Oral Hairy Leukoplakia

What is oral hairy leukoplakia?

Oral hairy leukoplakia is a condition triggered by the Epstein-Barr virus (EBV). It causes white patches on your tongue. Sometimes the patches happen in other parts of your mouth. The patches may look hairy. This is where the name comes from. Oral hairy leukoplakia happens most often in people with a weak immune system such as those infected with HIV. HIV is the virus that causes AIDS.

What causes oral hairy leukoplakia?

Oral hairy leukoplakia is caused by conditions that weaken the immune system. This includes the Epstein-Barr virus. It occurs most often in people infected with HIV. Oral hairy leukoplakia may also happen in other people with suppressed immune systems. This includes organ transplant recipients, people with cancer, and people taking systemic or inhaled steroids.

Who is at risk for oral hairy leukoplakia?

Oral hairy leukoplakia is most common in people with HIV. It may be a warning that your HIV has worsened. It is a sign of a weak immune system. If you have HIV and are exposed to EBV, you are at great risk of getting oral hairy leukoplakia. People with HIV who smoke are also at a greater risk of getting it.

What are the symptoms of oral hairy leukoplakia?

White patches on the tongue are the main symptom of oral hairy leukoplakia. The patches are:

  • White and folded in appearance

  • Hairy, hair-like growths come from the folds in the patches

  • Lasting (permanent), you can’t remove the patches with a toothbrush or with another oral care tool

Sometimes the patches cause discomfort and taste changes. Other times there are no symptoms.

The symptoms of oral hairy leukoplakia may look like other health conditions or problems. Always talk with your healthcare provider for a diagnosis.

How is oral hairy leukoplakia diagnosed?

Oral hairy leukoplakia patches are easy to identify. Healthcare providers can often diagnose it from a physical exam alone. A mouth infection called thrush can look very similar. But your healthcare provider can often remove thrush growths on the tongue. This helps your provider to tell the difference between the 2 conditions.

A biopsy of one of the patches can confirm the diagnosis. But this test often isn’t done unless the patches look abnormal. Or a biopsy may be done if your healthcare provider thinks the patches may be cancer or another rare condition.

How is oral hairy leukoplakia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Oral hairy leukoplakia itself doesn’t often need treatment if there are no other symptoms. It may go away on its own. But it may mean your healthcare provider needs to take a closer look at your HIV treatment to help boost your immunity.

In some cases, your healthcare provider may prescribe an antiviral drug or medicine to use on the patches. Rarely, in more severe cases, your healthcare provider may surgically remove the sore.

What are possible complications of oral hairy leukoplakia?

Oral hairy leukoplakia is often linked to an HIV infection. So complications are also linked to HIV. They include low immunity and even death. Oral hairy leukoplakia often means that you need HIV treatment or that your healthcare provider needs to change your current treatment.

Can oral hairy leukoplakia be prevented?

Preventing oral hairy leukoplakia starts by having a healthy immune system. Stick to your prescribed HIV treatment plan and dental hygiene routine. Also take steps to maintain a healthy lifestyle. Practice safe sex, exercise regularly, and follow a healthy diet. Don't smoke. Contact your healthcare provider if you have questions or new symptoms.

When should I call my healthcare provider?

Oral hairy leukoplakia is often painless. But it can be a warning sign of HIV or a severe immune system problem. See your healthcare provider right away.

Key points about oral hairy leukoplakia

  • Oral hairy leukoplakia is a condition triggered by the Epstein-Barr virus.

  • It happens most often in people whose immune systems are very weak. It is most often seen in people with HIV.

  • The condition causes white patches on the tongue.

  • The patches can cause mild discomfort and taste changes or no symptoms at all.

  • Treatment is aimed at treating the underlying immune problem, such as HIV.

  • This condition can be a warning sign of HIV or a severely weakened immune system.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions, especially after office hours and on weekends and holidays.

Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 9/1/2023
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