Upper-lip pigmentation – what can be done?
One of the most frustrating challenges in skin aesthetics is the appearance of a dark shadow above the upper lip. This phenomenon, called “mustache pigmentation,” is not real hair, but rather a darker skin patch that creates the illusion of a shadow or mustache. It is a common skin condition, mainly among women, and it can cause significant embarrassment and affect self-confidence. But before running to find miracle solutions, it is important to deeply understand what this phenomenon is, why it appears specifically in this sensitive area, and what the most effective ways are to treat it and prevent its return — emphasizing that personalized treatment is better than a general one.
What exactly is upper-lip pigmentation?
Pigmentation on the upper lip is a type of hyper-pigmentation (over-production of pigment) that appears specifically in the area above the upper lip. The most common medical term for this type of pigmentation is melasma (Melasma). Our skin gets its color from a pigment called melanin (Melanin), produced by melanocytes (Melanocytes). The main role of melanin is to protect the skin from the harmful effects of UV radiation (sun exposure). When melanocytes produce an excessive and uneven amount of melanin, dark patches appear on the skin.
In the case of upper-lip pigmentation, these spots appear relatively symmetrically above the lip, and sometimes may connect to similar spots in other areas of the face, such as the cheeks, forehead, and chin. This is why melasma is sometimes called a "pregnancy mask", even though it also appears in women who are not pregnant, and even in men (although much less frequently). The area above the upper lip is particularly sensitive and prone to issues because it is anatomically prominent, highly exposed to the sun, and undergoes many processes such as hair removal, which may irritate it.
The main causes: Why does it happen specifically there?
Upper-lip pigmentation is a complex condition, and it is usually caused by a combination of several factors working together. Understanding these factors is critical for building an effective treatment and prevention plan.
Sun exposure (UV radiation) : The number-one enemy — this is the most significant and common trigger. Sun radiation (both UVA and UVB) stimulates the melanocytes to produce more and more melanin as a protective mechanism. In the upper-lip area, the exposure is direct and intense. In addition to ultraviolet radiation, visible light (such as light from screens and lamps) can also contribute to worsening the condition, especially in people prone to melasma. It’s important to understand that this is not only about intentional tanning at the beach. Even everyday casual exposure — such as driving in a car, sitting near a window at the office, or a short walk outside — accumulates and causes damage. For people who are prone to melasma, even very short sun exposure can significantly worsen pigmentation or trigger it to reappear after treatment.
Hormonal changes : This is the main distinguishing factor that makes melasma so common among women. The hormones estrogen and progesterone are known to stimulate pigmentation. They cause melanocytes to become overly sensitive and react more strongly to triggers such as sunlight.
Pregnancy : The dramatic increase in hormone levels during pregnancy is a very common trigger for the development of the “pregnancy mask”, which often includes the upper-lip area.
Hormonal birth control : Birth control pills, hormonal intrauterine devices (IUDs), and other hormonal treatments can be a significant trigger for the development of melasma in many women.
Natural hormonal fluctuations : Fluctuations during the menstrual cycle or around menopause can also have an effect.
Genetics and skin tone : A genetic predisposition plays a significant role. If a mother or sister has upper-lip pigmentation, the likelihood that you will also develop it is higher. In addition, the condition is more common among people with darker skin tones, such as those of Mediterranean, Asian, or African descent. In them, melanocytes are naturally more active and respond more strongly to any stimulus.
Post-inflammatory hyperpigmentation (PIH) : Apart from classic melasma, there is another type of pigmentation called post-inflammatory hyperpigmentation (PIH). This is a dark spot that forms as a scar after the skin experiences trauma or inflammation.
Hair removal in the upper-lip area as a cause
Hot wax: Waxing causes trauma to the skin. The combination of heat and pulling can create inflammation. If the area is exposed to the sun in the days following the treatment (while it is still sensitive), the likelihood of developing a dark spot is high.
Threading and tweezers : These methods can also cause irritation and inflammation, especially if performed aggressively.
Hair removal creams : Chemicals in these creams can cause irritation or a mild chemical burn, which may lead to PIH.
Acne : Inflammatory pimples in the upper-lip area can leave behind dark spots.
So how do you blur the "mustache"?
Treatment for upper-lip pigmentation is challenging and requires a combination of patience, consistency, and a multi-system approach. It’s important to remember: there is no single magic solution, and the goal is to blur the spot and prevent its return, not necessarily to completely erase it forever.
The foundation of any treatment: complete sun protection
This is the most important step. Without strict sun protection, no other treatment will work. Any progress you achieve will be undone by a single short sun exposure.
Broad-Spectrum SunscreenUse a sunscreen with at least SPF 50, which protects against UVA rays (which cause aging and pigmentation) and UVB rays (which cause burns).
Mineral ProtectionFor treating melasma, it is highly recommended to use a sunscreen containing mineral ingredients such as zinc oxide or titanium dioxide. These ingredients create a physical barrier on the skin that reflects the rays, and are considered more effective in protecting against visible light and blue light (HEV), which are also known to worsen melasma.
Proper ApplicationApply a generous amount (at least half a teaspoon for the face) every morning, even if staying indoors. Reapply every two hours outdoors, or after sweating or swimming.
Additional Protective MeasuresWearing a wide-brimmed hat and sunglasses is essential during prolonged outdoor exposure.
Topical treatment for upper-lip pigmentation
Topical treatment for pigmentation focuses on active ingredients whose goal is to treat existing spots and create an even skin tone. The treatment works simultaneously on two main and complementary levels:
1 Inhibition of Melanin Production (Brightening Action)
This goal is mainly achieved through tyrosinase inhibitors. The enzyme tyrosinase is the central and key enzyme in the process of pigment (melanin) production in the skin.
Methods to inhibit tyrosinase:
Medical treatment (prescription) — Especially strong medical agents (for example, in concentrations of up to 4% of certain substances) that inhibit the enzyme powerfully and are available only under a doctor’s supervision.
Cosmetic treatment (over-the-counter)Ingredients intended for daily use. These act through a similar mechanism and include: Vitamin C (in stable forms and high concentration), niacinamide, azelaic acid, kojic acid, and various plant extracts such as licorice.
2 Acceleration of Cell Turnover (Exfoliating Action)
These ingredients are essential for skin renewal. They help remove skin cells that already contain excess pigment, thereby revealing a newer, brighter skin layer.
Ingredients to accelerate cell turnover:
Vitamin A derivatives (retinoids) — These are powerful ingredients that speed up cell renewal and help distribute melanin more evenly. Strong medical derivatives are available by prescription, and gentler cosmetic derivatives are also available.
Hydroxy acids (AHA/BHA) — Acids such as glycolic acid, lactic acid, and salicylic acid help gently exfoliate the top layer of the skin (epidermis). In doing so, they help blur surface spots and improve the penetration of other active brightening ingredients.
Note:
Usage should start gradually and carefully due to their potential to cause skin irritation.
Professional Clinic Treatments
When home treatment does not provide sufficient results, or in cases of deep pigmentation, one can turn to professional treatments performed by dermatologists or certified cosmeticians.
Chemical Peeling
This treatment uses high-concentration acid solutions (such as glycolic acid, TCA, and others) to create controlled exfoliation of the upper skin layers. The peeling reveals new, refreshed skin with a more even tone. Different types of peels exist at various depths, and the choice depends on the depth of pigmentation and the skin type.
Laser and Light Technologies (IPL)
This is an advanced option but requires great caution. These lasers work by sending short energy pulses that break down melanin clusters in the skin without damaging the surrounding tissue.
Light Technologies (IPL)
Use broad-spectrum light pulses absorbed by the pigment.
Important to know :
Laser and light treatments must be performed by an experienced professional skilled in treating melasma. Heat is one of the triggers for melasma, and improper treatment (using too high intensity or unsuitable technology) can worsen pigmentation instead of improving it.
Prevention is Key: How to Stop the Next Spot?
As in many cases, prevention is the best treatment, especially considering that melasma tends to recur.
Smart Management of Hair Removal
If you suffer from a tendency toward upper-lip pigmentation, it is worth reconsidering your hair removal method. Avoid hot wax. It is the most aggressive and traumatic method for the skin in this area. Consider alternatives:
Shaving : Contrary to the myth, shaving does not thicken the hair. It is the gentlest method that does not cause trauma to the skin.
Hair Removal Creams : Conduct a 24-hour sensitivity test before use to ensure there is no allergic reaction or irritation.
Laser Hair Removal : This can be a good option, but only if performed in a professional clinic by a therapist who understands the risks involved in treating an area prone to melasma.
If you still choose wax or threading, do it in the evening so the skin is not exposed to the sun immediately after the treatment while it is irritated. Apply a soothing cream after the procedure, and make sure to protect the skin from the sun in the following days.
Hormonal Awareness
If you notice that pigmentation appeared or worsened after starting hormonal birth control, discuss it with your gynecologist. It may be possible to find a non-hormonal alternative or a different type of pill with a milder effect. During pregnancy, simply be extra diligent about sun protection.
Gentle and Supportive Skincare Routine
Avoid anything that may irritate the skin. Irritation = inflammation = risk of pigmentation. Avoid using aggressive grainy scrubs in the area. Avoid strong rubbing of the face with a towel. Use products containing antioxidants (such as Vitamin C, Vitamin E, green tea) that help neutralize damage from free radicals caused by sun exposure, air pollution, and blue light.
Return to Healthier Skin with SKCURE
If you are dealing with dark and bothersome pigmentation spots in the upper-lip area, the SKCURE platform offers a smart and effective telemedicine solution created especially for you. We invite you to complete a short questionnaire on the website and undergo advanced assessment by our AI system. Afterwards, you will meet virtually with an expert doctor who will recommend treatment options precisely tailored to your skin type and the unique pigmentation pattern. Instead of buying many products and wasting time on ineffective combinations, we provide a personalized formula that includes up to six active and effective ingredients in a single product—a formula designed to treat upper-lip pigmentation accurately, efficiently, and delivered straight to your home.
Authored By - Dr. Shlomo Sadoun
A pioneering pharma entrepreneur with over two decades of experience in the health and biotechnology sectors. Operating at the intersection of science, innovation, and a global vision, leading the development of advanced medical solutions with a real impact on patients’ lives.