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Black Hairy Tongue
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The name of this condition is descriptive of the appearance of the surface of the tongue. It occurs in any race and in both men and women though more frequently in men. The condition occurs much more commonly in older adults but can also affect children. It is also known as Brown Hairy Tongue or Linqua Villosa Nigra and represents a change of the tongue’s papillae or what is commonly referred to as the taste buds. These papillae elongate and reach a length of several millimeters giving the surface of the tongue a hairy or furry appearance.

This elongation of the tongue’s papillae is the result of hypertrophy and reduced desquamation (shedding) of the tongue’s papillae. These elongated taste buds will become discolored and the colors vary depending on the precipitating cause of the condition. It is rarely symptomatic but some patients report a gagging sensation or a tickling sensation of the roof of the mouth.

Potential causes include smoking, oral antibiotics, Candida albicans (a yeast organism), poor oral hygiene, medications that include bismuth, and oxidizing agents such as peroxide found in some mouth washes. Colors can be black, brown, yellow, pink, green, red and are generally based on type of precipating condition. Use of colored mouth wash may cause green or red, heavy tobacco use or heavy consumption of tea or coffee can result in black or brown, bismuth (Pepto Bismol) gives a pinkish color, and candies can also add their own color to the condition.

There is no specific medical treatment. The condition is treated by eliminating the cause, if known, and practicing good oral hygiene. This includes regular brushing of the teeth and tongue with fluoride toothpaste as well as regular flossing of the teeth.


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