November 24, 2022

Blue Hairy Tongue and White Hairy Tongue Syndrome

Blue Hairy Tongue

Hairy tongue syndrome is a relatively uncommon tongue condition causing a thickened and discolored tongue appearance. The most common discoloration is black (see below). However, other colors may be less commonly seen such as brown, white, and most rarely, even blue. Regardless of the color, the treatment is all the same.

Normally the dorsal surface of the tongue mucosa is covered by filiform papillae protrusions that typically rise less than 1mm from the surface. However, in hairy tongue syndrome, these normally very short tongue protrusions can grow to over 1 cm in length and 2mm width.

This carpet of abnormally long filiform papillae protrusions then secondarily collect fungi, bacteria, and inorganic particles which leads to the discoloration and the appearance of hairy tongue syndrome. To reiterate, micro-organisms found in hairy tongue syndrome is coincidental and not causative. I will further stress that although fungi and bacteria may be present and do contribute to the discoloration, there is no "infection" present per se. These organisms are happily just living on the surface without actually invading the tongue lining.

Treatment (if pursued) is really to address the long filiform papillae and not so much what's on it.

To read more about black hairy tongue and what is done for treatment (if pursued), click here.

Black Hairy Tongue (most common)

White Hairy Tongue

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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