Medically Reviewed by Jabeen Begum, MD on November 08, 2023
4 min read

Leukoplakia causes white, red, or gray patches on your tongue, the inside of your cheek, or on the floor of your mouth. It’s usually your body's reaction to irritation of your mouth tissues.

Leukoplakia can happen at any time in your life, but it's more common in older adults.

It's usually harmless, but sometimes it may lead to mouth cancer. So it's important to see your doctor for a diagnosis and proper treatment. 

Leukoplakia vs. thrush

Leukoplakia is often mistaken for thrush, but they aren't the same thing. Thrush is a fungal infection caused by candida yeast. It shows up as white spots in your mouth that can be wiped away, leaving red and sometimes bleeding areas underneath. 

There are a few types of leukoplakia:

Homogenous leukoplakia: Patches from homogenous leukoplakia are relatively even in color and texture. It usually doesn't lead to oral cancer.

Non-homogenous leukoplakia: Patches from non-homogenous leukoplakia are more oddly shaped and may be white or red, flat, or with a raised surface. This type of leukoplakia is less common and more likely to become mouth cancer than homogenous leukoplakia.

Proliferative verrucous leukoplakia (PVL): Patches from PVL are small and white. These patches may grow quickly and have a bumpy or lumpy surface. Research shows that this type of leukoplakia may become oral cancer in more than 60% of people who have it. 

Hairy leukoplakia is another form of the condition in which patches look white and fuzzy. It's caused by the Epstein-Barr virus and usually affects people who have a weakened immune system, such as those with HIV or AIDS. It's normally painless and noncancerous. 

Leukoplakia patches on your tongue, gums, roof of your mouth, or the inside of your cheeks may be:

  • White, gray, or red
  • Regularly or oddly shaped
  • Thick and flat or slightly raised
  • Smooth, rough, fuzzy, or ridged

The patches can't be wiped away, and they may change slowly over weeks to months. They’re usually painless, but they may be sensitive to touch, heat, spicy foods, or other irritation.

Causes of leukoplakia include:

  • Irritation from rough teeth, fillings, crowns, or dentures that don't fit well and rub against your cheek or gum
  • Smoking or using chewing tobacco regularly
  • Long-term, heavy alcohol use
  • Changes in your genes that cause mouth cells to grow faster than usual
  • A weakened immune system, often from HIV or AIDS
  • The Epstein-Barr virus, in the case of hairy leukoplakia

You're more likely to get leukoplakia if you:

  • Regularly drink a lot of alcohol
  • Smoke or chew tobacco
  • Have a weakened immune system

Your doctor or dentist will look at your mouth and try to figure out what's causing your symptoms. If they think it might be leukoplakia, they may take a sample of your mouth tissue for testing in what's called a biopsy. This can tell if you have early signs of mouth cancer. There are two methods:

Oral brush biopsy: In this noninvasive procedure, the doctor removes cells from patches with a spinning brush.

Excisional biopsy: Part of a patch or a whole patch may be removed with surgery. 

Excisional biopsies are usually more accurate than oral brush biopsies. In both cases, your doctor will send the sample to a lab for testing. 


Removing the source of irritation that's causing leukoplakia is often enough to make it go away. For example, if a rough tooth or an irregular surface on a denture or a filling is rubbing the inside of your mouth, the tooth will be smoothed and dental appliances repaired. If leukoplakia is caused by smoking, cutting back or stopping smoking or using other tobacco products can help.

Leukoplakia is usually harmless, and patches often clear in a few weeks or months after the source of irritation is removed. If that doesn't work, the lesion may need to be removed with a scalpel, laser, or by freezing.

Hairy leukoplakia usually doesn't need any special treatment. But since it's a sign that your immune system may not be working well, your doctor may look for ways to boost your immune system. Sometimes, they might give you an antiviral drug. 

Leukoplakia doesn't usually cause any long-term damage to the tissues in your mouth, but it can come back after you've had the patches removed. 

It also makes you more likely to get mouth cancer, even after treatment.


The best way to prevent leukoplakia is to avoid the things that may cause it. Look out for anything that can irritate or damage the tissues of your mouth, and take good care of your teeth and gums. Try these tips:

  • Stop smoking or chewing tobacco.
  • Avoid other smoked or inhaled things like cannabis, resin, and cloves.
  • Limit your alcohol.
  • See your doctor and dentist for regular checkups.
  • Don't use harsh teeth whiteners or mouth rinses.
  • Let your dentist know right away if you feel any discomfort from fillings, crowns, braces, or dentures.
  • Avoid very hot drinks.
  • Avoid hard candies or other foods that might have sharp edges.
  • Eat a healthy diet with lots of fruits and vegetables.

See your dentist or doctor if you have:

  • White patches or sores in your mouth that don’t go away in 2 weeks
  • Lumps or white, red, or darkened patches
  • Changes in your mouth tissue
  • Ear pain when you swallow
  • Trouble opening your jaw