"Black hair" on your tongue? Here is what it could be

ST. LOUIS – When Dr. Yasir Hamad learned that a patient's tongue had turned black, he decided he had to see it for himself.

"This was the classic case" of a disease known as the black hairy tongue, said Hamad, an assistant professor in the Department of Medicine at the University of Washington School of Medicine in St. Louis. Hamad published the case Wednesday in the New England Journal of Medicine.

Despite the name, the black hairy tongue is not a hair at all. They are tiny nubbins on the tongue, called taste buds, which grew up and became black. According to a study last year, these bumps, generally less than one millimeter, can reach between 12 and 18 millimeters.

As the taste buds develop, it is thought that they catch microscopic particles, thus giving bacteria and other microbes the opportunity to grow on the tongue, causing a strange discoloration.

Black hairy tongue is an uncommon and harmless side effect of some medications, but it can also be related to smoking, poor oral hygiene and certain medical conditions.

Patient Hamad, a 55-year-old woman, had received an antibiotic called minocycline to treat a wound infection after a car accident, according to her report. Within a week, her tongue became black, she started to feel nauseous and there was an unpleasant taste in her mouth.

"As scary as it sounds, the good part is that it's actually reversible," Hamad said. Four weeks after the doctors changed their medication, the patient's tongue returned to normal.

It's hard to say how rare this is, Hamad said, but it's the first case he's seen in 10 years of practice.

If your tongue starts to look strangely black and hairy, he adds, do not panic and consult your doctor because other conditions may look like this.

"Many things you can diagnose just by looking at your mouth," said Hamad, with a message to fellow doctors. "That's the lesson: do not miss this part of the body when you examine the patient."

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