What is leukoplakia?
Key points
Leukoplakia is usually harmless and often resolves on its own. Sometimes it’s a sign of something more serious.
You can identify this condition by the appearance of white or gray patches in your mouth. If you’re a woman, it can also appear on your genitals.
If your doctor suspects your spots may be a sign of something more serious, they may do tests, such as a biopsy.
Leukoplakia is a condition in which thick, white patches form on your tongue and the lining of your mouth. Smoking is the most common cause. But other irritants can result in this condition as well.
Mild leukoplakia is usually harmless and often goes away on its own. More serious cases may be linked to oral cancer. These must be treated promptly.
Regular dental care can help prevent recurrences.
Learn more: Why are there spots on your tongue? »
What are the symptoms of leukoplakia?
Leukoplakia is marked by unusual-looking patches inside your mouth. These patches can vary in appearance and may have the following features:
white or gray color
thick, hard, raised surface
hairy (hairy leukoplakia only)
red spots (rare)
Redness may be a sign of cancer. See your doctor right away if you have patches with red spots.
Learn more: What does mouth cancer look like? »
Leukoplakia most often occurs on your tongue. It can also appear inside your cheeks and on your gums. The patches may take several weeks to develop, and they’re rarely painful.
Some women may develop leukoplakia on the outside of their genitals in the vulva area.
CAUSES
What are the causes of leukoplakia?
The exact cause of leukoplakia is unknown. It’s primarily linked to tobacco use. Smoking is the most common cause. But chewing tobacco can also cause leukoplakia.
Other causes include:
injury to the inside of your cheek, such as from biting
rough, uneven teeth
dentures, especially if improperly fitted
inflammatory conditions of the body
Research suggests there may be a link between leukoplakia and the human papilloma virus.
Hairy leukoplakia
The Epstein-Barr virus (EBV) is the main cause of hairy leukoplakia. Once you get this virus, it remains in your body permanently. EBV is usually dormant. However, it can cause hairy leukoplakia patches to develop at any time. Outbreaks are more common in people with HIV or other immune problems.
Find out more: Epstein-Barr virus (EBV) test »
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DIAGNOSIS
How is leukoplakia diagnosed?
Leukoplakia is usually diagnosed with an oral exam. During a physical exam, your dentist or primary care doctor can confirm if the patches are leukoplakia. You might mistake the condition for oral thrush. Thrush is a yeast infection of the mouth. The patches it causes are usually softer than leukoplakia patches. They may bleed more easily.
Your dentist or doctor may need to do other tests to confirm the cause of your spots. This helps them suggest a treatment that may prevent future patches from developing.
If a patch looks suspicious, your dentist or doctor will do a biopsy. To do a biopsy, they remove a small piece of tissue from one or more of your spots. They then send that tissue sample to a pathologist for diagnosis. The goal is to look for signs of oral cancer.
TREATMENT
What are the treatment options for leukoplakia?
Most patches improve on their own and don’t require any treatment. It’s important to avoid any trigger that may have caused your leukoplakia, such as tobacco use. If it’s related to irritation from a dental problem, your dentist may be able to address this.
If a biopsy comes back positive for oral cancer, the patch must be removed immediately. This can help prevent the spread of the cancer.
Small patches can be removed by a more extensive biopsy using laser therapy or a scalpel. Large leukoplakia patches require oral surgery.
Hairy leukoplakia may not require removal. Your dentist or doctor might prescribe antiviral medications to help stop the patches from growing. Topical ointments containing retinoic acid can also be used to reduce patch size.
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PREVENTION
How can leukoplakia be prevented?
Many cases of leukoplakia can be prevented with lifestyle changes:
Stop smoking or chewing tobacco.
Reduce alcohol use.
Eat antioxidant-rich foods such as spinach and carrots. Antioxidants may help deactivate irritants that cause patches.
Contact your dentist or doctor immediately if you suspect leukoplakia. This can help keep the patches from getting worse.
Follow-up appointments are crucial. Once you develop leukoplakia, you have an increased risk of developing it again in the future.
OUTLOOK
What is the long-term outlook for leukoplakia?
In most cases, leukoplakia isn’t life threatening. The patches don’t cause permanent damage to your mouth. Lesions usually clear on their own within a few weeks after the source of irritation is removed. However, if your patch is particularly painful or looks suspicious, your dentist may order tests to rule out:
oral cancer
HIV
AIDS
A history of leukoplakia can increase your risk for oral cancer, so let your doctor know if you’ve noticed irregular patches in your mouth. Many of the risk factors for leukoplakia are also risk factors for oral cancer. Oral cancer can form alongside leukoplakia.
