Black Hairy Tongue
(Lingua Villosa Nigra)
What is Black Hairy Tongue?

Black Hairy Tongue is the name given to the appearance of
an abnormal coating of the tongue.

It is a benign disorder characterised by thickening of the
filiform papillæ (these are mushroom-shaped projections
covering most of the top surface of the tongue) of the
tongue.  A brownish-black discoloration of the
Why does it happen?

There is defective shedding of the cells in the central
column of the
filiform papillæ of the tongue resulting in the
formation of highly elongated, horn-like spines or "hairs" -
the hallmark of this disease.  The cause for this is unknown
and often no definite cause can be identified.

Often there are no symptoms other than the cosmetic or
anxiety over its cause. Some patients complain of gagging,
nausea, alteration of taste or bad breath.

Contributing factors may include:

  • administration of topical or systemic antibiotics
  • poor oral hygiene
  • smoking
  • alcohol
  • use of mouthwashes
  • iron compounds use of medications containing bismuth
    such as Pepto-Bismol antiseptic lozenges

How is it treated?

The condition may be very persistent and treatments
include increasing hydration and salivation, discontinuing
smoking, brushing the tongue with a soft tooth brush
followed by use of a dilute solution of
hydrogen peroxide,
scraping the tongue with a peach stone,
topical retinoids or
steroids, gentian violet, thymol, salicylic acid or vitamin B
and surgical excision of the papillæ.

Useful Websites:

Mayo Clinic

Medline Plus


New England Journal of Medicine
Last Updated 10th November 2010