What Causes Dark Spots On The Tongue?

Reasons For Dark Spots On The Tongue

The tongue is a small yet mighty muscular organ. It helps you swallow, chew, and talk. You wouldn’t be able to enjoy all the tasty food you eat without it! But if you find small dark spots on your tongue, you’re likely to freak out. They can show up on the tip, underneath, or along the sides of your tongue. The spots might vary in color, ranging from purple to black.

Wondering what business they have on a pink tongue? The potential reasons vary in severity. To be safe, always visit your doctor to rule out serious diseases.


1. Skin Hyperpigmentation

Excess melanin production can cause dark spots on the tongue

Hyperpigmentation occurs when the body makes excess melanin. In most cases, this is absolutely harmless. It’s common in dark-skinned individuals, affecting 30% of African American women and 25% of African American men.1


Don’t forget that the oral cavity is made of tissue, and it’s colored with melanin. If there’s too much tissue, black, gray, blue, or brown spots can show up in the mouth or skin.2

2. Medicines

Antibiotics, antifungals, and birth control can result in dark spots on the tongue


Are you on a new drug? Hyperpigmentation is a possible side effect. Antibiotics, antifungals, birth control, hormones, and chemotherapy can all bring on dark spots. The roof of the mouth and gums are usually affected, but watch out for changes on the tongue, too.3

3. Pregnancy

Dark spots on the tongue can be caused by hormonal changes during pregnancy


During pregnancy, hormonal changes may cause hyperpigmentation. It’s most common on the upper lip, cheeks, and forehead. The tongue might develop discoloration, too.4

4. Tobacco

Chewing tobacco and smoking cigarettes can increase the possibility of oral dark spots


Smoking cigarettes and chewing tobacco are likely to bring on oral dark spots. The chemicals in cigarettes and tobacco can enhance the number and activity of melanin-producing cells in the mouth.

According to a 2015 study, this affects 1 in 5 smokers. It’s even more common in women on birth control or hormone replacement therapy.5


5. Heavy Metal Poisoning

Dark spots on your tongue could be the result of heavy metal poisoning

If your blood has a high level of heavy metals, oral discoloration is possible. Examples include lead, mercury, arsenic, gold, and silver. In adults, heavy metal vapors are the most common offender. Be extra careful if you use these at work.6


6. Addison’s Disease

Dark spots on the tongue are a major symptom of Addison’s disease

Oral hyperpigmentation is a major symptom of Addison’s disease, a condition where the adrenal gland doesn’t make enough hormones. Up to 92% of Addison’s patients experience oral hyperpigmentation.

The most common cause is autoimmune adrenalitis, or destruction of the adrenal glands by the body’s immune system. Certain proteins are overproduced and result in hyperpigmentation on the tongue, gums, hard palate, and inside of the cheeks. As a result, you may develop blue-black or brown streaks or spots.7

7. Tuberculosis

Tuberculosis damages the adrenal glands and causes dark spots on the tongue

Tuberculosis can also damage the adrenal glands. It’s a severe, contagious bacterial infection that mostly affects the lungs.8 Less than 20% of Addison’s cases are actually caused by tuberculosis. Luckily, as the infection improves, so do Addison’s symptoms like dark spots.9

How To Get Rid Of Dark Spots

Most dark spots on the tongue aren’t dangerous. However, remedies will depend on the cause. Here are a few simple steps to steer clear of dark spots.

  • Practice good oral hygiene.
  • Drink lots of water.
  • Limit or quit using tobacco.
  • Request a different medicine if the prescribed medicines are causing hyperpigmentation.
  • Take prescription drugs as directed.

Don’t ignore dark spots that are inflamed, bleeding, or painful. Talk to your doctor if you’re dealing with a serious condition. If the spots come and go, take a photo so your doctor can check them out.