What causes white spots, dots or patches on lips? Could they be due to canker sores, HPV STD, milia, oral thrush, herpes, oral cancer, Fordyce spots or mucous cysts? Discover the various causes of this spots and learn how to treat or cure them.
Having white spots on your lips can make you feel more self-conscious or even lower your self-esteem. Whether they are harmless or not, no one wants to have them.
These spots can be small (little or tiny) or bigger in size. They could be flat (non-raised) or raised (bumpy or pimple-like). Furthermore, they can also form patches, clusters, widespread or exist singly. Finally, they could be painful (sore or a cause burning feeling) or painless.
Where are they likely to appear? These whitish dots affect any area around your lips including on your inside, on corners, on the upper, lower, or be along your lip line, and mouth cavity. In fact, some of these bumps can also be on your face or any other part of the body.
They have many causes. Some of these causes could be genetic while others are due to some illness, products used, some abnormalities or poor personal hygiene. So, what are some of the reasons why you have these spots, or what are they?
1. Fordyce Spots
If you have small yellowish, white or a pale pimple or bump-like dots with sharp demarcation that is between the red colored part of your lip and your normal skin i.e. on the vermilion border, they could be Fordyce spots or granules, also known as sebaceous prominence.
According to medicalnewstoday.com, Fordyce spots are “pale red, yellow-white or skin-colored bumps or spots that appear on the shaft of the penis, the labia, scrotum, or the vermilion border of the lips of a person's face.” They usually are about 1mm to 3mm in size, and they occur when one has a sebaceous gland that lacks a hair follicle.
Besides being on your vermilion border, they also tend to affect the buccal mucosa -“the inner lining of the cheeks and lips” [medicinenet.com].
This is according to maxillofacialcenter.com, which states that Fordyce granules “common sites of occurrence are the buccal mucosa (often bilateral), the upper lip vermilion, and the mandibular retromolar pad and tonsillar areas.”
Fordyce spots affect male and female, and they are not associated with any illness, disease, or infections. They are painless, harmless and they are not a sign of STI (sexually transmitted infection) or cancer. Fordyce granules tend to be bigger and more visible when someone grows older.
Treatment: Treatment is generally discouraged. However, if you really want to treat these spots, the common treatments are electrodesiccation, use of pulsed dye lasers, and micro-punch technique. Chemical peels and anti-sebum ointment or creams can also be of some help.
2. HPV STD
The other possible reason can be Human papillomavirus (HPV) infection. This infection is caused by about 200 different HPV strains, some of which have been linked to cancer of cervix, vagina, vulva, anus, and penis as well as oropharyngeal and mouth cancers.
HPV is an STD that is “transmitted through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus” [cdc.gov].
Once you have it, HPV commonly affects the genital areas (vagina, vulva, cervix, penis, and anus) as well as throat and mouth (in case of oral HPV), and can result to genital and oral warts respectively.
Oral HPV can cause warts “anywhere within the oral cavity or on the lips” [library.everyonehealthy.com], which can “be white and dome-shaped or flat-topped growths the same color was your mouth” [healthcentre.org.uk].
For the case of lips, they are more common on the inner part where their appearance can vary from being small to spiked or cauliflower-like masses that have projections.
It is, therefore, a fact that HPV can cause these dots or bumps. They are painless unless you irritate them, and you can have just one or in multiples.
Treatment: HPV is not curable although some cases may disappear without treatment. Going for HPV vaccines have been shown to help reduce risks of cervical and genital cancers. It is unknown if these vaccines can help in reducing risks of oral cancer due to HPV oral infections.
Note: In case of an ulcer or sore on your lips that doesn’t go away or heal after two weeks, causes pain when swallowing or a persistent lump on your neck, see your doctor.
3. Milia – small and hard to touch
If you have little whitish headed bumps that keep on coming and going away, you could be having milia. Milia is associated with “small, hard, white bumps” [paulaschoice.com] common on the face but “can occur even on mucous membranes such as the inner surface of the cheek or the vermillion border of the lips” [dermadoctor.com]
They form when skin cells are trapped instead of being naturally shed off and they are common in babies but occur even in preteens, teens, and adults.
Some ingredient in lip care products, sun damage and allergic reaction to fluoride in toothpaste are other factors that have been blamed for milia.
Treatment: The best treatment of milia is exfoliation. However, retinol can be of help and if milia won’t come out, consider seeing a doctor or dermatologists for removal. Do not remove them forcefully.
4. Oral thrush
Oral thrush, caused by a fungal infection can cause creamy “white lesions on the lips, mouth, gums, or tonsils” [healthline.com]. When they are on your inner and outer part, the lesions can appear patchy.
Although many other strains can cause oral thrush, Candida albicans is the common strain of yeast associated with oral thrush especially in people who use corticosteroids, birth control pills or antibiotics.
Furthermore, illness such as dry mouth, cancer, HIV/AIDS infection having an organ transplant, anemia, wearing dentures, diabetes or even being pregnant can increase the risk of having oral thrush.
Treatments: Oral thrush can be managed or treated with antifungal medications (liquids, tablets or lozenges).
5. Herpes simplex virus (HSV) – cold sores or fever blisters
If they are painful, itchy, white bumpy blisters, it could be cold sores or fever blisters, i.e., “cold sores are small blisters that develop on the lips or around the mouth” [nhs.uk]. Their cause is a contagious viral infection transmitted by skin contact treated by oral and topical antiviral medication.
The fluid-filled blisters initially look like small sores that often come in clusters forming patches. They tingle and are usually on your lip line where the lip meets body skin and the corner of your mouth. Later on, they tend to merge before bursting living oozy shallow open sores, which will eventually crust over.
6. HIV Aids
When one has HIV, they are more vulnerable to canker sores, cold sores, and oral thrush. All these will tend to cause this problem and in your mouth cavity. However, these spots are not a sign of HIV.
7. Oral cancer
If the white patches are initially is flat and painless and then begins being to ulcerate, it could be a due to oral cancer. This spots or bumps tend to grow, and they are hard or never heals.
On possible cause of oral cancer, apart from family cancer history, people who excessively drink, smoke, have HPV infections or are exposed to the excessive sun have a higher risk factor.
Treatments: Treatment is by removal of the cancerous growth, followed by chemotherapy or radiation therapy. If treated diagnosed early, you can beat it.
Note: You should only be worried if such a spot won’t go away and it grows since it could be an oral cancer sign.
8. Canker sores
Another possible cause of white spots, including those inside of the lip, cheek or mouth, is canker sores.
Canker sores are painful, i.e., expect pain, burning, tingling ulcerative patches can be round whitish, gray, or yellowish in color with their edges being red. They are not cancerous and fade away within two weeks.
Canker sores can be due to allergic reactions to some food, tissue trauma, impaired immune system and nutritional deficiencies, especially iron, folic acid, zinc, or vitamin B-12.
Gastrointestinal diseases such as Cohn’s disease as well as the celiac disease have also blamed for canker sores.
Treatment: In most cases, canker sores heal without treatment. If they are severe, a doctor might prescribe corticosteroid ointment, antimicrobial mouth rinse or OTC and/or prescribed solutions to reduce irritation and pain.
This is a problem where your skin loses pigmentation. The exact cause is unknown but it has been associated with cancer and an autoimmune disease. Vitiligo forms more of patches other than spots even on your lips.
Treatments: Treatment is by topical steroid therapy, skin graft, tattooing, autologous melanocyte transplant, depigmentation, and psoralen photochemotherapy
10. Mucous Cysts
A mucous cyst or a mucocele refers to fluid-filled sacs, swellings or bumps that occur inside the mouth or lips especially the inside the lower one. They form due to plugging of mucus
They can also be due to lip biting, salivary gland rapture or piercings. When they deep in your skin, they tend to be whitish, tender when touched and appear like a nodule.
Usually, they are painless and temporary cysts that will go away after some time, but a few could form a permanent cyst, which might require treatment.
Treatments: In severe cases, they can be dealt with through laser therapy, cryotherapy or use of intralesional corticosteroid injections.
11. Contact allergy
Contact with some “chemicals like mica and titanium are especially known to induce inflammation and irritation of lip mucosa leading to the lumpy bumpy appearance of lips along with irritation, burning and peeling of lip” [newhealthguide.org].
Treatment: To treat contact allergy, use steroids and antihistamines especially in cases of a swelling and/or you have an inflammation. Furthermore, avoid coming in contact with the allergens (allergy-causing irritants).
12. Lip pimple
This is another possible cause. There are many causes acne or pimples in this area. See more on pimples on lips where you will cover all the reasons and how to get rid of these pimples.
Fibroma refers to a “benign tumor of fibrous connective tissue” [ncbi.nlm.nih.gov] that forms a smooth lump in the oral cavity. It could be the color of your mouth (pink) or paler, i.e., whitish.
It is often caused by trauma especially if you have the lip biting, teeth grinding or the habit of rubbing your lips against poorly fitting dentures.
Treatments: To successfully treat these bumps, which can grow one needs to go for surgical removal.
Most people panic when they notice some whitish spots, dots or bumps after Juvederm. For instance, here is what one user asked on realself.com:
“I had Juvederm in my lips, and I see little white "pimples" under the skin on my lips. I never had those before. You can't feel them, but up close, you can see them. What is this?”
In response, various doctors mentioned the fact that it could be due to unrelated cause such as Fordyce spots or the permanent sebaceous glands, which become more noticeable after the procedure.
This is the same case for people who complain these dots when they stretched their lips. Stretching makes permanent sebaceous glands more visible.
14. Other causes
Other possible causes include dryness, sunburn blisters (can be yellowish white), bacterial infection, and hairy leukoplakia (which appear as white, patches on inside lip, inside cheek and on the sides of your tongue).
If they small or little
Whereas some could be bigger and patchy especially those caused by oral cancer, oral thrush or vitiligo, at times you can have small tiny ones.
Furthermore, they could be bump like (raised) or flat, clustered or singly existing and tend to be more visible when you stretch your lips.
If they are painless, they are likely to be milia, Fordyce spots or HPV (in case they have not been irritated).
On the other hands, painful, tingling, sore dots or spots, it could be herpes mainly if you have clustered specks that form fluid-filled blisters.
Slightly bigger ones are likely to be pimples, fibromas or mucous cysts or canker sores (if very painful).
When on lower lip
When on the lower lip, they can be due to any of the causes we have already discussed. Mucous cysts and hairy leukoplakia tend to be common on your lower inner lip, but they could due to other reasons we have explained in details.
When on upper lip
White spots on upper lip can be caused by any of the causes we have discussed. If you have them after waxing or threading, it could be infected ingrown hair. This will tend to be on your lip line and beyond.
When inside of the lip
It is common to have the whitish spot on the inside of the lip. They could be clustered or singly existing, painless or painful, small or bigger.
If the spots are painless (cause no pain), they are likely to be mucous cysts (fluid-filled sac like), milia or Fordyce spots (if they are small), fibroma or oral HPV. Milia tend to cause hard tiny white bumps.
On the other hand, if they are painful (sore, burning or hurts), they are likely to be canker sores, fever blisters, infected piercing, and oral thrush (common in babies and toddlers but can affect adults too, and it will tend to cause whitish sore patches and not dots). Having irritated oral HPV warts can also cause some pain.
Finally, oral cancer, hairy leukoplakia, and trauma can also result in this problem. It is wise to go for a medical checkup in case your spots do not go away after two weeks.
When on the lip line
If you have them found along your lip line, the most probable culprit will be Fordyce Spots and milia both, which are small, painless. Pimples can also be a cause.
Finally, although not restricted to this area, herpes simplex virus can also result in whitish bumps on this location.
When on lip corner
If they are in this part, these are likely to be canker and cold sores. Both are painful
How to get rid of them and tips
While looking at each cause, we covered the various cures and treatments required. We are going to mention a few general tips that can help you.
- To begin with, do not pick them. Always resist the urge to do so as this will increase the chances of getting an infection.
- Rinse your lip with warm salty water (about a half a teaspoon of salt added to a cup of warm water). Swish the mixture in your mouth before spitting it out.
- Book an appointment with your doctor if the affected area bleed, cause neck, and jaw swelling, make your tongue numb or you have trouble swallowing. Also, if you have a fever, sore throat or you feel like something is caught in your throat, see your doctor too.
Our references and sources