Black hair tongue

The Black hair tongue refers to a change in the tongue, which is characterized by a dark, furry coating on the tongue. It is cosmetically disruptive, but in most cases harmless. The causes, symptoms, diagnosis and treatment options are explained below.

What is a black hair tongue?

A doctor should be consulted if the person has a burning sensation or an itchy tongue. This also leads to bad breath and permanent nausea, so that the person affected also completely loses their appetite.
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The Black hair tongue is found in around 3 percent of the population, especially men. It manifests itself in the dark, fur-like coating in the middle to rear third of the tongue. This is caused by the elongation of the filamentous papillae on the tongue, which grow from around 1 mm to 1.8 cm and form this fur-like coating.

These “hairs” are colored green, brown or even black by food and beverages as well as microorganisms. The tongue coating can be very extensive and reach into the so-called throat, where it causes a very unpleasant and annoying tickling and sometimes a gagging sensation when speaking and swallowing. In many cases, the black hair tongue disappears on its own after several weeks or months.

causes

The filamentous papillae are often colored by pigment-producing bacteria and sometimes also by infections with Candida albicans. In the latter, there is also often a strong burning sensation in the tongue. Another possibility are ingested food and beverages (cigarettes, coffee, tea and alcohol) or medication, for example cortisone or antibiotics, which change the local environment in the oral cavity.

Various possible risk factors are known, but the exact cause has not yet been established. Poor oral hygiene and insufficient scraping of the tongue from teeth, palate and food seem to be equally important, for example when liquid food is consumed and too little solid food is chewed.

The appearance of the black tongue coating is also observed with a yeast infection, a vitamin deficiency (especially vitamin B) and excessive tobacco consumption. Other possible reasons are chemotherapy or radiation treatment, AIDS and being severely underweight. Other possible triggers are irritating substances such as strong mouthwashes or rinses.

Symptoms, ailments & signs

The black hairy tongue shows up as a colored, hairy coating on the tongue. The discoloration can be gray, green, yellow, brown or even black. Possible complaints are itching, burning tongue, changes in taste, for example a metallic taste, bad breath, poor appetite and nausea.

When swallowing and speaking, it is possible that the "hairs" trigger a tickling or nausea. In extreme cases, the tongue coating can lead to swallowing and speech disorders. The black hair tongue can disappear on its own or persist over a long period of time.

Diagnosis & course of disease

The diagnosis should always be made by a doctor. Here the elongated papillae over 3 mm are the most important criterion. This is because the tongue may be colored even temporarily without extending the filamentary papillae. This can be, for example, when consuming blueberries or other fruits.

But this can also be the case with the consumption of red wine, the use of mouthwashes or the ingestion of bismuth salts. A similar picture can also cause diseases, for example hairy leukoplakia, candidiasis and the like. Therefore, thorough questioning of the patient is very important.

Complications

In most cases, this complaint does not result in special compilations or serious complaints. The patient's health is usually not negatively affected, so that the complaint does not have to be treated in every case. Most people affected suffer from discoloration of the tongue.

This discoloration can be accompanied by itching, which can lead to a burning sensation or pain in the tongue. The disease also has a negative effect on the sense of taste, so that changes can occur. Furthermore, those affected often suffer from bad breath, nausea or vomiting. The patient's quality of life is considerably restricted and reduced.

If there is no treatment, the disease often leads to swallowing difficulties or speech disorders. As a rule, the disease can be treated relatively well with the help of medication. There are no particular complications. Surgical interventions are only necessary in rare cases. The patient's life expectancy also remains unchanged from the disease.

When should you go to the doctor?

This disease should always be treated by a doctor whenever possible. As a rule, there is no independent healing, so treatment by a doctor is essential. Furthermore, the symptoms can worsen if the disease is not treated in time. First and foremost, the underlying disease that is responsible for this complaint must also be identified. A doctor should be consulted if the person has a burning sensation or an itchy tongue. This also leads to bad breath and permanent nausea, so that the person affected also completely loses their appetite.

In many cases, difficulty speaking or swallowing is also an indication of the disease. Above all, a doctor should be consulted if the patient suffers from a black tongue and the color does not go away on its own. A dermatologist or general practitioner can usually be seen for this disease. The further treatment depends on the exact symptoms and the underlying disease.

Treatment & Therapy

The treatment of a black hairy tongue can be done both without medication and with medication: First, regular cleaning of the tongue coating with a soft toothbrush or tongue cleaner is recommended. Good oral hygiene is the best way to get rid of impurities and prevent them from reoccurring. Strong mouthwashes must be stopped because they can trigger and promote the symptoms.

If possible, the risk factors should be eliminated. The discoloration can be eliminated, for example, after stopping or reducing the triggering medication. If you have a dry mouth, it is important to ensure that you drink enough fluids.

If symptoms cannot be relieved, medication is another option. Keratolytics such as salicylic acid, trichloroacetic acid or urea can be applied locally in an appropriate dilution. These funds should of course be prescribed by a doctor. External or internal antimycotics are only used if a fungus colonization with Candida albicans has been determined. In severe cases, the active pharmaceutical ingredient isotretinoin can be considered for treatment.

However, the precautionary measures must be observed here, as numerous side effects are possible. The therapy basically depends on how pronounced the black hair tongue is. In milder cases, changing the diet and avoiding noxious substances, such as smoking, usually leads to a reduction in symptoms and complaints. In pronounced cases, however, surgical removal under local anesthesia may be necessary.

You can find your medication here

➔ Medicines against tartar and tooth discoloration

prevention

The best prevention of black hair tongue lies in good oral hygiene, a healthy and high fiber diet. A soft toothbrush or a special tongue cleaner can significantly support the abrasion of the dark coating on the tongue. It is also helpful to chew the food thoroughly. A coating that remains on the tongue from food residues, germs and cells must be removed by appropriate abrasion.

Therefore, fruits, raw vegetables and firm bread should be chewed thoroughly. The tongue is rubbed as intensively as possible in this way. Smoking should also be avoided. It is important to avoid potentially triggering factors. Therefore, it is primarily important to find the causes of the black hair tongue.

Aftercare

The black hair tongue often disappears on its own after a few weeks or months. In severe cases, symptomatic therapy with vitamin C tablets or tongue scrapers is possible. After the condition has subsided or has been cured, follow-up care by the doctor is necessary. Follow-up care is provided by the ear, nose and throat specialist, dentist or family doctor.

The medical professional will perform a physical exam and then discuss any symptoms or side effects of the medication with the patient. As part of the physical exam, the oral cavity and especially the tongue are examined. The doctor uses a tongue scraper for this. If necessary, a smear must be taken again. The black hair tongue can be accompanied by side effects such as inflammation in the oral cavity, which must be clarified.

If no abnormalities are found, the therapy can be terminated. A one-time follow-up examination is usually sufficient. Should complications arise, therapy must be restarted. The patient should consult the doctor at regular intervals until the condition is cured. Since the black hairy tongue can sometimes be a psychological burden, a follow-up discussion with a therapist may be useful. The exact follow-up measures are based on the symptoms.

You can do that yourself

A black hair tongue can be treated with or without medication. The present symptoms are decisive for this. Very good oral hygiene is essential for a black hairy tongue. Regular cleaning with a soft toothbrush or tongue cleaner can be successful in some cases. The focus here is on removing existing contamination and preventing it from occurring again. However, strong mouthwashes should be avoided. They can possibly lead to further problems.

Risk factors should also be eliminated as far as possible. First of all, nicotine consumption should be mentioned. Various changes in diet and habits often help to alleviate or reduce the disease in mild cases. Various types of medication can also be the cause of this disease. The attending physician should carefully review the existing medication and, if necessary, determine any incompatibilities.

If these measures do not relieve the symptoms, drug treatment is also possible. The means of choice here are keratolytics such as salicylic acid, trichloroacetic acid or urea. They are applied locally in an appropriate dilution according to a doctor's prescription. Antimycotics are only used after reliable knowledge about the cause of the black hairy tongue. Since side effects can occur here under certain circumstances, the use must be carefully considered.