Table of ContentsView AllTable of ContentsSymptoms and TypesOral Cancer RiskWhen to Visit a Healthcare ProviderCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms and Types
Oral Cancer Risk
When to Visit a Healthcare Provider
Causes
Diagnosis
Treatment
Leukoplakia is a condition involving thickenedwhite patcheson the mucous membranes (lining) of the mouth, gums, and/or tongue that cannot be wiped away. While most cases never become cancerous, others do—even if they have no signs of cancerous changes when diagnosed.
Leukoplakia that is consistent in its appearance (homogenous type) is associated with a higher risk of oral cancer compared with types that are not (non-homogenous type).
Verywell / JR Bee
Leukoplakia Symptoms and Types
Symptoms and signs of leukoplakia, which may not be noticed in initial stages, may include:
These can vary depending on the type.
Leukoplakia is often mistaken forthrush, a yeast infection of the mouth and gums. A notable difference? Thrush causes creamy white patches that can be wiped away. Those associated with leukoplakia cannot.
Pictures of White Spots on Tongue
Homogenous Leukoplakia
Non-Homogenous Leukoplakia
Non-homogenous types of leukoplakia, such as the rarespeckled type, cause both white and red areas in the mouth. These areas may also be bumpy or irregular in shape.
This photo contains content that some people may find graphic or disturbing.See PhotoDermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Proliferative verrucous leukoplakia (PVL)is a rare and aggressive type of non-homogenous leuloplakia.It usually begins as thick white patches on the inside of the cheeks and tongue. As it spreads, the patches start to look like warts or cauliflower.
Oral Hairy Leukoplakia
Oral hairy leukoplakia is a different kind of leukoplakia that causes fuzzy white patches that look like folds or ridges. They often appear on the sides of the tongue.
Oral hairy leukoplakia occurs in 1% to 2% of the population and is most common in people over 40. It may affect any part of the mouth. Oral leukoplakias on the underside of the tongue, floor of mouth, and soft palate are more likely to become precancerous (dysplastic). Some oral leukoplakias are not just white but may appear red, rough, and warty, Oral hairy leukoplakia is an outlier, as it isnotconsidered a precancerous condition.
This condition is common in people with a severely compromised immune system, such as those withEpstein-Barr virus (EBV), and may be one of the very firstsigns of HIV.
Leukoplakia and Oral Cancer Risk
A 2019 study published inJournal of the National Cancer Institutefound there was a 40.8-fold increased risk of oral cancer in those with oral leukoplakia. The researchers also found that approximately one in 30 individuals with oral leukoplakia will develop oral cancer over a five-year period.
Still, most of the time, the white patches from leukoplakia are not considered cancerous.When they are an early sign of mouth cancer, they are usually due to non-homogenous types of the condition.
PVL, in particular, is associated with a high risk of oral cancer.
Oral hairy leukoplakia is not associated with a risk for cancer.
In particular, be sure to see a healthcare provider if you notice:
Although leukoplakia doesn’t normally cause any type of pain, you should still be evaluated. If it is leukoplakia and an early sign of oral cancer, early treatment is key. If it’s not, the mouth patches could be a sign of something more serious.
Long-term use of tobacco (smoking or chewing) or other irritants are the most common cause of leukoplakia. Other causes may include:
A diagnosis of leukoplakia usually involves:
A biopsy involves tissue removal from the body to examine it for a disease such as cancer. Cancer testing for those with leukoplakia may include:
If an excisional biopsy is positive, the healthcare provider may make a referral to an oral surgeon or an ear-nose-throat specialist (otolaryngolosist) for oral cancer treatment.
Leukoplakia Treatment
Usually, removing the source of the irritation—smoking, chewing tobacco, excessive alcohol use, or dental causes—is enough to cure leuoplakia.
However, if there is a positive biopsy result, further treatment is necessary. Treatment of leukoplakia is most effective after early diagnosis.
This may include:
Keep in mind that even after leukoplakia patches are removed, there is still an increased risk of oral cancer.
In any case, you will needregular follow-up visitsto check for recurring symptoms of leukoplakia (which are common).
You will also need to learn to thoroughly and regularly performself-inspections of the mouth.
Summary
Leukoplakia is a condition involving white patches that form inside the mouth. These patches can appear uniform in color (homogenous), or they can look like red and white areas that are bumpy and irregularly shaped (non-homogenous).
Common causes include smoking, chewing tobacco, drinking, or exposure to other irritants (such as e-cigarettes).
Leukoplakia is often a warning sign, signaling that a person should make some healthy lifestyle adjustments. In some cases, leukoplakia can develop into oral cancer.
Symptoms of Oral Hairy Leukoplakia
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brigham and Women’s Hospital. Division of Oral Medicine and Dentistry.Oral Leukoplakia.MedlinePlus.Leukoplakia.Greenspan J, Greenspan D, Webster-Cyriaque J.Hairy leukoplakia; lessons learned: 30-plus years.Oral Dis. 2016;22:120-127. doi:10.1111/odi.12393Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature.Otolaryngol–head neck surg. 2015;153(4):504-511. doi:10.1177/0194599815586779National Organization for Rare Disorders.NIH GARD Information: Proliferative verrucous leukoplakia.Chaturvedi AK, Udaltsova N, Engels EA, et al.Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study.JNCI: Journal of the National Cancer Institute. 2020;112(10):1047-1054. doi:10.1093/jnci/djz238Carrard V, van der Waal I.A clinical diagnosis of oral leukoplakia; A guide for dentists.Med Oral. Published online 2017;23(1):e59-e64. doi:10.4317/medoral.22292Mohammed F, Fairozekhan AT.Oral leukoplakia. StatPearls [Internet].Additional ReadingNguyen H, Kitzmiller JP, Nguyen KT, Nguyen CD, Chi Bui T.Oral carcinoma associated with chronic use of electronic cigarettes.Otolaryngol (Sunnyvale). 2017;07(02). doi:10.4172/2161-119X.1000304
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brigham and Women’s Hospital. Division of Oral Medicine and Dentistry.Oral Leukoplakia.MedlinePlus.Leukoplakia.Greenspan J, Greenspan D, Webster-Cyriaque J.Hairy leukoplakia; lessons learned: 30-plus years.Oral Dis. 2016;22:120-127. doi:10.1111/odi.12393Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature.Otolaryngol–head neck surg. 2015;153(4):504-511. doi:10.1177/0194599815586779National Organization for Rare Disorders.NIH GARD Information: Proliferative verrucous leukoplakia.Chaturvedi AK, Udaltsova N, Engels EA, et al.Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study.JNCI: Journal of the National Cancer Institute. 2020;112(10):1047-1054. doi:10.1093/jnci/djz238Carrard V, van der Waal I.A clinical diagnosis of oral leukoplakia; A guide for dentists.Med Oral. Published online 2017;23(1):e59-e64. doi:10.4317/medoral.22292Mohammed F, Fairozekhan AT.Oral leukoplakia. StatPearls [Internet].Additional ReadingNguyen H, Kitzmiller JP, Nguyen KT, Nguyen CD, Chi Bui T.Oral carcinoma associated with chronic use of electronic cigarettes.Otolaryngol (Sunnyvale). 2017;07(02). doi:10.4172/2161-119X.1000304
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Brigham and Women’s Hospital. Division of Oral Medicine and Dentistry.Oral Leukoplakia.MedlinePlus.Leukoplakia.Greenspan J, Greenspan D, Webster-Cyriaque J.Hairy leukoplakia; lessons learned: 30-plus years.Oral Dis. 2016;22:120-127. doi:10.1111/odi.12393Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature.Otolaryngol–head neck surg. 2015;153(4):504-511. doi:10.1177/0194599815586779National Organization for Rare Disorders.NIH GARD Information: Proliferative verrucous leukoplakia.Chaturvedi AK, Udaltsova N, Engels EA, et al.Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study.JNCI: Journal of the National Cancer Institute. 2020;112(10):1047-1054. doi:10.1093/jnci/djz238Carrard V, van der Waal I.A clinical diagnosis of oral leukoplakia; A guide for dentists.Med Oral. Published online 2017;23(1):e59-e64. doi:10.4317/medoral.22292Mohammed F, Fairozekhan AT.Oral leukoplakia. StatPearls [Internet].
Brigham and Women’s Hospital. Division of Oral Medicine and Dentistry.Oral Leukoplakia.
MedlinePlus.Leukoplakia.
Greenspan J, Greenspan D, Webster-Cyriaque J.Hairy leukoplakia; lessons learned: 30-plus years.Oral Dis. 2016;22:120-127. doi:10.1111/odi.12393
Abadie WM, Partington EJ, Fowler CB, Schmalbach CE.Optimal management of proliferative verrucous leukoplakia: a systematic review of the literature.Otolaryngol–head neck surg. 2015;153(4):504-511. doi:10.1177/0194599815586779
National Organization for Rare Disorders.NIH GARD Information: Proliferative verrucous leukoplakia.
Chaturvedi AK, Udaltsova N, Engels EA, et al.Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study.JNCI: Journal of the National Cancer Institute. 2020;112(10):1047-1054. doi:10.1093/jnci/djz238
Carrard V, van der Waal I.A clinical diagnosis of oral leukoplakia; A guide for dentists.Med Oral. Published online 2017;23(1):e59-e64. doi:10.4317/medoral.22292
Mohammed F, Fairozekhan AT.Oral leukoplakia. StatPearls [Internet].
Nguyen H, Kitzmiller JP, Nguyen KT, Nguyen CD, Chi Bui T.Oral carcinoma associated with chronic use of electronic cigarettes.Otolaryngol (Sunnyvale). 2017;07(02). doi:10.4172/2161-119X.1000304
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