Black spot on the inside of the cheek: is it serious?


Black spots on the inside of the cheek can have several causes, such as blisters or hyperpigmentation. In rare cases, they can indicate something more serious, such as oral cancer. Many mild conditions can cause a black spot to appear on the inside of the cheek. Often there will be no other symptoms, and the situation will improve without treatment. In rare cases, however, a black spot on the inside of the cheek can be a symptom of oral melanoma. This is a rare type of cancer.

Here are some potential causes of a black spot on the inside of the cheek. As well as some treatment options and the circumstances under which a person should contact their doctor.

Main causes of black spots on the inside of the cheek

– Blood blisters

Blisters are raised bubbles on the skin with fluid inside. They can occur anywhere on the body, including the mouth. Blood vesicles contain blood and appear dark red or purple. They can develop in the mouth as a result of an accidental cheek bite or an allergic reaction.


Blood blisters are usually not harmful, and they often get better without treatment. Sometimes, however, they can cause pain or discomfort. In these cases, over-the-counter pain medications can be used.

– Amalgam tattoos

Tattoos amalgamation occurs when metal fillings leak, causing dark marks to appear inside the mouth. These marks can appear when a dentist places or removes a filling and tiny fragments of metal fall between the teeth. They most often appear on the gum or cheek, near the amalgam. However, they can appear anywhere in the mouth.


Amalgam tattoos do not cause no symptoms and do not require any form of treatment.

– Smoking

Smoking can cause smoker’s melanosis. This is a condition in which brown or black pigmentation develops inside the mouth and throat.


This condition is not harmful and does not require treatment. However, the tobacco smoke that causes these spots is harmful to various areas of the body. For example, smoking can cause gum disease, tooth loss and oral cancer, as well as several other conditions.

– Oral melanoma

Melanoma is a cancer of pigment-producing cells, or melanocytes, which usually affects the skin. However, these cancers can also occur on mucous membranes, such as in the mouth. Oral melanoma usually appears as a raised area that appears black, brown, or dark blue. These marks can be asymmetrical with an irregular edge. There may also be swelling, if inflamed.

Researchers aren’t sure what the risk factors are, but they may include them:

dental irritation


alcohol consumption


The main treatment option for melanoma buccal is surgery. Your doctor may also recommend radiation therapy.

– Addison’s disease

Addison’s disease is an endocrine disorder that occurs when the adrenal glands, which are the glands at the top of the kidneys, do not make enough of certain hormones. These include cortisol and aldosterone. Addison’s disease can cause darker areas to develop on the skin and inside the mouth.

Other symptoms may be seen:

chronic fatigue

muscle weakness

abdominal pain

weight loss

loss of appetite


Treatment of the disease Addison’s will include hormone replacement drugs. People can take a corticosteroid, such as hydrocortisone, to replace the missing cortisol.

How to diagnose the origin of a black spot on the inside of the cheek

A doctor or dentist will do a physical exam of the blackheads to determine the cause. He will likely ask the person if the spots are painful or if they are accompanied by symptoms. A doctor may also check a person’s medical history for any signs of a genetic condition, such as Peutz-Jeghers syndrome, that could be the cause. They can also examine the person’s dental record for the presence of metal fillings. Depending on its assessment, your doctor may also order additional tests to make a definitive diagnosis. For example, it may require a blood test or a skin sample for further analysis.

When to contact a doctor for a black spot on the inside of the cheek

Many causes of black spots on the inside of the cheek, like amalgam tattoos, are harmless. Although no medical treatment is necessary for some causes of black spots in the cheek, a doctor should be contacted for any sore or spot that lasts more than three weeks. If the black areas develop sores or ulcers, these may be symptoms of oral cancer. Early detection of oral cancer is crucial for successful treatment.

Don’t panic if you have a black spot on the inside of the cheek

There are many possible causes of black spots on the inside of the cheek. For most people, these spots do not cause any additional symptoms and do not require treatment. Some people may need over-the-counter treatments for causes that cause pain, such as blood blisters. Other causes, such as oral cancer, will require medical treatment. Although the black spots inside the mouth can be harmless, it is helpful to see a doctor for persistent cases. They can help determine if the stain is harmless or requires additional care.


Adrenal insufficiency & Addison’s disease. (nd).

Ahmadi-Motamayel, F., et al. (2013). Report of a rare and aggressive case of oral malignant melanoma.

Canker sores (mouth ulcers): Overview. (2019).

Kanagaraj, S., et al. (2018). A short review on smoker’s melanosis.

Key statistics for oral cavity and oropharyngeal cancers. (2021).

Mouth cancer. (2020).

Mouth sores and pain. (2020).

Mouth ulcers. (nd).

Ni Riordain, R. (2013). Amalgam tattoo.

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