Hairy Tongue: Symptoms, Causes, and Treatment (2024)

Hairy tongue, also known as black hairy tongue, is a condition in which the center of the tongue has a fuzzy appearance. In severe cases, the center of the tongue may look like it’s covered in hair.Sometimes, people with hairy tongue experience color changes that cause their tongue to look brown, white, yellow or pink.

The condition happens when the filiform papillae—the bumps that appear on tongues—don’t shed properly. Instead, they grow longer, giving off a fuzzy appearance. The condition is associated with poor oral hygiene and can often be reversed with a better brushing and oral hygiene routine.

Continue reading to learn more about why a hairy tongue can develop, what foods cause a hairy tongue, and how you fix hairy tongue.

Hairy Tongue: Symptoms, Causes, and Treatment (1)

Symptoms of Hairy Tongue

The main symptom of hairy tongue is a changed appearance of the tongue. Otherwise, the condition is often asymptomatic.

However, some people experience additional symptoms including:

  • Bad breath (halitosis)
  • Burning sensation, which is more common if you have a yeast or bacterial infection within the hairy tongue
  • Gagging sensation when swallowing
  • Tickling on the roof of the mouth
  • Changes to taste

Causes of Hairy Tongue

The most common causes of hairy tongue are:

  • Poor oral hygiene routine
  • Dehydration
  • Prolonged antibiotic use
  • Smoking
  • Viral infections

A healthy toothbrushing routine, which includes brushing the tongue, can help shed excess filiform papillae. But if you don’t brush often enough, the papillae can continue to get longer and longer. Papillae are made from keratin, the same material that hair is made from, which can lead to a hairy appearance. This is also why hairy tongue is more common in people with soft diets, since the food they eat is not abrasive and doesn’t cause the papillae to shed.

Antibiotic use can contribute to hairy tongue because they change the normal microbiome of the mouth. Smoking and drinking too much coffee may also change oral health, increasing the risk of hairy tongue.

What Medications Can Cause Hairy Tongue?

Taking antibiotics can cause hairy tongue, especially if you’re taking them often or for a long time. Other medications have also led to reports of hairy tongue, including:

  • Antipsychotic medications, especially those that cause dry mouth
  • Chemotherapy drugs
  • Radiation to the head or neck

How to Treat Hairy Tongue

Hairy tongue can be treated by starting a good oral hygiene routine, including brushing your tongue. You should also address the underlying factors that might contribute to developing hairy tongue, like smoking, taking certain medications, or eating a soft diet.

A healthcare provider will be able to help you develop an oral care plan that can reduce the risk of developing hairy tongue, while keeping you on the medications or diet that you need.

Complications Associated With Hairy Tongue

When your papillae are longer than normal, they can trap bacteria, fungi, and debris. This can increase your risk for a tongue infection, including oral yeast infection, or thrush. If your hairy tongue doesn’t resolve with brushing, you may need to talk to a healthcare provider about treating underlying infections to help clear the hairy tongue.

Are There Tests to Diagnose the Cause of Hairy Tongue?

Hairy tongue is usually diagnosed by observation alone. There’s no test that can diagnose hairy tongue. However, if a healthcare provider suspects an infection, they may order a culture that can test for bacteria or yeast.

When to See a Healthcare Provider

If you notice that your tongue is becoming fuzzy or discolored, you can try to treat it on your own by improving your oral hygiene routine and brushing your tongue. If that doesn’t help, see a healthcare provider. They can create a treatment plan and identify the causes contributing to your hairy tongue.

Summary

Hairy tongue is a condition where the filiform papillae on the tongue become extra long. Since the papillae are made from keratin, the same material that hair is made of, the tongue can have a fuzzy or hairy appearance as the papillae grow.

The condition can most often be treated by improving your oral hygiene routine, including brushing your tongue. If that doesn’t work, speak with your healthcare provider, who can help you develop a treatment plan and determine what might contribute to your hairy tongue.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. MedlinePlus. Tongue problems. National Library of Medicine.

  2. American Academy of Oral Medicine. Hairy tongue.

  3. Burge E, & Kogilwaimath S. Hairy tongue. Canadian Medical Association Journal.

  4. Brigham and Women's Hospital. Coated/hairy tongue.

  5. Ren, Jing, et al. Antibiotic-induced black hairy tongue: Two case reports and a review of the literature. The Journal of International Medical Research. 2020 doi: 10.1177/0300060520961279

  6. Johns Hopkins Medicine. Oral hairy leukoplakia.

Hairy Tongue: Symptoms, Causes, and Treatment (2)

By Kelly Burch
Burch is a New Hampshire-based freelance health writer with a bachelor's degree in communications from Boston University.

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