by Scholten A
(Oral Hairy Leukoplakia)


Oral leukoplakia is a condition where thick, white patches form in the mouth. The patches may be on the gums, tongue, or inner cheeks. Sometimes it can turn into cancer.

There are several types. Hairy leukoplakia is found in people with weak immune systems.


The exact cause is not known. This problem is often linked to long term irritation in the mouth. This may cause the cells to change and grow.

The condition may also be linked to certain viruses.

Risk Factors

Oral leukoplakia is more common in men after age 65. Other things that raise the risk are:

  • Smoking, including cigars and pipes
  • Using smokeless tobacco, such as chewing tobacco or snuff
  • Long-time alcohol use
  • Having a weakened immune system—a risk for hairy leukoplakia
  • Rough teeth
  • Rough places on dentures, fillings, or crowns
  • Having had Epstein-Barr virus


Symptoms of oral leukoplakia are patches on the tongue, gums, or inside the cheeks. They form over weeks or months. Patches may be:

  • White or gray, or have some red
  • Thick, slightly raised, or hardened on the surface
  • Sensitive to touch, heat, or spicy foods

There may be pain or signs of infection.

Hairy leukoplakia also has fuzzy white patches. They tend to be on the side of the tongue.


The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will examine the mouth. Most times, this is enough to make the diagnosis.

The doctor may also do a brush biopsy. Some cells will be taken from the mouth with a small brush. The cells will be tested. This is done to look for cancer or infections.


Treatment options are:

  • Removing the irritant—such as quitting smoking or fixing dental problems. This often takes care of the problem.
  • Medicines such as:
    • Ointments
    • Mouthwashes
    • Retinoids, vitamin A, beta carotene, or lycopene—taken by mouth
    • Antiviral medicines—to treat viruses that may be causing the condition
  • Removing patches—if the problem lasts or could be cancer. This may be done with:
    • Surgery
    • Laser treatment
    • Electrocauterization
    • Freezing


The risk may be lowered by:

  • Not using tobacco
  • Avoiding or limiting the use of alcohol
  • Seeing the dentist regularly


Mouth Healthy—American Dental Association 

National Institute of Dental and Craniofacial Research 


Canadian Dental Association 

Dental Hygiene Canada 


Hairy leukoplakia. DermNet NZ website. Available at: Accessed February 19, 2021.

Head and neck cancer. EBSCO DynaMed website. Available at: Accessed February 19, 2021.

Leukoplakia. American Osteopathic College of Dermatology website. Available at: Accessed February 19, 2021.

Leukoplakia. NHS choices website. Available at: Updated January 15, 2015. Accessed February 19, 2021.

Oral leukoplakia. DermNet NZ website. Available at: Accessed February 19, 2021.

Villa A, Sonis S. Oral leukoplakia remains a challenging condition. Oral Dis. 2018;24(1-2):179-183.

Revision Information

  • Reviewer: EBSCO Medical Review Board Mary Beth Seymour, RN
  • Review Date: 01/2021
  • Update Date: 02/19/2021