Labial melanotic macule Lip melanotic macula Hoogstra Medical Centers Not every dark spot 'down there' is dangerous but some can be Many women notice small brown or black spots on the vulva called melanotic macules. These are usually harmless, flat, Labial melanotic macule Melanotic macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight in single basal melanocytes; NO nests. More info like this in Vulvar Melanotic Macules DoveMed