Lip Pigmentation

Yes, but lasers are more effective with less side effects & quicker recovery. TCA peels can help, however they are associated with higher risks. 

Here is the summary-

• TCA 10-20%
• 2-3 sessions
• Expect flaking of 3 to 8 days
• Can improve genetic lip pigmentation
• TCA peels are best combined with topical pigment correctors

*We do not perform TCA peels on the lips as pico lasers are far better, with less side effects, better results & reduced downtime. 

If you are after natural remedies for lip pigmentation, you’re reading the wrong website. Our clinic is based on the science of treating pigment, not how to combine herbs & fairy dust. Regardless, here is what is in the scientific literature in the world of Reddit & Google experts: 

Lemon (with or without sugar): Heralded as a pigment inhibitor, lemon causes more harm than good, much like lime. Best served in drinks than on your lips. UV reacts with lemon juice, often worsening lip pigmentation. 

Lime: Lime is another citrus fruit that might help reduce melanin production. To make a simple treatment, combine the following in a small bowl:

– 1 1/2 teaspoons of fresh lime juice

– 1 teaspoon of honey

– 1 teaspoon of glycerin

Gently apply this mixture to your lips. Take note, lime & citrus fruits often cause a condition known as phytophotodermatitis, meaning light activated pigmentation. In the majority of cases, this home remedy causes more pigmentation on the lips. Lime, like lemon, has no place in naturopathy. 

Pomegranate Pomegranate extract may lighten skin hyperpigmentation. To make this remedy, mix the following into a paste: 

• 1 tablespoon pomegranate seeds
• 3/4 teaspoon rose water
• ¾  tablespoon dairy cream

Gently massage the paste into your lips for about three minutes, then rinse your lips with cool water. Repeat daily. It Tastes good, but does very little for pigmentation.

Coconut Oil: Use your fingertip to apply a small amount of coconut oil gently across your lips. You can repeat this several times a day and before bedtime for best results. This increases UV penetration into the skin or lips, often making pigment worse. 

Olive Oil: Before you go to bed, massage a few drops of olive oil onto your lips for hydration. This has at least a wee bit of science, as dermatologists employ olive oil for hydration. 

Cucumber Juice: Blend half a cucumber into juice, then refrigerate. Once chilled, dip a cotton ball into the juice and lightly apply it to your lips. Leave it on for 30 minutes, then rinse with cool water. Harmless. 

Strawberry: Mash five medium-sized strawberries and mix with 2 teaspoons of baking soda to create a paste. Apply to your lips at night and rinse with cool water in the morning. Harmless. 

Almond Paste: Mix 1 tablespoon of fresh dairy cream with enough almond powder to create a paste. Gently massage the mixture onto your lips for 3-5 minutes, let it dry for 5 minutes, and then rinse with warm water. Repeat daily. Harmless. 

The official guidelines is ‘no’ as even small amounts of hydroquinone have not been studied on the lips (oral ingestion). Based upon the risk to benefit ratio, your clinician will guide you accordingly, depending on formulation, percentage of HQ & type of pigment. 

We do not advocate HQ for genetic causes of lip pigmentation. 

Retinol & retinoids may produce a marginal improvement in lip pigmentation. Retinoids, contrary to popular belief, are safe on the lips. This includes prescription tretinoin, the exception is pregnancy. Here is how to use retinol or prescription retinoids- 

• Apply at night before bedtime
• Apply a small amount at first, increasing as tolerated
• Add lip balm (non-SPF) 30 minutes before application if skin irritation occurs
• Avoid retinol application during the day due to photosensitivity 

Retinoids are best combined with pico lasers for best outcomes. 

*Retinoids work by chemical exfoliation & pigment reduction via inhibition of enzyme called tyrosinase. 

Kojic acid can reduce pigmentation in three ways, 

1. As a potent pigment inhibitor. 
2. Gentle exfoliation
3. As a weak antioxidant. 

The optimal concentration ranges between 0.5 to 1.5%, often combined with arbutin & ascorbic acid. DermaCo makes a lip balm with the above ingredients. 

As a guide, lip balms are rarely if ever effective in addressing lip pigmentation, however given they are 1/50 the cost of lasers, you can give it a try before seeing our clinicians. 

HA or hyaluronic acid is a powerful humectant & hydrator of dry lips that can reduce pigment via light reflection & better skin quality. 

Injectable HA works better than topical skin care. 

Yes, but it is rare. The most common cause of pigmented spots on the lips are labial melanotic macules. They arise on the bottom lip & range in size between 2 to 8 mm in diameter. A dermatologist can usually tell the difference between a melanoma and a labial melanotic macule under dermoscopy. A shave biopsy is performed if in doubt. 

*For this diagnosis we suggest you see a medical dermatologist. Our dermatologists are procedural, namely we concentrate on removal of pigment, not screening for cancer. 

The list is exhaustive, a simplified version – 

• Freckles
• Drug induced; hydroxychloroquine, cardiac medications 
• Sunburn
• PIH due to fixed drug eruption
• Lentigo simplex (most common) 
• Solar lentigo
• Venous lake 
• Lentigo maligna 
• Peutz Jeghers syndrome
• Addison disease
• Laugier-Hunziker syndrome

A medical dermatologist is the best port of call for diagnosis, our clinicians remove pigment, but may refer you off for investigations.

Occasionally, our dermatologist may employ ablative lasers such as erbium & CO2. These lasers are reserved for precancerous lip pigmentation such as pigmented solar keratosis & hyperpigmentation. 

These lasers are not used to treat genetic causes of lip pigment nor are they employed to lighten lips. The same applies to YSGG lasers. 

In a recent study conducted by M. Agha in 2021 entitled, Er,Cr:YSGG 2780 nm Laser Treatment of Lip Melanin Hyperpigmentation we acknowledge that 74.1% of patients reported complete improvement of the lip pigmentation. This was correlated with a high satisfaction rate (84.7%) during the follow-up period with a low level of relapse.

We may offer ablative lasers in late 2025, however this will be conducted in hospital. The long recovery of 10-14 days is prohibitive in most, hence we prefer pico lasers for this task.  

*Ablative lasers are performed by our dermatologist. Cost ranges from $1990 to $2990, a Medicare claim is only possible if the cause of pigmentation is precancerous. A biopsy is mandatory to claim. 

Complex pigment removal is performed by our dermatologists. For lip lightening procedures, our nurses & dermal therapists perform laser. 

Costs vary depending on the complexity of pigment. As a guide- 

• Skin lightening (lips only): $550 to $690 per session, factor in 4-5 sessions spaced 2-3 weeks apart. 
• Pigment removal: lentigo, freckle, sun spot, performed by dermatologist; from $1490 per session. Factor in 2 sessions at most. 
• Ablative lip lightening procedures using erbium laser; $2690 (offered in 2025).

The main causes of white discoloration on the lower lips are-

• Leukoplakia or whitening due to precancerous changes & sun damage.
• Vitiligo.
• Scarring secondary to cold sores or trauma.

For diagnosis please consult a medical dermatologist. If suitable you will be referred to our procedural dermatologist for management. 

PIH or post-inflammatory hyperpigmentation is not uncommon from DIY chemical peels, especially from TCA peels or by non-specialists. This is due to-

1. Incorrect application.
2. Too high strength.
3. Wrong diagnosis. 
4. Sun exposure. 
5. Wrong skin type. 

Your skin care expert who did the peel can navigate & troubleshoot the solutions. They include –

1. Use of prescriptive pigment correctors that include arbutin, kojic acid, HQ, retinoids, anti-inflammatories & others. 
2. Pico or short pulse lasers in the correct settings. 
3. Plasminogen modulators.
4. PN or polynucleotide injectables. 

We do not typically take in PIH cases in Sydney or Brisbane, however our dermatologist plans to set up a public dermatology clinic in 2025-2026 to review these cases in a hospital setting. The same applies to HYPOPIGMENTATION due to peels. Treatment is complex & best dealt with in a public hospital system. The high cost of treatment is another factor to be considered. 

Yes, providing the right technique & diagnosis has been made. This treatment is offered by skin cancer GPs. It can be effective, however lasers are more accurate with faster healing times, acknowledging that nitrogen is more cost effective.