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).
What are the symptoms of black hairy tongue?
Usually, your tongue’s appearance is the only symptom, and it doesn’t hurt. Additional symptoms that may appear in some cases include:
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.
Oral hygiene
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.
Medications
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).
Surgery
Traditional or laser surgery is an option when nothing else has solved the problem.
How long does it take for black hairy tongue to go away?
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.
How is black hairy tongue diagnosed?
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.
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