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Common Tongue Conditions in People With HIV

by Carley Millhone
July 6, 2025
in Health
Reading Time: 7 mins read
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Mouth and tongue lesions are sometimes one of many first signs of human immunodeficiency virus (HIV). HIV weakens your immune system, which might depart you inclined to sores and infections.

If left untreated, oral well being points could cause ache and different well being problems.

frank600 / Getty Photos


Aphthous ulcers are small, yellow or grey sores with a purple border. They normally seem on the tongue, cheeks, or contained in the lips. Mouth ulcers could make speaking and consuming painful, particularly in the event that they’re situated underneath the tongue.

Mouth ulcers are sometimes a symptom of a weak immune system and stress. An estimated 50% of individuals with HIV expertise mouth and tongue ulcers due to their weakened immune methods. Dry mouth attributable to HIV and HIV drugs may improve your threat of mouth sores.

Sores will finally heal on their very own. Delicate ulcers may be handled with over-the-counter (OTC) numbing lotions that assist relieve ache and promote therapeutic. Extra extreme sores are handled with prescription corticosteroid mouthwashes or drugs.

Tunatura / Getty Photos


Oral thrush is a sort of yeast an infection that causes patches of creamy white or yellow bumps that coat the tongue. These patches may be painless, or they could burn and bleed. Oral thrush may have an effect on the tonsils, throat, cheeks, gums, and roof of the mouth. 

Oral thrush is the most typical mouth an infection that impacts individuals dwelling with HIV. It is regular for yeast (a sort of fungus) to dwell in your mouth. Nonetheless, in case you have a weakened immune system on account of HIV, it is simpler for this fungus to develop an excessive amount of, resulting in an infection. As a result of saliva within the mouth has antibodies to battle infections, HIV-related dry mouth additionally will increase your threat of oral thrush.

Prescription antifungal lozenges, drugs, or mouthwashes can deal with oral thrush. Nonetheless, oral thrush usually returns in case your immune system is simply too weak.

Oral bushy leukoplakia (OHL).
Picture Credit score: U.S. Facilities for Illness Management and Prevention

Oral bushy leukoplakia (OHL) causes white, hair-like patches on the edges of the tongue. It will probably additionally seem on the insides of the cheeks and decrease lip. These patches may be painless or trigger gentle ache. In additional extreme circumstances, you could lose your sense of style and expertise cold and hot sensitivity.

Individuals with Epstein-Barr virus (EBV)—a standard herpes virus—can develop oral bushy leukoplakia. EBV usually infects individuals with extraordinarily weak immune methods, particularly these with HIV. EBV infections are additionally extra frequent in individuals with untreated HIV.

Oral bushy leukoplakia patches usually go away randomly, however there isn’t a remedy for the underlying Epstein-Barr virus. Therapy for OHL might embody prescription anti-retroviral drugs to assist cut back patches and decrease EBV in your physique. Topical options, like podophyllin resin and retinoids, can be utilized to the tongue to take away patches. 

ardasavasciogullari / Getty Photos


Herpes simplex virus sort 1 (HSV-1) could cause swollen, painful sores and blisters on the tongue. Blisters are additionally frequent on the lips and the roof of the mouth. Herpes blisters begin as small clusters of white or yellow fluid-filled bumps that finally burst into one bigger purple sore. 

Oral herpes impacts practically 20% of individuals with HIV. Dwelling with a weak immune system will increase your threat of getting extra oral herpes outbreaks, which might additionally unfold extra simply.

Herpes sores are very contagious and might unfold from kissing or sharing utensils. There is no such thing as a remedy for oral herpes, however prescription antivirals may help cut back therapeutic time and future outbreaks.

Sol Silverman, Jr., DDS / CDC


Oral warts appear to be small, exhausting, skin-colored bumps or flat, white growths that resemble cauliflower. These painless warts usually seem on the tongue, lips, and within the mouth. On the tongue, warts normally look grey or white and develop on the edges of the tongue or the lingual frenulum (the fold beneath your tongue).

Oral warts are attributable to totally different strains of the human papillomavirus (HPV). Individuals with HIV usually tend to get HPV infections and oral warts due to their weakened immune system.

People who find themselves growing older with HIV or are doing extremely lively antiretroviral remedy (HAART) are additionally at an elevated threat of oral warts. Oral warts may be eliminated surgically or frozen off with cryosurgery. Nonetheless, warts can come again. 

MSC / Getty Photos


Oral melanin hyperpigmentation appears like flat, brown patches on the tongue, lips, gums, cheeks, or roof of the mouth. This discoloration is attributable to elevated melanin (pores and skin pigment) within the mouth.

You probably have HIV, the antiretroviral remedy (ART) treatment Retrovir (zidovudine), also called AZT, could cause oral hyperpigmentation as a facet impact. HIV-related oral hyperpigmentation does not normally trigger issues or require remedy. Nonetheless, for those who’re nervous in regards to the look of hyperpigmentation, speak together with your healthcare supplier. You could possibly swap to a special ART treatment.

Sustaining good oral hygiene may help forestall HIV tongue and mouth circumstances. Some dentist-approved suggestions embody:

  • Hold your mouth clear: Brush your tooth for 2 minutes and floss twice day by day to take away meals, plaque, and dangerous micro organism in your mouth. 
  • Go to your dentist often: See your dentist at the very least each six months for cleanings. If you do not have a dentist, ask your healthcare supplier or clinic for a referral. 
  • Take your HIV treatment: It is vital to take antiretroviral remedy drugs as directed and on schedule to cut back HIV in your physique and assist your immune system recuperate.
  • Keep away from dry mouth triggers: Restrict issues that may result in dry mouth, like smoking tobacco, consuming alcohol, and consuming salty meals.
  • Keep hydrated: Drink water usually, use a humidifier at bedtime, and think about using toothpaste or mouthwash designed to assist dry mouth.

You probably have HIV, it is vital to see your supplier for those who expertise any modifications in your mouth or tongue. Mouth sores, dry mouth, and oral infections are sometimes indicators that HIV is progressing and the immune system is turning into weaker. Some HIV drugs may make dry mouth worse, so your supplier might advocate a special remedy.

If left untreated, oral well being problems make you extra inclined to bacterial infections and septicemia (blood poisoning), which may be deadly with a weakened immune system. HIV-related tongue ulcers and dry mouth could cause ache that makes it exhausting to speak, chew, and swallow. Tongue lesions may put on down style buds and trigger lack of style.

Different warning indicators of HIV development that warrant a medical go to embody:

  • Fatigue
  • Fever
  • Chills
  • Sore throat
  • Mouth ulcers
  • Rash
  • Muscle aches
  • Swollen lymph nodes
  • Evening sweats

The HIV Providers Locator is a useful device to search out certified healthcare suppliers in your space.

Individuals with HIV usually tend to have ulcers, oral thrush, darkish spots, herpes, and warts that have an effect on the tongue and mouth. As a result of HIV weakens your immune system and might trigger dry mouth, oral well being circumstances are frequent.

Working towards good oral hygiene, taking your HIV drugs, and visiting your dentist often are important to assist forestall problems. 



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Tags: CommonConditionsHIVpeopleTongue
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