Black hairy tongue is more common in adults than children, and appears more often in men than women. People with cancer, people who smoke, and people who drink black tea may also be at a greater risk of developing black hairy tongue.
Read on to learn more about the causes, symptoms, treatments, and prevention of black hairy tongue.
Sex and gender exist on a spectrum. This article uses the terms “men” and “women” to refer to sex that was assigned at birth.
Black hairy tongue can result from many factors. Sometimes, the papillae on the tongue do not shed at their typical rate.
Our tongues have several parts that allow us to taste. Papillae, which are thin hair-like structures about one millimeter long, cover the tongue. Papillae contain taste buds and usually shed from our tongues at a regular pace.
When papillae do not shed regularly, a protein called keratin builds up. Bacteria, yeast, or even food particles can collect on the long papillae and create what looks like a black coating.
There are several other factors that can lead to black hairy tongue, such as:
- taking antibiotics, which can change the bacteria in your mouth and body
- taking medicines that contain bismuth subsalicylate, like Pepto-Bismol
- having dry mouth
- smoking
- chewing tobacco
- drinking too much alcohol, coffee, or tea
- using certain mouthwashes
- experiencing trigeminal neuralgia, a condition that causes facial pain
- lacking brushing or routine care for the mouth and teeth
As the name suggests, black hairy tongue looks like small, longer hairs grouped together toward the back of the tongue and coated with a discolored substance.
Depending on the cause of the buildup on the papillae, your tongue may look black or brown. It can also look green, white, or pink but will retain its “hairy” appearance.
Some people also experience other symptoms with black hairy tongue. These symptoms may include:
- bad breath or taste in the mouth
- sensation of tickling or burning on the tongue
- dysgeusia, or a distortion of your sense of taste
- nausea or gagging
A doctor or dentist can diagnose black hairy tongue after performing a physical examination and asking about your current medications and mouth care routine. If there is no obvious cause — like medications, medical conditions, or behaviors — your doctor might order more testing.
In some cases, cultures can help doctors determine if there are any bacterial or fungal infections present. If the condition does not respond to gentle brushing, a tongue biopsy may be necessary.
The treatment of black hairy tongue will depend on the cause. Once the cause is known, treatment often includes avoiding the factors that led to it. This may include stopping a specific medication, quitting smoking, or improving dental habits.
Doctors and dentists also typically recommend gently brushing the tongue a few times daily with a toothbrush or tongue scraper to remove the coating and encourage the papillae to shed.
After starting treatment, black hairy tongue often clears up within 1 or 2 days to possibly a few weeks. If an underlying condition contributes to black hairy tongue, managing that condition will be necessary in order to prevent a recurrence.
Men and older adults may be at a greater risk of developing black hairy tongue. Around 40% of people who develop the condition are more than 60 years old. Other risk factors may include:
- taking antibiotics or certain other medications
- smoking or using tobacco
- undergoing radiation therapy on the head or neck
- lacking teeth
- having difficulty maintaining dental hygiene habits
- living with HIV
In addition, a soft or liquid diet may allow papillae on the tongue to continue to grow. Also, people who have had black hairy tongue are more likely to experience it again.
To prevent black hairy tongue, experts recommend practicing daily oral hygiene by regularly brushing and flossing, and brushing your tongue with a toothbrush or tongue scraper.
Your doctor can tell you what else may be causing your black hairy tongue and recommend behavior modification, like smoking cessation programs, to help you.
Here are a few other commonly asked questions about black hairy tongue.
Is black hairy tongue a fungus?
In some cases, black hairy tongue can result from a fungal infection. Your doctor may prescribe antifungal medications and recommend diligent oral hygiene to help clear up the condition.
Is black hairy tongue serious?
Black hairy tongue is generally not serious. Many times, gentle brushing and practicing oral hygiene habits are the only necessary treatment measures.
Black hairy tongue is not a serious condition and is easy to diagnose and treat. It generally looks like a furry black or brown patch on the top of the tongue.
Black hairy tongue can have many causes, so treatment may vary. Brushing the teeth and tongue regularly is important for treating and preventing black hairy tongue. The condition usually recedes within a few days or weeks after starting treatment.
Talk with your doctor if you experience symptoms consistent with black hairy tongue.
