(Oral Hairy Leukoplakia)
Oral leukoplakia is the development of thick, white patches on the soft tissue of the mouth. This can include gums, tongue, or inner cheeks. The patches form over the course of weeks or months. Hairy leukoplakia is a specific type of leukoplakia that develops in people with weakend immune systems.
Leukoplakia is a change in cells. Over time, some leukoplakia can develop into cancer.
Leukoplakia is an overgrowth of these changed cells. It may develop for no reason. However, it is often associated with regular irritants to the tissue of the mouth such as:
- Smoking, including cigars and pipes
- Smokeless tobacco, including chewing tobacco or snuff
- Frequent alcohol use
- Rough teeth
- Rough places on dentures, fillings, or crowns
Some leukoplakia may have an association with the human papillomavirus (HPV).
Hairy leukoplakia is associated with Epstein-Barr virus. This virus can exist in your body but only cause problems if there is a weakened immune system, such as HIV.
Leukoplakia is more common in men after age 65. Other factors that may increase your chance of leukoplakia include:
- Tobacco use, especially smokeless tobacco
- Long-time alcohol use
- Suppressed immune system, which can occur with chronic health conditions or medications (hairy leukoplakia)
Leukoplakia causes patches on the tongue, gums, or inside of the cheeks. These patches may be:
- White or gray, rarely may have some red
- Thick, slightly raised, or hardened on the surface
- May develop slowly over time
There may be pain or signs of infection. The patches may also be sensitive to touch, heat, or spicy foods.
Hairy leukoplakia also has white patches but they are fuzzy patches. They also tend to appear on the side of the tongue.
You will be asked about your symptoms and medical history. A physical exam will be done, including the area where the patches are. In most cases, oral leukoplakia can be diagnosed during an oral exam.
Certain infections and cancers can cause patches in your mouth. Your doctor may do a brush biopsy to look for cancer or infections. The brush removes some cells to look at under a microscope.
Treatment options include:
- Removing the irritant—Quitting smoking or correcting dental problems often takes care of the problem.
- Removing patches—If the problem persists, or if signs of cancer are present, the dentist or doctor may need to remove patches of leukoplakia. This may be done with surgery, laser treatment, electrocauterization, or freezing, or topical medications.
If the patches do not fade as expected, the doctor may advise:
- Topical medications or solutions that are applied to the patches
- Medicated mouthwashes
- Oral medications, such as retinoids, vitamin A, beta carotene, or lycopene
- Antiviral medications—if the leukoplakia is due to viral infection (more common in people with suppressed immune function)
To help reduce your chance of leukoplakia:
- If you smoke, talk to your doctor about how you can successfully quit.
- Avoid or limit your use of alcohol.
- See a dentist regularly, especially if you have rough places in your mouth.
Mouth Healthy—American Dental Association
National Institute of Dental and Craniofacial Research
Canadian Dental Association
Dental Hygiene Canada
Hairy leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/hairy-leukoplakia.html. Accessed August 22, 2017.
Leukoplakia. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Leukoplakia. Accessed August 22, 2017.
Leukoplakia. NHS choices website. Available at: http://www.nhs.uk/Conditions/Leukoplakia/Pages/Introduction.aspx. Updated January 15, 2015. Accessed August 22, 2017.
Oral leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/oral-leukoplakia.html. Accessed August 22, 2017.
Oral hairy leukoplakia. AETC National Resource Center website. Available at: http://aidsetc.org/guide/oral-hairy-leukoplakia. Accessed August 22, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD FAAP Last Updated: 6/11/2015