What is leukoplakia?

Leukoplakia is a condition in which thick, white or grayish patches form usually inside your mouth. Smoking is the most common cause. But other irritants can cause 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 and must be treated promptly.

Regular dental care can help prevent recurrences.

Leukoplakia occurs on parts of the body that have mucosal tissue, such as the mouth.

The condition 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/fuzzy (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.

Leukoplakia can occur on your gums, the inside of your cheeks, under or on your tongue, and even on your lips. The patches may take several weeks to develop. They’re rarely painful.

Some women may develop leukoplakia on the outside of their genitals in the vulva area as well as inside the vagina. This is usually seen in menopausal women. It’s a benign condition. If there is concern about anything more serious, you should contact your doctor.

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
  • long-term alcohol use

While some research suggests there may be a link between leukoplakia and the human papilloma virus (HPV), there’s not enough evidence to support a connection.

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.

Leukoplakia is usually diagnosed with an oral exam. During an oral exam, your healthcare provider 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. Leukoplakia patches, unlike oral thrush, can’t be wiped away.

Your healthcare provider 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 healthcare provider 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 to check for precancerous or cancerous cells.

Most patches improve on their own and don’t require any treatment. It’s important to avoid any triggers that may have caused your leukoplakia, such as tobacco use. If your condition is 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 cancer cells from spreading.

Patches can be removed by using laser therapy, a scalpel, or a freezing procedure.

Hairy leukoplakia is not likely to result in mouth cancer and usually does not require removal. Your healthcare provider might prescribe antiviral medications to help stop the patches from growing. Topical ointments containing retinoic acid can also be used to reduce patch size.

Many cases of leukoplakia can be prevented with lifestyle changes:

Contact your healthcare provider immediately if you believe you have leukoplakia. They can help you 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.

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:

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.