What does it mean when a dark spot suddenly appears on the philtrum (the groove between the nose and upper lip), and what should be done about it?
Dec 01, 2025
Source: Cainiu Health
Dr. Li Feng
Introduction
In general, sudden darkening of the philtrum (the groove between the nose and upper lip) may be caused by external pigment deposition, local pressure or trauma, post-inflammatory pigmentation, fixed drug eruption, or contact dermatitis. Depending on the specific situation, improvement can be achieved through general management, medication, or other treatments. Daily care should include keeping the philtrum area clean and avoiding squeezing. Use gentle skincare products and perform a skin patch test before trying new products.
Under normal circumstances, sudden darkening or black discoloration in the philtrum (the groove between the nose and upper lip) may be caused by external pigment deposition, local pressure or trauma, post-inflammatory pigmentation, fixed drug eruption, or contact dermatitis. Depending on the specific cause, improvements can be made through general care, medications, or other treatments. A detailed analysis is as follows:
1. External Pigment Deposition
Colored substances such as lipstick or hair dye may adhere to the skin of the philtrum if not cleaned promptly, leading to pigment deposition. Thoroughly wash the area with a gentle facial cleanser, avoid further contact with such products, and apply a moisturizing lotion after cleansing.
2. Local Pressure or Trauma
Pressure or minor impact on the philtrum can cause rupture of subcutaneous capillaries, resulting in blood accumulation that appears dark or blackish. Avoid pressing or irritating the area. Apply cold compresses within the first 24 hours to stop bleeding, followed by warm compresses after 24 hours to promote absorption of the bruise.
3. Post-inflammatory Pigmentation
If the philtrum previously had inflammatory conditions such as acne or folliculitis, melanocytes may become overactive after inflammation resolves, leading to hyperpigmentation. Protect the area from sun exposure, and as directed by a physician, apply topical hydroquinone cream or tretinoin cream, and take oral vitamin C supplements.
4. Fixed Drug Eruption
After taking medications such as sulfonamides or antipyretic-analgesics, drug components may trigger localized allergic reactions, leaving behind dark patches once the reaction subsides. Discontinue the suspected medication immediately. As prescribed, take oral antihistamines such as loratadine capsules or cetirizine hydrochloride tablets, and apply mometasone furoate cream topically.
5. Contact Dermatitis
Exposure to allergens or irritants such as cosmetics or face masks may induce skin inflammation, which can result in pigmentation after resolution. Avoid contact with the triggering substance. As directed by a doctor, apply topical hydrocortisone butyrate cream or tacrolimus ointment, and take oral ebastine tablets.
In daily life, maintain cleanliness of the philtrum area and avoid squeezing it unnecessarily. Use mild skincare products and perform a patch test before trying new products. Practice proper sun protection when outdoors to minimize UV-induced irritation. If the dark spot persists, worsens, or spreads, seek medical attention promptly to determine the underlying cause.
