Black hairy tongue sounds awful, but it’s a harmless and fairly common condition. Poor oral hygiene, tobacco use and certain medications are just a few of the things that can cause black hairy tongue. The condition can usually be controlled with improved oral hygiene.
Black hairy tongue is a temporary, harmless and fairly common condition in which the top of your tongue looks hairy. However, the substance on your tongue isn’t really hair and it’s not always black — it can be brown, green, white or other colors.
Little bumps on the top of your tongue — called filiform papillae — grow and collect food, bacteria and dead skin cells, which provide the color. The papillae are usually about 1 millimeter (1/32 inch) long and they’re supposed to fall off, like a layer of skin being shed, before they grow. This shedding process is called desquamation. If the papillae don’t fall off, they can grow as long as 18 millimeters (3/4 inch).
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Black hairy tongue affects about 13 % of people at some point in their lives, according to the American Academy of Oral Medicine. It happens in all population groups, but is more common in men and in people over the age of 65.
Usually, your tongue’s appearance is the only symptom, and it doesn’t hurt. Additional symptoms that may appear in some cases include:
Advertisement
The two most common causes of black hairy tongue include poor oral hygiene and a diet of soft foods. This is because the shedding process requires stimulation and abrasion to the top of your tongue. Common black hairy tongue causes include:
Most of the time, a black hairy tongue just means you need to improve your oral hygiene at home. However, in some cases, the condition may be caused by an overgrowth of bacteria or fungi. In these instances, your healthcare provider can prescribe antibiotic or antifungal medications.
Advertisement
In most cases, your healthcare provider can make a diagnosis by looking at your tongue. Generally, no tests are necessary. Your healthcare provider might order a biopsy — an examination of tissue removed from your tongue — if there’s any doubt about the diagnosis or concern that black hairy tongue isn’t the only problem.
Black hairy tongue treatment usually involves improving your oral hygiene at home. If that doesn’t help, then your healthcare provider may prescribe medications — or in severe cases, recommend surgery.
If you have black hairy tongue, the first thing you should do is take steps to improve your oral hygiene. After brushing and flossing your teeth, be sure to clean your tongue thoroughly with a toothbrush or tongue scraper.
If black hairy tongue still persists after an improvement in oral hygiene, it can be treated with antibiotics, antifungal medications, mouthwash or retinoids (drugs related to vitamin A).
Traditional or laser surgery is an option when nothing else has solved the problem.
In most cases, black hairy tongue symptoms will go away on their own in about one to two weeks. If your symptoms last longer, schedule an appointment with your healthcare provider to discuss treatment options.
Brushing your tongue with a toothbrush or using a tongue scraper can remove the papillae and the food debris that might be caught in them. You should also brush your teeth twice a day, floss once a day and visit your dentist for routine exams and cleanings.
There are also some things you can do to reduce your risk for black hairy tongue. For example:
Once you figure out what caused black hairy tongue, you can take steps to treat it and reduce the risk of it happening again. Often, this just involves making minor lifestyle changes, such as cleaning your tongue daily.
You can try dealing with black hairy tongue yourself, for example, by brushing and scraping your tongue or drinking less coffee. If the condition persists, make an appointment with your healthcare provider. If you worry that one of your medications is causing black hairy tongue, talk to your healthcare provider before you stop taking something that’s been prescribed for you.
It’s also worth noting that black hairy tongue comes in different colors — and if it’s actually a white hairy tongue, it can be caused by something called hairy leukoplakia. This can be a sign of a virus.
A note from Cleveland Clinic
Black hairy tongue looks and sounds terrifying. But the condition is generally harmless and easy to treat. If you’ve tried home remedies and nothing is working, schedule a visit with your healthcare provider. They can determine what’s causing the condition and find ways to keep your tongue healthy.
Last reviewed on 04/07/2022.
Learn more about the Health Library and our editorial process.
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy