarcation line. As the name suggests, the cut off is sharp, like a line. 

Occasionally we get lucky with lasers, however you may require 4-8 sessions. It gets expensive, but if you would like to give it a go, you have been warned regarding the success rate. 

*Genetic cases may require 10 sessions with a success rate of only 20%.

Dr Davin Lim

650K subscribers

Can chemical peels be effective in treating hyperpigmentation around the mouth?

Chemical peels can be effective. Our favoured peels include Cosmelan, Dermamelan, & the Vi Precision Peel. Peels are only considered if the diagnosis is ascertained & inflammation has subsided. Peeling active areas of inflammation will lead to rebound pigment. The ideal formulation depends on your pigment type, depth, & skin type.

Pico lasers are the preferred method to treat post inflammatory hyperpigmentation around the mouth areas. They give relatively predictable results without side effects or downtime. 

More of our mostFrequently asked questions

Can vitamin C help treat dark skin - hyperpigmentation around the mouth?

Why is azelaic acid our preferred skin care ingredient for perioral pigment & hyperpigmentation around the mouth?

How to use glycolic acid for dark patches around the mouth?

What about niacinamide for perioral pigmentation?

Can retinol help treat perioral hyperpigmentation?

How to treat dark patches of the upper lip after laser hair removal or waxing?

What is melasma & does it affect the mouth area?

What is perioral dermatitis & how to treat it?

What is lip-lick dermatitis & how to treat it?

What are food allergies that can give rise to dark patches around the mouth?

What are common allergens in toothpaste that may lead to dark patches around the mouth?

What is patch testing & when is it required?

What natural remedies are there to lighten dark areas around the mouth?

What types of perioral hyperpigmentation are hard to treat?

What is the best cleanser to use if I have perioral pigment?

What are other types of lasers that can treat perioral pigment?

What prescription creams treat hyperpigmentation around the mouth- how professionals approach it?

A Summary Treating perioral pigment/ dark hyperpigmentation around the mouth

Dr Davin Lim | Dermatologist
The Melasma Clinic, Brisbane | Sydney

The diagnostic & treatment algorithm for dark patches around the mouth area (perioral hyperpigmentation) is even more complex than dark circles. Most cases are multifactorial, given the extraordinary amount of marketing, DIY tips, blog posts & accessibility to skin care ingredients. What starts off as a self-limiting inflammatory rash, leads inevitably to rip roaring irritant contact dermatitis as most patients will ‘have a go’ at treating the rash, & resulting pigmentation. 

As with all cases, identifying the cause of the pigment is paramount to effectively (in most cases) treating perioral hyperpigmentation. Once the provisional diagnosis has been made (most often by myself), I refer patients to my colleagues for investigations & medical management. It can be as simple as perioral dermatitis or as complex as occult allergens in foods, toothpaste, skin care & more. If the rash is not obvious, extensive patch testing is required by an allergist, or a dermatologist with an interest in patch testing. 

Once inflammation has subsided, we then can offer laser treatments. My favourite laser is the pico, with a large spot size with low power – energy settings. It is very effective in treating post-inflammatory hyperpigmentation, but highly ineffective in treating genetic causes of perioral pigmentation.

*Diagnosis of perioral pigmentation is more complicated than the description above. Dermatologists are also aware of rare causes. Examples include drugs such as clofazimine (made harder because it is used to treat Ashy dermatosis), amiodarone, silver, fixed drug (usually solitary or multiple circumscribed blue to grey patches) as well as genetic causes.