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Leukoplakia
(Hairy Leukoplakia, Smoker’s Keratosis)

Definition:
Caused by chronic irritation, leukoplakia is a disorder of the mouth’s mucous membranes. White patches form on the tongue or inside of the mouth over weeks or months. This can also occur on the vulva in females, but for unknown reasons. One type, known as hairy leukoplakia, is a type found only in people who are HIV-positive. Most cases of leukoplakia get better once you remove the source of irritation. In rare cases, though, leukoplakia can lead to oral cancer. If you notice any signs, see your dentist or doctor.

Causes:
Hairy leukoplakia results from a virus that becomes active in the body when the immune system becomes weak. Infection may play a role in other cases as well. Leukoplakia usually results from irritants, such as these:
  • Pipe or cigarette smoking
  • Chewing tobacco or snuff
  • Rough teeth
  • Rough places on dentures, fillings, or crowns
Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition. Discuss these risk factors with your doctor:
  • Age: Older than 65
  • Sex:
    • More men than women get leukoplakia
    • In women, it more often develops into cancer
  • Lifestyle:
    • Tobacco use (especially smokeless tobacco)
    • Long-time alcohol use
  • Conditions: HIV-positive or weakened immune system
Symptoms:
In some cases, leukoplakia resembles oral thrush, an infection also associated with HIV and AIDS. Leukoplakia is usually harmless, but sometimes leads to cancer. If you have any of these symptoms for more than a week, see your dentist or doctor:
  • Lesion on the tongue or gums, inside of the cheeks, or on the vulva
    • White, gray, or red in color
    • Thick, slightly raised, or hardened surface
  • Sensitivity to touch, heat, or spicy foods
  • Pain or other signs of infection in chronic cases
  • With hairy leukoplakia: painless and fuzzy, white appearance
Diagnosis:
In most cases, a dentist can diagnose leukoplakia with a mouth exam. To confirm a diagnosis or to check for cancer, an oral brush biopsy may be needed. This involves removing some cells with a small brush. It takes only minutes and is painless. A pathologist then checks these cells for signs of cancer. Sometimes the dentist uses a scalpel to remove cells after numbing the area.

Treatment:
Talk with your doctor about the best treatment plan for you. Treatment options include:

Removing the Irritant
Quitting smoking or correcting dental problems often takes care of the problem.

Removing Patches
If the problem persists, or if signs of cancer are present, your dentist or doctor may need to remove patches of leukoplakia.

Medication
For hairy leukoplakia, doctors may also prescribe antiviral medicines. These include valacyclovir and famciclovir. Or doctors may prescribe a topical solution, such as podophyllum resin.

Prevention:
To help reduce your chances of getting leukoplakia, take the following steps:
  • Stop using tobacco.
  • Avoid or limit your use of alcohol.
  • See a dentist regularly, especially if you have rough places in your mouth.
  • Eat plenty of fresh fruits and vegetables, which are full of antioxidants.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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