Overview
Black hairy tongue
Black hairy tongue
Black hairy tongue is caused by a buildup of dead skin cells on the tiny bumps on the tongue called papillae. Food, drinks, tobacco, bacteria or yeast, and other substances can get trapped on the papillae and stain them.
Black hairy tongue is a condition of the tongue that gives it a dark, furry look. The look usually results from a buildup of dead skin cells on the many tiny, rounded bumps on the surface of the tongue. These bumps, called papillae, contain taste buds. When these bumps become longer than usual, they can easily trap and be stained by tobacco, food, drinks, bacteria or yeast, or other substances.
Black hairy tongue may look alarming, but it's usually painless and doesn't cause any health problems. The condition usually goes away by dealing with the causes and by regular mouth and tongue cleaning.
Symptoms
Symptoms of black hairy tongue include:
- Black color of the tongue, but the color may be brown, green, yellow or white.
- A hairy or furry look to the tongue.
- Changed taste or a metallic taste in your mouth.
- Bad breath.
- Gagging or tickling feeling in your mouth, if the papillae are very large.
- Rarely, a burning feeling on the tongue if hairy black tongue is caused by a yeast or bacterial infection.
When to see a doctor
Though it doesn't look good, black hairy tongue is usually a harmless condition. It's usually short term when steps are taken to get rid of or manage the cause.
See your healthcare professional or dentist if:
- You don't know what's causing black hairy tongue and want to talk about what steps to take.
- You're worried that it might be related to a health issue.
- Black hairy tongue doesn't go away even though you brush your teeth and tongue twice a day.
Causes
Black hairy tongue usually happens when the many tiny, rounded bumps on the tongue, called papillae, grow too long because they don't shed dead skin cells. Food, drinks, tobacco, bacteria or yeast, and other substances can get trapped on the papillae and stain them. This makes the tongue look dark and hairy.
The cause of black hairy tongue can't always be found. Possible causes of black hairy tongue include:
- Changes in the healthy bacteria or yeast found in the mouth when taking antibiotics.
- Poor cleaning of the mouth and tongue.
- Dry mouth.
- Eating a soft diet that doesn't help to rub dead skin cells from your tongue.
- Regularly using mouthwashes that have oxidizing agents, such as peroxide, that can irritate your mouth.
- Using tobacco.
- Drinking a lot of coffee or black tea.
- Regularly drinking large amounts of alcohol.
- Certain medicines.
- Having a condition that lowers your ability to fight infections, such as cancer or HIV.
Risk factors
Poor mouth and tongue cleaning, dry mouth, and eating only soft foods may raise your risk of black hairy tongue.
If you're male or an older adult, if you smoke, or if you've had hairy black tongue in the past, you may have a higher risk of the condition.
Dec. 22, 2023
FAQs
Black hairy tongue usually happens when the many tiny, rounded bumps on the tongue, called papillae, grow too long because they don't shed dead skin cells. Food, drinks, tobacco, bacteria or yeast, and other substances can get trapped on the papillae and stain them. This makes the tongue look dark and hairy.
What can black hairy tongue be caused from? ›
A black hairy tongue is caused by too much bacteria or yeast growth in the mouth. The bacteria build up on tiny rounded projections called papillae. These lie along the surface of the tongue. Instead of shedding as they normally do, the papillae start to grow and lengthen, creating hair-like projections.
What is the number one cause of hairy tongue? ›
Q: What causes hairy tongue? A: It can occur from poor oral hygiene (mouth cleaning), the use of medications, chronic or extensive use of antibiotics, radiation treatment to the head and neck area, excessive coffee or tea drinking, or tobacco use.
What vitamin deficiency causes hairy tongue? ›
If the tongue is not smooth because of rubbing against the teeth, crowns, implants or a denture than nutritional deficiency may be the culprit. Vitamin deficiency, especially vitamin B12 deficiency (pernicious anemia), can be the cause.
Why won't my hairy tongue go away? ›
Most of the time, a black hairy tongue just means you need to improve your oral hygiene at home. However, in some cases, the condition may be caused by an overgrowth of bacteria or fungi. In these instances, your healthcare provider can prescribe antibiotic or antifungal medications.
Is black hairy tongue serious? ›
Black hairy tongue usually doesn't need medical treatment. Though it may not look good, it's usually a short-term, harmless condition. Good mouth and tongue cleaning can help get rid of black hairy tongue.
What illness causes a black tongue? ›
Black tongue is a benign condition typically caused by the overgrowth of dead skin cells, resulting in elongated papillae and a hairy appearance. Other factors contributing to this condition include inadequate oral hygiene, a soft diet, and staining from bacteria, food, yeast, and other substances.
What drug causes hairy tongue? ›
A range of medications have been linked to hairy tongue including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth [1], erlotinib [2], linezolid [3]. Other factors that may cause, and/or aggravate hairy tongue include: Poor oral hygiene. Smoking or chewing tobacco.
What does a black tongue indicate? ›
Black hairy tongue is caused by a buildup of dead skin cells on the tiny bumps on the tongue called papillae. Food, drinks, tobacco, bacteria or yeast, and other substances can get trapped on the papillae and stain them. Black hairy tongue is a condition of the tongue that gives it a dark, furry look.
What virus causes hairy tongue? ›
Oral hairy leukoplakia is a condition triggered by the Epstein-Barr virus (EBV). It causes white patches on your tongue. Sometimes the patches happen in other parts of your mouth. The patches may look hairy.
Smokers and people with poor oral hygiene are more likely to experience hairy tongue. It can be treated with daily brushing of the tongue and the use of a tongue scraper.
What can I prescribe for hairy tongue? ›
In most cases, the treatment of hairy tongue does not require pharmacologic intervention. If Candida albicans is present, topical antifungal medications can be used when the condition is symptomatic (eg, glossopyrosis). Topical application of retinoids has been used with some success.
What is the solution for hairy tongue? ›
Brushing the tongue daily with a soft-bristled toothbrush and toothpaste or a solution of 1 part hydrogen peroxide to 2 parts water may help remove the hair-like growths. This may also help prevent hairy tongue.
What is the difference between hairy tongue and coated tongue? ›
What do they look like? Coated tongue typically appears as a white, cream, brown or dark layer on the top surface of the tongue. Hairy tongue appears as small 'hair-like' projections coming from the top surface of the tongue, particularly at the back, which can be yellow, dark brown or black in colour.
What is the prognosis for hairy tongue? ›
Prognosis is good, and treatment consists of gentle brushing of the tongue, but many anecdotal reports exist demonstrating the use of medications or other products to treat this condition.
Is hairy tongue precancerous? ›
According to the Cleveland Clinic, 3-17.5% of people with leukoplakia develop squamous cell carcinoma, a common skin cancer type, within 15 years. However, they say that oral hairy leukoplakia doesn't cause cancer at all.
What diseases cause hairy tongue? ›
A tongue with the condition called oral hairy leukoplakia is usually caused by a viral infection, such as human Immunodeficiency virus (HIV) or Epstein-Barr virus (EBV), weakening a person's immune system.
How do you treat a black hairy tongue? ›
What is the treatment of hairy tongue?
- Discontinuing responsible drugs.
- Avoiding smoking and excessive alcohol intake.
- Encouraging good oral hygiene.
- Gentle tongue debridement, with a tongue scraper or soft toothbrush and solution containing 3% hydrogen peroxide or baking soda [1]
- Antiseptic mouthwash.
Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%.
