Julie Powell, the author of Julie and Julia, tweeted before her recent death at age 49 that she had “something that’s literally Black Hairy Tongue” and that her doctor thought it was “no big deal.” This, of course, spawned rampant speculation that the black hairy tongue was, in fact, a big deal, and possibly related to her death. (Gizmodo has more on that here; Powell reportedly died of cardiac arrest.) So, what is black hairy tongue, anyway?
What black hairy tongue looks like
First of all, if you want to see a photo of this condition, by all means, take a look; I won’t share one here (because it’s a bit gross), but you can find one at Mayo Clinic. Note that while tongue may have a portion that is discolored, it isn’t always black. (It may look brown, green, yellow, or other colors.)
The tongue will also look fuzzy. This is because the little fuzzy bits we normally have on our tongue, called papillae, haven’t been shedding the way they usually do, so they appear longer.
Why people get black hairy tongue
Those papillae on our tongue normally wear away at about the same rate they grow. In the same way that our skin constantly sheds dead cells, our tongue sheds its own cells during the course of everyday life. We lose a few cells every time we eat, for example.
But if you have black hairy tongue, those cells aren’t getting rubbed off, and you may have bacteria or other microorganisms growing on the surface of your tongue, changing the color.
Black hairy tongue is more likely to be an effect of other health conditions or personal care issues than a cause. For example, if you have dry mouth due to medications or if you’ve been eating a liquid or soft diet, you’re more likely to develop black hairy tongue. Tobacco, alcohol, and coffee or tea can also contribute, according to Mayo Clinic.
What to do if you get black hairy tongue
Black hairy tongue isn’t usually a problem by itself, but it can signal that something else is wrong. “Prognosis is excellent with treatment of underlying conditions,” write gastroenterologists Grigoriy Gurvits and Amy Tan in the World Journal of Gastroenterology.
They note that the condition occurs more often in people with cancer and HIV than it does in the general population. COVID can also cause several different mouth-related issues, and black hairy tongue is “quite commonly demonstrated” among COVID patients, according to this paper on tongue pathologies in COVID. According to her Twitter feed, Powell did contract COVID in the weeks before her death.
All of this means that you should seek medical care if you suddenly have a black hairy tongue and don’t know why. The tongue fuzz itself is not going to hurt you, but you’ll want to make sure it isn’t a sign of something more serious. In the meantime, brushing or scraping your tongue may help with its unsightly appearance.
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