Black Spots on the Tongue: Are They Normal?

Q: Black Spots on the Tongue: Are They Normal?

Hello： Currently, it is recommended to rinse your mouth more often and to avoid spicy or irritating foods for observation. <br>If the number of black spots increases or their area expands, it may indicate a fungal infection, and you will need to seek medical treatment again. <br>

There are spots on the tongue that resemble moles?

Hello Doctor: Recently, I noticed a few small black spots on my tongue that look like moles.
They are not painful or itchy, and they are relatively small, about the size of a dot made by a ballpoint pen.
I recently visited an ENT specialist, who told me that this is a normal phenomenon because there are many hair-like structures on the tongue.
If these structures metabolize or shed too quickly, their color can appear darker, resembling black spots.
The doctor advised me not to worry about it.
Is this normal? If so, will these black spots disappear? I would like to consult your opinion, thank you!

Qb, 20~29 year old female. Ask Date: 2015/10/03

Dr. Zheng Jueyi reply Otolaryngology

Hello: Currently, it is recommended to rinse your mouth more often and to avoid spicy or irritating foods for observation.
If the number of black spots increases or their area expands, it may indicate a fungal infection, and you will need to seek medical treatment again.
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: 2015/10/03

More Info

The appearance of black spots on the tongue can be concerning, but in many cases, they are benign and not indicative of a serious health issue. Based on your description, it seems that you have small black dots that are painless and not itchy, which is a positive sign. The fact that you have already consulted an ENT specialist who reassured you that these spots are normal is encouraging.

Black spots on the tongue can arise from several causes. One common reason is the accumulation of keratin, a protein that can build up on the surface of the tongue, leading to a condition known as "black hairy tongue" (lingua villosa). This condition occurs when the filiform papillae on the tongue become elongated and discolored, often due to poor oral hygiene, smoking, or certain medications. The black coloration can result from the accumulation of food particles, bacteria, and dead cells.

Another possibility is that these spots are simply benign pigmented lesions, which can occur naturally on the tongue. These spots can be similar to freckles or moles found on the skin and are usually harmless. They may not require any treatment unless they change in size, shape, or color, or if they become symptomatic.

In some cases, black spots can also be associated with certain medical conditions, such as oral melanoma, a rare but serious form of skin cancer that can occur in the mouth. However, given that your spots are small, painless, and have been evaluated by a healthcare professional, the likelihood of this being the case is low.

As for whether these black spots will disappear, it depends on their underlying cause. If they are due to keratin buildup, improving oral hygiene practices—such as regular brushing of the tongue, staying hydrated, and avoiding tobacco products—may help reduce their appearance. If they are benign pigmented lesions, they may remain unchanged over time.

In summary, while the presence of black spots on the tongue can be alarming, they are often harmless, especially when accompanied by no other symptoms. It is essential to maintain good oral hygiene and monitor any changes in the spots. If you notice any changes or if new symptoms arise, it would be wise to follow up with your healthcare provider for further evaluation. Regular dental check-ups can also help ensure that your oral health is maintained and any concerns can be addressed promptly.

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