What is a hairy tongue?
Another common condition, characterized by an abnormal desquamation of the filiform papillae,which,
instead of being 1 mm long, can become 15 mm in length, thus giving the tongue its characteristic “hairy”
coating, plus a brownish-to-blackish discoloration (lingua villosa nigra, or “black hairy tongue”). Note
that a hairy tongue also may appear brown, white, green, or pinkish, depending on its etiology and
secondary factors (such as the use of colored mouthwashes, breath mints, candies). Common causes
include radiation therapy to the head and neck and certain medications, especially broad-spectrum
antibiotics. The condition, however, may often be idiopathic, and in this case usually results from
inadequate tooth brushing, or a diet with too little roughage to mechanically débride the dorsum of the
tongue. Prevalence is high, and usually higher with age (from 8.3% in children and young adults to 57% in IV drug abusers and prison inmates), probably because of the high frequency among older subjects of practices that predispose to the condition. Although there is no racial predilection, a hairy tongue is more prevalent in males.
It is also more prevalent in HIV patients, smokers, and tea/coffee drinkers. It is usually
asymptomatic, although patients may complain of tickling (and at times gagging) upon swallowing.
Overgrowth of Candida sp. may result in a burning feeling (glossopyrosis), while retention of oral debris
between the elongated papillae (and its associated bacterial and fungal overgrowth) may cause halitosis.
Yet, like the scrotal tongue, a hairy tongue is usually of little clinical significance. Differential diagnosis
includes oral candidiasis and the much more ominous hairy leukoplakia. Treatment consists in using a tongue
scraper to remove elongated papillae and retard the growth of additional ones.
Another common condition, characterized by an abnormal desquamation of the filiform papillae,which,
instead of being 1 mm long, can become 15 mm in length, thus giving the tongue its characteristic “hairy”
coating, plus a brownish-to-blackish discoloration (lingua villosa nigra, or “black hairy tongue”). Note
that a hairy tongue also may appear brown, white, green, or pinkish, depending on its etiology and
secondary factors (such as the use of colored mouthwashes, breath mints, candies). Common causes
include radiation therapy to the head and neck and certain medications, especially broad-spectrum
antibiotics. The condition, however, may often be idiopathic, and in this case usually results from
inadequate tooth brushing, or a diet with too little roughage to mechanically débride the dorsum of the
tongue. Prevalence is high, and usually higher with age (from 8.3% in children and young adults to 57% in IV drug abusers and prison inmates), probably because of the high frequency among older subjects of practices that predispose to the condition. Although there is no racial predilection, a hairy tongue is more prevalent in males.
It is also more prevalent in HIV patients, smokers, and tea/coffee drinkers. It is usually
asymptomatic, although patients may complain of tickling (and at times gagging) upon swallowing.
Overgrowth of Candida sp. may result in a burning feeling (glossopyrosis), while retention of oral debris
between the elongated papillae (and its associated bacterial and fungal overgrowth) may cause halitosis.
Yet, like the scrotal tongue, a hairy tongue is usually of little clinical significance. Differential diagnosis
includes oral candidiasis and the much more ominous hairy leukoplakia. Treatment consists in using a tongue
scraper to remove elongated papillae and retard the growth of additional ones.