Black Spots on Tongue Causes, Small, under Tongue, on Tip, Side of Tongue

by Annie Shuler

Why do I have black spots on my tongue? What do these black spots on my tongue mean? If you have dark or black dots, patches, marks or spots on tongue, they could indicate a number of things. Discover the cause of these spots on your tongue including those on the tip, side and under your tongue.

Black spots on tongue refer to small, tiny or little black or dark dots on your tongue that could be on your entire tongue surface, on the tip of your tongue, side or under your tongue. They could be in babies (infants or children) as well as adults. They vary the intensity with some so dark while others might have a lighter pigmentation i.e. grey or light grey.

These darks spots or dots could patchy often beginning from the sides of the tongue towards the center and in some cases be bumpy (slightly raised up) and they could also be on your lips and other parts of your mouth and face i.e. black spots on tongue and lips. It is also normal to have just one black spot on tongue since these spots are caused by a number of things.

You might be having permanent dark marks or spots i.e. dark spots on the tongue that won’t go away, those that come once and disappear or those that keep on coming and disappearing after some time (a few days, weeks or months). In rare instances, the black spots on tongue hurt (are painful or cause discomfort). This could be an indication they are caused by some sort of infection including tongue cancer (oral cancer).

What does it mean to have a black tongue

Having a dark mark on the tongue might mean any of the causes we have discussed above. Some people are superstitious about it and have attributed some explanations i.e. there are many black spots on tongue superstitions and myths you might have heard of such as good or back luck, bad omen, being under a spell, curse, etc. For instance, in India, it is believed that if you have a little or tinny spots on your tongue, whatever you say shall come to pass someday. These are just superstitions and myths.

What causes black spots on the tongue or why do I have black spots on my tongue?

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If you have black spots on the tongue, whether it is just one black spot on your tongue, they are many, small or big, you will be concerned on what could be causing them. You need not worry since many things could have caused them and most of the causes of these black marks or dots on your tongue are harmless. So, why do you have black spots on your tongue or what are their causes in humans?

Hyperpigmentation

This occurs when you have excessive or too many pigments i.e. melanin. Pigments are what give your skin, eyes and hair their color. If you have much of them on your tongue, you might end up having a harmless black spotted tongue. Tongue hyperpigmentation is caused by pigmented cells called melanocytes.

At times, you could be suffering from melanoma, a cancer type that is formed from pigment cells. Melanoma is commonly caused by UV radiation from sunlight. The risk is more on people who are 40 years old, especially women. Most of the melanoma is black or brown but they could be dark-colored, pink, red or purple.

Some people might find such a tongue unattractive and want to remove the dark spots. Laser surgery could be of help. Furthermore, a number of home remedies such as potato juice, lemon juice, aloe vera, rosehip oil and cucumber juice can help lighten any darkened skin including your tongue.

Going for products that have hydroquinone, soy milk, cucumber, calcium, azelaic acid, or kojic acid reduces melanin production. See a dermatologist for further advice.

Dark spots on the tongue during pregnancy in a woman

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In some instances, you might have black spots on the tongue during pregnancy or when using some contraceptives. Contraceptives and pregnancy can cause hormonal changes that influence the endocrine system and thus discoloration and hyperpigmentation might occur.

Oral fibroma

This is a common oral benign tumor characterized by dome or polyp shape i.e. a round, smooth, firm lump attached at its base or by a stalk to part of the oral cavity tissue and it is similar to freckles and moles on the skin and it could be dark-colored. It can be caused by a number of things, one of them being constant irritation from your teeth, piercings or dental appliances.

To treat fibroma, you need to undergo surgical excision. However, surgical procedures do not guarantee you that they will not appear again. Do not ignore them since they can grow and pose oral issues. Furthermore, avoid tongue injuries especially re-injuring the area where a fibroma was removed since it can encourage it to grow again.

Black spots on the tongue from oral cancer

Although very rare, it is possible to have black spots on your tongue due to oral cancer. When caused by cancer, you will tend to have other oral cancer symptoms such as a chronic sore throat, hoarseness of voice, swallowing, speaking and jaw movement difficulties, sores on your neck, mouth, and face that bleed easily among many other symptoms.

This is one of the rare side effects of oral cancer. You should not panic if you have a black-spotted tongue. Oral cancer treatment includes chemotherapy, radiations to destroy cancerous cells as well as surgical operations to remove any cancerous cells.

Tongue piercing

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If you have tongue piercings, they could be behind the small black marks on your tongue. Sometimes, the area where you had a piercing might lose its pigmentation leaving some dark spots or patches. The black marks near a tongue piercing are not only caused by the bruising during the piercing process but also by studs and jewelry you wear.

Treat any tongue piercing infection early enough, follow aftercare procedure, go for titanium or gold jewelry (they cause less allergic reactions) and avoid playing with your piercing.

Hairy black tongue

Excessive use of antibiotics, soft diets, poor oral hygiene, drinking and smoking tobacco can lead to hair-like black spots on your tongue i.e. a hairy tongue due to elongated and irritated papillae. These black clusters are caused by the growth of fungi on your tongue and it will disappear on its own if you stopped drinking and/or smoking. Poor hygiene has also been attributed to this problem among other causes.

The use of breath mints and mouthwashes at times might make the black or dark spots to turn white or pink. Do not be surprised if this occurs. Furthermore, when you have a hairy tongue, there is a likelihood of suffering from oral Candida Albicans or oral thrush infection.

Antifungals and some home remedies are known to cure black spots on the tongue due to fungal growths. Ensure you get the right diagnosis and change your hobbies such as tobacco chewing and smoking, alcohol consumption as well as poor oral hygiene.

Tongue injury and trauma

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Tongue injuries are a possible cause of black patches on your tongue especially if the injury causes sores. For instance, you could end up with bumps and black spots on the tongue from biting or after biting your tongue as well as from other tongue injuries including those that are caused by dental appliances, piercings, etc.

Allergic reactions and exposure to some chemicals

Exposure to some chemicals such as bismuth including Pepto-Bismol chewable tablets can make your entire tongue to be black or cause black patches on your tongue. Furthermore, allergic reactions to some allergens such as medications might cause a stained tongue.

To deal with this problem, avoid getting contact with allergens, use antihistamines and go for further treatment in case the problem persists.

Chemotherapy

Some cancer patient has noted black spots on the tongue during chemotherapy. This often occurs with nail pigmentation too. Although the problem does not happen to everyone, it is possible to have dark spots on the tongue after or during chemotherapy.

Being anemic

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Anemia is a possible cause of back tongue spots. Many patients have reported this problem. The spots could be clustered or scattered on the tongue. However, a pale tongue is a more common symptom of anemia.

STD and HIV

Sexually transmitted diseases such as HIV and genital warts are known to cause some blemishes on tongue especially white spots (rarely black spots) sores on tongue, mouth, lips among other parts of the body. Before you conclude that your dark marks on the tongue are related to STDS or HIV, you should be having other symptoms that might make you settle for such a conclusion.

Other causes of dark spots on the tongue

Besides the above causes, this condition could be hereditary, caused by bacteria overgrowth, Laugier-Hunziker syndrome, Peutz-Jeghers syndrome, Adrenocortical insufficiency, poor oral hygiene or dilated blood vessels especially on the under tongue among many other causes.

The black spot under the tongue

Black spots under tongue can be caused by various things including those we have already mentioned such as oral cancer, tobacco chewing, excessive smoking and drinking, bacterial overgrowth, piercing, injuries such as tongue biting, melanoma, hyperpigmentation, among many causes. In older people, this problem could be caused by dilated blood vessels especially if it appears black-blue in color.

The black dots under tongue could also vary in size with some small (tiny) while others might be bigger. They could also be on other parts of your body including your cheeks. It is possible to have a single spot too. See the picture or image for a clear visual impression of what they look like.

Black tongue in babies (infants and children)

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in babies, infants or children, a black-spotted tongue could be due to allergic reactions, oral thrush (usually white but can also be black), debris build-up due to breastfeeding, antibiotic therapies (if hairy and black), among other causes

Black spots on side of tongue

Sometimes, the dark marks on the tongue appear on the side of your tongue. They could be small, bigger, on one side (e.g. left or right side) or both sides. Dental issues and appliances are the most common causes of dark spots on the side of the tongue. In addition, this problem could be caused by many other causes such as adrenocortical insufficiency, malignant melanoma if they keep on growing in size, smoking, drinking, tobacco chewing, etc.

Small black spot on the tongue (little, Tiny)

There are no specific causes of small, little or tiny spots on tongue on a human being. These tiny black dots caused by the same reasons we have already discussed. Generally, they are painful and harmless. However, in some cases, especially when related to some diseases and conditions, they could hurt.

Black spots on tip of the tongue

If you have patchy, tinny, little or small spots on tip of the tongue, they too could be caused by a number of things especially hyperpigmentation, smoking, acid reflux, poor oral hygiene, the tip of the tongue piercing, dental appliances among other causes. You will notice this problem for both adults and children.

Treatment and cure of dark spots on the tongue

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If you notice some serious symptoms alongside a dark spot on the tongue, you need to get checked especially for cancer since early treatment such as early chemotherapy, surgery and radiation can resolve the problem. Any temporary black spots on the tongue should be removed with normal oral care routine especially those caused by chemical exposures. Some foods such as coffee, licorice, tea can cause temporary darkening of the tongue.

Ensure proper oral hygiene such as gently brushing your tongue twice with a soft brush to remove any buildups on your tongue that can cause a black tongue. Eat a healthy and balanced diet full of roughages, vegetables and fruits.

Finally, suck small pieces of pineapple and keep them on your tongue base for about 40 seconds before chewing them for 8 minutes will help fade any dark spots on your tongue. Do this twice a day for a duration of about two weeks.

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