The side effects of an adverse reaction to antibiotics typically mimic an allergic reaction. A rash could develop or the face, lips, and tongue could swell. There are also gastrointestinal reactions including stomach pain, bloating, vomiting and diarrhea. A recent article in a Washington medical journal addressed the case of a 53-year-old woman who went to her doctor with symptoms that presented as a discolored (black) tongue, a bad taste in her mouth, and it appeared that her tongue had sprouted hair.

Upon examination, the physician determined that an allergic reaction to antibiotics had resulted in a condition known as lingua villosa nigra or black hairy tongue. Despite it being designated black hairy tongue the tongue can assume one of a variety of hues including brown, yellow, or white.

Black hairy tongue does not lead to any long term health problems. Besides the initial shock of thinking your tongue has changed color and grown hair, the worst system is usually a metallic or sour taste in the mouth. Food particles collecting and decaying between the papillae can cause bad breath. A build-up of Candida Albicans yeast that occurs naturally in the gut can lead to a burning sensation known as glossopyrosis. A sensation that the roof of the mouth is being tickled, nausea, and gagging may also be experienced.

The “hairs” on the tongue are not hairs at all but rounded protuberances on the tongue known as papillae. Typically, papillae are shed but when they are not shed they continue to grow to produce the appearance of hair. The discoloring can be attributable to food particles trapped between the papillae, bacteria, or yeast.

The role that antibiotics play in causing black hairy tongue is that they may alter the number of bacteria that occurs naturally in the mouth. Only about 13% of the world’s population will develop lingua villosa nigra at some point in their life.

Men and the elderly are most likely to experience black hairy tongue. An allergic reaction to antibiotics is but one potential cause of lingua villosa nigra. Other causes include tobacco use, poor oral hygiene, dehydration, excessive consumption of tea or coffee, and black hairy tongue can also be a side effect of radiation treatments focusing on the head and neck. Intravenous drug use can lead to black hairy tongue.

Black hairy tongue normally clears up on its own. If any extreme discomfort is experienced a doctor should be consulted immediately. As lingua villosa nigra a non-life threatening condition any medical intervention would be strictly for the patients peace-of-mind.

While the risk of contracting black hairy tongue is minimal lifestyle changes can reduce the risk even further. Smoking cessation, not using stomach medications that contain bismuth, avoiding mouthwashes containing menthol, peroxide, or witch hazel are examples of the necessary lifestyle changes. It is also necessary to focus on proper oral hygiene including regular visits to the dentist, and scraping or brushing your tongue at bedtime.

Rinsing your mouth with sodium bicarbonate (baking soda) eating pineapple, and rolling a peach pit around in your mouth can also help. To recap, a reaction to antibiotics can cause black hairy tongue. Symptoms include a bad taste in the mouth, bad breath, and a tickling or gagging sensation. Black hairy tongue is not life-threatening and has no long-term consequences.