Darkness Around Mouth

Darkness around mouth, that's one of the problem which is a major concern in our Indian population. Let's discuss about the major causes, types, and treatment available for this problem.

One of the most common reasons and first genetic cause in Indian population is pigmentary demarcation lines. They are abrupt lines of darkness which start from angle of mouth and extend downwards to chin area. They are present in dark population and often runs in family and associated with similar problems around eyes also. Their treatment includes regular pigment reduction laser along with sun protection.

The other genetic cause is having short chin or loss of volume over chin area which in some cases can create illusion of having darkness around this region. You can compare it to a deflated balloon which looks much darker as compared to an inflated ones. Skin booster or dermal fillers can help in treating this cause.

The second category is metabolic causes:If you have deficiency of Vitamin B12, you can have this pigmentation which is associated with darkening of knuckles, oral ulcers and body weakness.Similarly, anemia though not the sole factor can also aggravate existing pigmentation and can be associated with darkness around mouth, hair fall and body s/s of anemia.Correction of these causes by supplementation can be helpful in these cases.

If you are overweight, have insulin resistance or diabetic, you can have a condition known as acanthosis nigricans where there is velvety thickening of skin giving an appearance of dirt accumulation. This type is associated with darkness around eyes, forehead, neck, underarms and groin region. Weight reduction, dietary changes and insulin sensitizers like myoinositol and metformin helps in this condition. Also addition of depigmenting creams, peels and lasers help a bit in these cases.

The third category is PIH where due to some pre-existing problem, there was some redness or reaction which healed up with pigmentation. You can have a reaction around this area due to use of some cosmetics or intake of medications which may have caused fixed drug reaction especially on lips and can heal withpih

If you have a problem of drooling of saliva seen in sleep, then this can lead to pigment deposit over lip corner and extending downwards.If you have a habit of licking your lips, there can be redness, chapping over lips and border of lips and eventually causes PIHdue to overuse of steroids over this area, some can develop a condition known as peri oral dermatitis leading to PIH. Even long term dryness can also create PIH.
Use of excessive scrubs,lemon, potato, loofahs, hot water, rubbing can cause more pigmentation ironically. This is a condition known as macular amyloidosis and avoidance of these factors are the mainstay treatment.

So how can you treat this problem?

• First of all, one needs to be avoiding all sort of irritants on this area including scrubs, cosmetics and steroids.
• Keep area moisturized. Avoid lip licking and saliva drooling. You can use a thick layer of Vaseline to take care of area affected.
• Reduce your weight and supplement with vitamins if deficient.
• One can start with skin lightening creams containing glycolic caids, retinols, azelaic acid, kojic acid, arbutin Milder chemical peels like arginine, lactic and glycolic may be required.

For deeper pigmentation and pigmentary demarcation lines, pigment reduction laser like Q switched NdYag needs to be done at regular intervals to decrease this kind of pigment. Sometimes skin boosters and fillers rich in hyaluronic acid need to be done to hydrate the area and help in filling any volume loss.

Apart from this, one can use concealer to cover up this area in case early response is needed. As you understood, there is not one cause and a correct treatment would depend on type of pigmentation, one should take dermatologist consultation to guide through right path.