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Oral Hairy Leukoplakia

Oral Hairy Leukoplakia

Oral hairy leukoplakia is a condition that the Epstein-Barr virus (EBV) can trigger. The condition causes white lesions, or patches, on your tongue. Sometimes the lesions occur in other areas of your mouth. The patches may be hairy in appearance. This is where the name comes from. Oral hairy leukoplakia occurs most often in people whose immune systems are suppressed to an advanced degree. HIV (human immunodeficiency virus) often causes this condition.


White patches are the primary 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.

Who’s at risk

Oral hairy leukoplakia is most common in people with HIV. The condition may be a warning that your HIV has worsened. It is a sign of immune system suppression. If you have HIV and are exposed to EBV, you are at great risk of developing oral hairy leukoplakia.


Oral hairy leukoplakia lesions are easy to identify. Health care providers can often diagnose the condition from a physical exam alone. Oral candidiasis, or thrush, can be similar in appearance. However, doctors  can often remove oral growths on the tongue due to thrush. This helps to distinguish between the two conditions.

A biopsy of one of the patches can provide definitive proof that EBV is present and has led to oral hairy leukoplakia. Health care providers usually won’t perform this test, however, unless the lesions look unusual, or if they suspect cancer or another rare condition.


Doctors usually do not treat oral hairy leukoplakia itself. There are no other symptoms. Instead, it may indicate to your health care provider to take a closer look at your HIV treatment to help boost your immunity.

When you require specific treatment, your doctor may prescribe an antiviral drug. This might include acyclovir, famciclovir, or valacyclovir. In rare instances, your doctor may remove the sore through a surgical procedure.


Because oral hairy leukoplakia is usually related to an HIV infection, complications are related to HIV. They include compromised immunity and even death. Oral hairy leukoplakia often means that you need HIV treatment or that your doctor needs to change your current treatment.


Preventing oral hairy leukoplakia starts by having a healthy immune system. Adhere to your suggested HIV medical and dental hygiene regimens and maintain a healthy lifestyle: Practice safe sex, exercise regularly, and follow a healthy diet. Do not smoke. Contact your health care provider if you have questions or new symptoms.

When to call the doctor

Though often painless, oral hairy leukoplakia can be a warning sign of HIV or a severely compromised immune system. Seek medical attention immediately.