50-Year-Old Man from India Who Suffered from a Stroke Develops a Black ‘Hairy’ Tongue

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A 50-year-old man showed up in a dermatology center and had himself examined for growing thick black coating on his tongue. It covered most of his tongue for about two weeks except in the sides and middle part, but was totally painless.

2 weeks prior to when the man stepped inside the clinic, he received a diet of pureed food and liquids, as well as oral antiplatelets and antihypertensives. However, three months prior to developing such condition, the man apparently suffered from a stroke with dense hemiplegia, according to ScienceAlert.

The doctors diagnosed the condition as black hairy tongue (lingua villosa nigra), an abnormal coating on the top (dorsal) surface of the tongue, the American Academy of Oral Medicine defined. Hairy tongue can happen at any age but more likely in old age. It is relatively temporary and harmless, occurring in as much as 13% of the population.

Black hairy tongue defined

Indian dermatologists say black hairy tongue was more likely to occur in people on a pureed diet, and it forms due to lack of abrasion or stimulation to the top of the tongue. This results to buildup of protein called keratin, the same protein that makes up the hair on your head.

It typically appears brown, yellow, or green, as well as black, according to National Institutes of Health, depending on the bacteria and fungi that grows in the surface. If it happens to be the anaerobic bacteria, it's when it gives the tongue the black appearance.

The Dermoscopy results of the man presented in JAMA Dermatology showed thin, elongated, black fibers, with visible Amorphous yellowish deposits.

People who have this condition usually do not have symptoms, although there may be occasional burning, gagging, or tickling feeling.

Other predisposing factors include poor oral hygiene, smoking, oxidizing mouthwashes, oral antibiotics, excessive coffee or tea drinking, and conditions that suppress the immune system, such as HIV or cancer. It may also be associated with halitosis or bad breath.

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How to prevent hairy tongue

The man's findings made the diagnosis of black hairy tongue (BHT), and was given advice regarding proper cleansing measures to help ease discoloration. When religiously followed, the patient's condition could be resolved after 20 days according to doctors.

To eliminate buildup, good oral hygiene with a toothbrush or tongue scraper will do. In cases where there is persistent coating on the tongue, the patient can consult their dentist or other trained oral health professional. If simple measures don't work, an aid of medical or surgical treatments by qualified individuals is best.

Nonetheless, prevention is always better than cure. Most individuals can prevent this by practicing good oral hygiene. While BHT can occur at any point, certain lifestyle factors can aggravate the risk such as use of tobacco and alcohol, dehydration, and poor oral hygiene.

It is important to note that individuals previously diagnosed black hairy tongue are at greater risk for recurrence, which is why more diligence in oral hygiene should be observed.