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Hairy leukoplakia is a viral infection of the tongue that appears as white, scaly lesions that can look like hair. It is common in HIV-positive individuals and caused by the Epstein-Barr virus. Treatment may include antiviral medication, but addressing the underlying condition is more important.
Hairy leukoplakia is a viral infection of the tongue that appears as rough, scaly, white lesions that appear to sprout hair. The condition is most commonly seen in HIV-positive individuals and is often one of the first signs that a person is infected. The lesions are usually painless and cause no unpleasant symptoms, but medical evaluation is still important to determine the underlying cause and receive the proper treatment.
Medical research has indicated that hairy leukoplakia is caused by the Epstein-Barr virus, a common viral agent found in the mouth and other mucous membranes. Almost everyone in the world carries the virus, but it remains dormant and completely harmless in healthy individuals. When the immune system is weakened by HIV, AIDS, immunosuppressive drugs, or frequent blood transfusions, the Epstein-Barr virus can become activated and trigger the development of hairy leukoplakia.
The first sign of hairy leukoplakia is usually a thin whitish film on the sides of the tongue. Over several days or weeks, small flat lesions tend to develop on different sections of the tongue. The lesions develop a hairy appearance as they begin to flake and develop raised ridges. The outer surface of the scales can scrape off during brushing or rinsing, exposing the darker interior of a lesion. Pain is rare with hairy leukoplakia, but lesions that break open and become infected with bacteria can cause tenderness and inflammation.
A doctor can confirm hairy leukoplakia by collecting and analyzing a small tissue sample. In a medical laboratory, a clinical pathologist inspects the tissue under a microscope to rule out other possible causes of tongue discoloration, such as cancer and bacterial infection. Patients who don’t know if they are HIV positive typically receive blood tests.
Hairy leukoplakia may not require medical attention if it causes no physical symptoms. If the lesions are large or painful, a doctor may prescribe an oral or topical antiviral medication to shrink them and help prevent new ones from developing. Brushing regularly and avoiding tobacco products and spicy foods helps reduce the chances of a recurring bacterial infection in your mouth.
In most cases, doctors are more concerned about the underlying causes of hairy leukoplakia than the lesions themselves. Treatment regimens for HIV or another immunosuppressive condition are started immediately after they are detected. Patients may need to take daily oral medications or receive regular injections for the rest of their lives to help manage symptoms and slow the progression of serious disease.
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