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Even tanning after mild sunburn can be considered as an example of external PIH and dark color occurring with acne lesions would be an example of internal PIH

The varicosities may be small or large

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Oral Melanotic Macule An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth

PubMed Hofmann-Wellenhof R, Marghoob AA, Zalaudek I

This prevents DNA damage within skin cells, significantly lowering the risk of conditions such as sunburn, premature aging, and even skin cancer