Hairy tongue

What is the hairy tongue?

The hairy tongue is an unusual and harmless condition characterized by an 'hairy' enlargement and discoloration of the filiform papillae. The filiform papillae are small conical protuberances found on the surface of the front two-thirds of the tongue that do not carry taste buds.

Also known as black hairy tongue and lingua villosa nigra.

Who has a hairy tongue?

Hairy tongue occurs most often in adults over the age of 40 and is rare in babies. [one].

A variety of drugs have been linked to hairy tongue, including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth [1] Erlotinib [2] Linezolid [3].

Other factors that can cause and / or aggravate the hairy tongue include:

• Poor oral hygiene

• Smoking or chewing tobacco

• Drinking alcohol
• Cocaine
• Mouthwash containing chlorhexidine or peroxidase
• Colorful drinks, including coffee.
• Dehydration
• Hyposalivation (dry mouth)
• Radiotherapy [3].

What are the clinical features of the hairy tongue?

The filiform papillae can grow up to 18 mm in length, a “hairy” appearance [4]. The tongue is discolored, usually brown or black, although brown, yellow and green have also been described. [5]. The posterior surface of the tongue is generally affected, and the tip and sides of the tongue are often spared [4].

Hairy tongue is generally asymptomatic and the main problem is its unsightly appearance. Occasionally, patients may complain of a burning or tingling sensation on the tongue, nausea, or halitosis (bad breath).

What causes hairy tongue?

The hairy tongue is due to the defective detachment of the superficial cells. Abnormal filiform papillae prevent normal cleaning and debridement Therefore, debris accumulates on the tongue. The bacteria and yeasts overgrow and make porphyrins (deeply colored organic compounds), which can contribute to discoloration [5].

How is hairy tongue diagnosed?

Hairy tongue is a clinical diagnosis [4].

It is important to keep a detailed history to establish possible contributing factors. Investigations may include:

• Swabs for bacterial culture
• Scraped mushrooms
• Language biopsy

What is the treatment of hairy tongue?

The furry tongue is generally self-limiting. If desired, treatment options include:

1. Discontinue responsible drugs
2. Avoid smoking and excessive alcohol consumption.
3. Promote good oral hygiene.
4. Gentle debridement of the tongue, with a tongue scraper or soft toothbrush, and solution containing 3% of hydrogen peroxide or sodium bicarbonate [1]

5. Antiseptic mouthwash

6. Current antifungal agent for oral Candida albicans if present
7. Current retinoid

If another treatment fails, trim the papillae with carbon dioxide To be Burns and electrodesiccation have been described [5].