(Hairy Leukoplakia; Smoker’s Keratosis)
  • Definition

    Leukoplakia is a disorder of the mouth’s mucus membranes. White patches form on the tongue or inside of the mouth over weeks or months. This can also occur on the vulva in females, but for unknown reasons. One type, known as hairy leukoplakia, is a type found primarily in people who have HIV or other types of severe immune deficiency.
  • Causes

    Hairy leukoplakia results from infection with the Epstein-Barr virus.
    Leukoplakia usually results from irritants, such as:
    • Pipe or cigarette smoking
    • Chewing tobacco or snuff
    • Rough teeth
    • Rough places on dentures, fillings, or crowns
  • Risk Factors

    Leukoplakia is more common in men after 65 years of age. These other risk factors increase your chance of developing leukoplakia. Tell your doctor if you have any of these risk factors:
    • Sex: In women, the condition often develops into cancer.
    • Lifestyle:
      • Tobacco use, especially smokeless tobacco
      • Long-time alcohol use
    • Having a weakened immune system such as from HIV
  • Symptoms

    Symptoms may include:
    • Lesion on the tongue or gums, inside of the cheeks, or on the vulva that is:
      • White, gray, or red in color
      • Thick, slightly raised, or hardened on the surface
    • Sensitivity to touch, heat, or spicy foods
    • Pain or other signs of infection
    • With hairy leukoplakia: painless and fuzzy, white appearance
    In some cases, leukoplakia looks like oral thrush , which is an infection also associated with HIV/AIDS and lowered immune function.
    Oral Thrush—Resembles Leukoplakia
    Copyright © Nucleus Medical Media, Inc.
  • Diagnosis

    In most cases, a dentist can diagnose leukoplakia with a mouth exam. To confirm a diagnosis or to check for cancer, an oral brush biopsy may be needed. This involves removing some cells with a small brush. It takes only minutes and is painless. A pathologist then checks these cells for signs of cancer. Sometimes the dentist or oral surgeon uses a scalpel to remove cells after numbing the area.
  • Treatment

    Talk with your doctor about the best treatment plan for you. 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, your dentist or doctor may need to remove patches of leukoplakia.
    • Taking medication—For hairy leukoplakia, the doctor may prescribe antiviral medicines. Or, a solution to apply to the skin may be prescribed.
  • Prevention

    To help reduce your chance of getting leukoplakia, take the following steps:
    • If you smoke, quit .
    • Avoid or limit your use of alcohol.
    • See a dentist regularly, especially if you have rough places in your mouth.

    American Dental Association http://www.mouthhealthy.org

    National Institute of Dental and Craniofacial Research http://www.nidcr.nih.gov


    Canadian Dental Association http://www.cda-adc.ca

    Canadian Dental Hygienists Association http://www.cdha.ca


    Hairy leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/hairy-leukoplakia.html . Updated May 22, 2013. Accessed September 18, 2013.

    Oral hairy leukoplakia. AETC National Resource Center website. Available at: http://www.aids-ed.org/aidsetc?page=cm-525a%5Fohl . Updated June 2012. Accessed September 18, 2013.

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