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Leukoplakia

Hairy leukoplakia; Smoker's keratosis

Leukoplakia are patches on the tongue, in the mouth, or on the inside of the cheek.

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Causes

Leukoplakia affects the mucous membranes of the mouth. The exact cause is not known. It may be due to irritation such as:

The disorder is more common in older adults.

A type of leukoplakia of the mouth, called oral hairy leukoplakia, is caused by the Epstein-Barr virus. It is seen mostly in people with HIV/AIDS. It may be one of the first signs of HIV infection. Oral hairy leukoplakia can also appear in other people whose immune system is not working well, such as after a bone marrow transplant.

Symptoms

Patches in the mouth usually develop on the tongue (sides of the tongue with oral hairy leukoplakia) and on the insides of the cheeks.

Leukoplakia patches are:

Exams and Tests

A biopsy of the lesion confirms the diagnosis. Examination of the biopsy may find changes that indicate oral cancer.

Treatment

The goal of treatment is to get rid of the leukoplakia patch. Removing the source of irritation may cause the patch to disappear.

If removing the source of the irritation does not work, your health care provider may suggest applying medicine to the patch or using surgery to remove it.

For oral hairy leukoplakia, taking antiviral medicine usually causes the patch to disappear. Your provider may also suggest applying medicine to the patch.

Outlook (Prognosis)

Leukoplakia is usually harmless. Patches in the mouth often clear up in a few weeks or months after the source of irritation is removed.

In some cases, the patches may be an early sign of cancer.

When to Contact a Medical Professional

Call for an appointment with your provider if you have any patches that look like leukoplakia or hairy leukoplakia.

Prevention

Stop smoking or using other tobacco products. Do not drink alcohol, or limit the number of drinks you have. Have rough teeth treated and dental appliances repaired right away.

Related Information

Chronic
Mouth ulcers

References

Holmstrup P, Dabelsteen E. Oral leukoplakia-to treat or not to treat. Oral Dis. 2016;22(6):494-497. PMID: 26785709 www.ncbi.nlm.nih.gov/pubmed/26785709.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Disorders of the mucous membranes In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 34.

Sciubba JJ. Oral mucosal lesions. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 89.

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Review Date: 8/25/2019  

Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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