BLACK HAIRY TONGUE

Black hairy tongue (BHT) is a benign discoloration of the dorsal surface of the tongue. Excessively long filiform papillae are black in color due to accumulation of keratin and chromogenic microorganisms.

• The condition usually occurs in older individuals but infants as young as 2 months of age may be affected.
• Common contributing factors include poor oral hygiene, regular use of oxidizing mouthwashes, dry mouth, antibiotic use, tobacco, coffee, tea, alcohol, and eating mainly soft foods.
• Some oral antibiotics can precipitate a black, hairy tongue by altering the microflora of the oral mucosa. Reported offenders include the tetracyclines (like doxycycline and minocycline), erythromycin, penicillins, linezolid, and amoxicillin-clavulanate.
• Taking bismuth subsalicylate (Pepto-Bismol) can induce it as well.

BHT occurs because of a buildup of keratin cells, which are the proteins that also make up human hair. This buildup can give the tongue a rough, hairy texture. This rough surface also provides an excellent area for bacteria and fungi to multiply, which could also cause a green tongue.

Clinical

The dorsal surface of the tongue is blackened. The filiform papillae are long and dark in color.

RegionalDerm

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