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What causes black hairy tongue?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 26, 2025.

Official Answer by Drugs.com

Black hairy tongue is often caused by an overgrowth of papillae (taste buds) on the tongue. It results in a dark, furry appearance of dead skin cells on the surface of the tongue that can be stained from bacteria, food, or tobacco. Although it may be unpleasant, it doesn't usually require medical treatment and it's temporary and harmless.

Men have been shown to be about three times more commonly affected than women.

What causes black hairy tongue?

Risk factors for black hairy tongue include:

A "pseudo-black hairy tongue" (that mimics the look of black hairy tongue without the elongated cells on the tongue) can also occur from using products containing bismuth, such as Pepto-Bismol.

Read more about that in the FAQ Why does Pepto-Bismol turn your tongue black?

Related questions

What does black hairy tongue look like?

Black hairy tongue can have different appearances in people, but you may have:

How do you get rid of black hairy tongue?

Be sure to practice good oral hygiene and brush your teeth (and tongue) twice a day. Discontinuation of the agent that is causing the discoloration, such as medications, may be needed. Always speak with your healthcare provider before stopping a prescribed or recommended medication.

Visit your dentist regularly and maintain a well-balanced diet. Talk to your doctor to see if any of your medications may be the cause. If your symptoms do not improve, contact your healthcare provider for further evaluation.

See the Drugs.com section on drug side effects to check your medications.

This is not all the information you need to know about this condition and does not take the place of your doctor’s directions. Discuss this information and any questions you have with your doctor or other health care provider.

References
  • Gurvits GE, Tan A. Black hairy tongue syndrome. World J Gastroenterol. 2014 Aug 21;20(31):10845-50. doi: 10.3748/wjg.v20.i31.10845. PMID: 25152586; PMCID: PMC4138463.

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