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 weak immune systems. HIV (human immunodeficiency virus) often causes this condition.

What causes oral hairy leukoplakia?

Oral hairy leukoplakia is caused by conditions that weaken the immune system. This includes the Epstein-Barr virus and HIV.

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

  • White and “corrugated,” or folded, in appearance
  • Hairy, hair-like growths come from the folds in the patches
  • Permanent, you can’t remove the patches with a toothbrush or with another oral care tool

Sometimes, the patches cause discomfort and taste changes.

The symptoms of oral hairy leukoplakia may look like other medical 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. Oral candidiasis, or thrush, can be similar in appearance. However, your healthcare provider can often remove thrush growths on the tongue. This helps your healthcare provider to tell the difference between the two conditions.

A biopsy of one of the patches can confirm the diagnosis. But, this test usually isn’t done unless the patches look unusual, or if they suspect cancer or another rare condition.

How is oral hairy leukoplakia treated?

Your healthcare provider will figure out the best treatment based on:

  • How old you are
  • Your overall health and medical history
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Oral hairy leukoplakia itself doesn’t usually need treatment. There are no other symptoms. 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. Rarely, in more severe cases, your healthcare provider may surgically remove the sore.

What are the complications of oral hairy leukoplakia?

Because oral hairy leukoplakia is usually related to an HIV infection, complications are related 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. Do not smoke. Contact your healthcare provider if you have questions or new symptoms.

When should I call my healthcare provider?

Though often painless, oral hairy leukoplakia 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 that the Epstein-Barr virus can trigger.
  • It happens most often in people whose immune systems are very weak and is most often seen in people with HIV.
  • The condition causes white lesions, or patches, on the tongue.
  • Treatment is aimed at treating the underlying immune problem, such as HIV.
  • Oral hairy leukoplakia 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.
  • 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.

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