Black Spots on the Tongue: Causes and Concerns

Black spots on the tongue

I have a large and a small black bump on the left side of my tongue.
What could be the reason for this?

bruce, 20~29 year old female. Ask Date: 2016/03/18

Dr. Zheng Jueyi reply Otolaryngology

Hello, it is recommended to seek medical examination for assessment.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/03/18

More Info

Black spots on the tongue can be concerning, and it's important to understand the potential causes and when to seek medical attention. The appearance of black spots or lesions on the tongue can arise from various factors, and while some may be benign, others could indicate underlying health issues.

1. Possible Causes:
- Hyperpigmentation: This is a common cause of black spots on the tongue. It can occur due to an increase in melanin production, which may be influenced by genetics or certain medications.

- Oral Melanotic Macule: This is a localized area of increased pigmentation that can appear on the tongue. It is usually harmless and does not require treatment unless it changes in size or color.

- Black Hairy Tongue: This condition occurs when the filiform papillae (small bumps on the tongue) become elongated and discolored, often due to poor oral hygiene, smoking, or certain medications. It can give the appearance of black spots or a black coating on the tongue.

- Fungal Infections: Oral thrush, a yeast infection caused by Candida, can lead to white or black lesions on the tongue. This is more common in individuals with weakened immune systems or those taking antibiotics.

- Geographic Tongue: This benign condition can cause irregular patches on the tongue that may appear darker in some areas. It is often associated with sensitivity to certain foods or stress.

- Oral Cancer: While less common, persistent black spots or lesions that do not heal can be a sign of oral cancer. It is crucial to monitor any changes in size, shape, or color.

2. When to Seek Medical Attention:
- If the black spots on your tongue persist for more than two weeks, it is advisable to consult a healthcare professional.
- If you experience additional symptoms such as pain, swelling, difficulty swallowing, or changes in taste, these could indicate a more serious condition that requires immediate evaluation.

- Regular dental check-ups can also help identify any oral health issues early on.

3. Diagnosis and Treatment:
- A healthcare provider will typically perform a visual examination of the tongue and may ask about your medical history, lifestyle habits (such as smoking or alcohol use), and any medications you are taking.

- In some cases, a biopsy may be necessary to rule out more serious conditions, especially if there is a concern about cancer.

- Treatment will depend on the underlying cause. For example, improving oral hygiene can help with black hairy tongue, while antifungal medications may be prescribed for oral thrush.

In summary, while black spots on the tongue can be benign and related to factors such as pigmentation or oral hygiene, it is essential to monitor their appearance and seek medical advice if they persist or are accompanied by other concerning symptoms. Regular dental visits and maintaining good oral hygiene are key components in preventing and addressing oral health issues.

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