Have you ever brushed your teeth in the morning and looked in the mirror and noticed that your tongue is black, like it has a lot of little hairs growing on it? It's a really scary and disturbing sight. You might think, "What happened to me?" But the good news is that, although it looks scary, it's usually harmless and temporary. Today, let's talk about this 'black hairy tongue' or simply Black Hairy Tongue as doctors call it.
What exactly is this? Does it grow hair on the tongue?
No. Despite the name, tongue hairs don't actually grow on the tongue. So what do these hairs look like?
Simply put, we have very small bumps on our tongue. If you look in a mirror, you can see these. These are what we call papillae . The taste buds that help us taste are inside these papillae. Normally, just like our skin sheds and new skin grows, the top layer of these papillae is constantly shed. We call this process desquamation .
But sometimes, these papillae don't fall off completely and start to grow longer. Sometimes they can grow as long as 18 millimeters, or about ¾ of an inch. When they grow this long, they look like hairs.
Then why is this black?
These elongated papillae get stuck between food particles, dead skin cells, and bacteria. These stuck things and bacteria are what cause the tongue to turn black, brown, sometimes green, white, or other colors. So, despite the name 'Black Hairy Tongue', it doesn't always have to be black.
What are the symptoms of this?
Often the only symptom is a change in the appearance of the tongue. This can include the appearance of black or brown hairs on the tongue. This is usually not painful. However, some people may also experience the following:
- Bad breath
- A burning, tingling, or nauseating feeling on the tongue
- Feeling like food tastes different
Why is this happening? What are the main reasons?
The two main reasons for this condition are poor oral hygiene and eating only liquid or soft foods . Think about it, those papillae we talked about earlier need some friction, that is, rubbing, to come off. When we brush our tongue with a toothbrush, or when we eat slightly spicy foods, this friction occurs and the papillae come off. But when that doesn't happen, they start to grow.
Let's look at other reasons that affect this in the table below.
| Reason | Description |
|---|---|
| Some medications | This condition can be caused by changes in the normal bacterial composition of the mouth, especially due to antibiotics and some antidepressants. |
| Excessive drinking of coffee and tea | This risk is higher for people who drink a lot of coffee or tea per day. |
| Tobacco use (smoking, chewing betel nut) | Tobacco stimulates the growth of papillae and also causes spots to form on them. |
| Dry mouth | When saliva production in the mouth decreases, the washing away of dead cells and bacteria is reduced. |
| Mouthwash containing peroxide | Continuous use of mouthwashes containing oxidants such as peroxide may also be a cause of this. |
| Weakened immunity | The risk of this condition increases when the body's immune system is weakened due to conditions such as cancer, HIV, or cancer treatments (chemotherapy, radiation). |
Who is most at risk of developing this condition?
Although this can develop at any age, it is most common in men over the age of 65.
How does a doctor recognize this?
In most cases, your doctor can diagnose Black Hairy Tongue by examining your tongue. No special tests are usually needed. Very rarely, if another medical condition is suspected, a small piece of tissue from your tongue may be taken for a biopsy .
What are the treatments for this?
It's not as difficult to cure as you might think. The main thing is to take care of your oral health.
Simply put, the best treatment for this condition lies in your own hands. It can be completely cured with a few simple daily habits.
Let's look at the treatment methods in the table below.
| Treatment method | What to do |
|---|---|
| Improving oral health | This is the first and most important step . After brushing your teeth, gently brush your tongue with a toothbrush or tongue scraper. Do this at least twice a day. |
| Stopping addictive habits | If you smoke, stop. Limit your intake of coffee, tea, and alcohol. |
| Drug use | If your oral health is not improving, it could be a fungal or bacterial infection. In such a case, your doctor may prescribe antifungal or antibiotic medications. There are also other treatments, such as retinoids. |
| Be careful about the medications you take. | If you suspect that this condition is caused by a medication you are taking, never stop it on your own . Talk to your doctor about it. He or she will decide whether it is appropriate to stop it or switch to another medication. |
Do you need to see a doctor?
You can try home remedies first. This means cleaning your tongue thoroughly every day and cutting down on coffee. If there is no improvement after a week or two of changing these habits, it is best to see a doctor.
Be sure to talk to your doctor, especially if you think this is due to a medication you are taking.
A few questions that many people ask
What is the difference between Black Hairy Tongue and Oral Hairy Leukoplakia?
This is a very important question. We have said that in Black Hairy Tongue, the tongue can be black, brown, or green in color. But if these hairy things on your tongue are white , it could be another condition called Oral Hairy Leukoplakia . Unlike Black Hairy Tongue, this condition of Leukoplakia can be associated with some viral infections. Therefore, if you have something like this in your tongue, it is important to seek medical advice.
Is this caused by sexually transmitted diseases (STDs)?
No. Sexually transmitted diseases do not directly cause Black Hairy Tongue. However, conditions that weaken the immune system, such as HIV, can increase the risk of developing it.
This condition usually clears up completely within a few days or a week or two with good oral hygiene habits, so don't be alarmed by its appearance.
Take-Home Message
- Black Hairy Tongue is a scary-looking, but harmless, temporary condition.
- These are not actually hairs, but rather the result of the elongation of parts of the tongue called papillae.
- Maintaining good oral hygiene, especially daily tongue cleaning, is the best way to prevent and treat this condition.
- Habits such as smoking and excessive coffee/tea drinking can be the main causes of this condition.
- If home remedies do not help or you have any concerns about a medication you are taking, consult your doctor for advice.
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