Leukoplakia Home A-Z Health Information Health Library A-Z Leukoplakia Overview Leukoplakia refers to the growth of white patches or plaques that develop on the mucous membranes inside the oral cavity, including the tongue, cheeks, and gums. The patches are often thickened, and they typically cannot be wiped off, a feature that distinguishes them from other types of white lesions in the mouth, such as those caused by oral thrush. Leukoplakia is considered a precancerous condition as leukoplakia lesions have the potential to develop into oral cancer; however, not all lesions become cancerous. Causes and risk factors Tobacco use: Smoking (even smokeless tobacco) is the most well-known risk factor for leukoplakia. Constant irritation caused by tobacco products can lead to the formation of these white patches.Alcohol consumption: Heavy drinking, especially in combination with tobacco use, increases the risk of leukoplakia and may also increase the risk of malignant transformation.Chronic irritation or trauma: Regular irritation from ill-fitting dentures, sharp edges of teeth, or other mechanical factors can contribute to the development of leukoplakia.Human papillomavirus (HPV): Some studies suggest that certain strains of the human papillomavirus (HPV), especially HPV-16, may be involved in leukoplakia development, particularly in the context of oral cancers.Weakened immune system: Conditions like HIV/AIDS or immunosuppressive treatments (e.g., chemotherapy, organ transplant drugs) can increase susceptibility to leukoplakia.Nutritional deficiencies: Deficiencies of vitamins, particularly vitamin A and B12, may contribute to leukoplakia.Age and gender: Leukoplakia is more common in the elderly or middle-aged individuals. Further, men are at a higher risk of being affected by this condition than women.Other factors: Certain chronic conditions, such as lichen planus (a disease that affects the skin and mucous membranes), can also predispose individuals to leukoplakia. Symptoms White patches: The hallmark of leukoplakia is the appearance of thick, white or greyish patches in the mouth. These patches may be slightly raised or flat and cannot be wiped away.Rough texture: These patches are often thick and rough in texture. They may be irregular in shape.Burning sensation: Though most people with leukoplakia do not experience pain or other symptoms, some individuals may feel a burning sensation or discomfort.Ulceration: In some cases, leukoplakia patches may appear red, ulcerated, or indurated (hardened), which may suggest dysplasia (abnormal cell growth) or early stages of cancer. Diagnosis Visual examination: The mouth and the lesions are visually inspected to look for signs, such as changes in texture, size, or colour, which may indicate more severe issues.Biopsy: This may be recommended for persistent or suspicious lesions to determine whether the lesion/patch is dysplastic (associated with abnormal cell growth) or cancerous.Other tests: Depending on the clinical presentation, i.e., the features and duration of lesion presentation, additional tests (e.g., imaging or HPV testing) may be recommended. Treatment Treatment for leukoplakia is usually focused on addressing the underlying causes, managing symptoms, and monitoring the condition for signs of malignant transformation.Eliminating irritation:Abstinence from smoking and alcohol: One of the most important steps is to quit tobacco use and reduce alcohol consumption, as both are major risk factors for leukoplakia and oral cancer.Address chronic irritation: If ill-fitting dentures, rough dental fillings, or sharp teeth are causing the irritation, they should be adjusted or repaired.Surgical treatment:Surgical removal of lesions: In some cases, particularly if the leukoplakia lesions are large, persistent, or show signs of dysplasia, surgical removal may be necessary.Medications:Topical steroids: In cases where there is significant inflammation or discomfort, topical steroids (like corticosteroid ointments) may be prescribed to reduce irritation and inflammation.Cryotherapy: This technique can be used to remove the patches; it involves freezing the leukoplakia lesion(s) with liquid nitrogen.Laser treatment: Lasers can be used to remove the patches or reduce the size of the lesions, especially in cases of localised leukoplakia.Nutrient supplementation: If leukoplakia is linked to a deficiency (e.g., vitamin A or B12), nutritional supplementation may be recommended. When to see a doctor Consult a healthcare professional, preferably a dentist if you notice any white patches, unusual growth(s), or persistent sores in your mouth. Prevention Quit smoking and tobacco use: This is most effective for reducing leukoplakia risk.Limiting alcohol consumption: This can also decrease the risk of leukoplakia, especially when combined with cessation of smoking.Regular dental checkups: These can help detect early signs of leukoplakia and other oral conditions.Healthy diet: This may help decrease leukoplakia risk, particularly if nutritional deficiencies are a contributing factor.