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Leukoplakia Content Supplied by NHS Choices

Leukoplakia is a white patch that develops in the mouth.

The condition is usually painless, but is closely linked to an increased risk of mouth cancer.

What are the symptoms

The main feature of leukoplakia is a white patch in the mouth that can't be removed by rubbing.

A white patch most commonly occurs on the tongue but can also develop on the:

  • floor of the mouth
  • soft palate (back of the roof of the mouth)
  • inside of the cheek
  • lower lip
  • gums

There's usually only one clearly defined patch, but there can sometimes be more than one spread over a larger area.

The patch is almost always painless and may be slightly raised, with a thickened or irregular feel to it. The patch is often persistent and can't be removed by brushing or scraping. Sometimes, there's also redness around the affected area.

When should I seek medical advice

Visit your dentist if you notice a white patch in your mouth that doesn't heal within 14 days.

Leukoplakia doesn't usually cause pain or discomfort, but your dentist will be able to rule out other causes of the white patch, such as a fungal infection.

Your dentist may also be able to assess your risk of developing oral cancer in later life. As part of this risk assessment, you may have to attend regular follow-up appointments or see a specialist so that your leukoplakia can be carefully monitored.

You may be referred to a specialist for a biopsy, which involves removing a small piece of tissue from the patch. The tissue sample will be sent to a laboratory so it can be examined to see if it's potentially cancerous.

What causes leukoplakia

In a few cases, the cause of leukoplakia is unknown (idiopathic) and certain factors are thought to increase your chances of developing it.

Tobacco (smoking and chewing it) and heavy alcohol consumption are the two main risk factors for leukoplakia. This is because these substances irritate the mucous membranes (soft tissues) in your mouth.

Persistent infections caused by candida (thrush) can also lead to leukoplakia. This is known as candidal leukoplakia.

Other causes of white patches include:

  • frictional keratoses - this can be caused by misaligned teeth, ill-fitting dentures or long-term cheek biting
  • oral lichen planus - a non-infectious rash that can sometimes occur in the mouth
  • oral thrush (candidiasis) - a short-term fungal infection of the mouth
  • a vitamin A or B deficiency

Read more about the causes of leukoplakia.

Treating leukoplakia

Leukoplakia doesn't usually cause symptoms and it shouldn't affect your quality of life. However, it should be investigated.

Stopping smoking or chewing tobacco and reducing your alcohol consumption may help clear up the white patches in your mouth, as well as reducing your chances of developing mouth cancer.

If you're thought to have an increased risk of developing mouth cancer, leukoplakia can be surgically removed to ensure any abnormal cells don't later become cancerous.

Regardless of the treatment you receive, it's important to have your mouth regularly examined by a dentist or suitable specialist to ensure the condition isn't progressing.

Read more about treating leukoplakia.

Preventing leukoplakia

It's not always possible to prevent leukoplakia developing because it sometimes has no identifiable cause. This is known as idiopathic leukoplakia.

The best thing you can do is to avoid using any form of tobacco and to reduce your alcohol consumption.

A diet containing plenty of fresh fruit and vegetables may also help prevent leukoplakia and mouth cancer.

Read more about food and diet and healthy eating.

Who's affected by leukoplakia

Leukoplakia is a common condition. It's estimated that about one in 100 people will develop leukoplakia at some point in their life.

However, leukoplakia rates are higher in parts of the world such as India and Taiwan, where the use of chewing tobacco and related products, such as the areca nut (also known as the betel nut), is widespread.

Men are twice as likely as women to develop leukoplakia, and most cases affect older adults who are 50-70 years of age.

Hairy leukoplakia

Hairy leukoplakia is a type of leukoplakia that affects people with a weakened immune system (the body's natural defence against infection and illness), particularly those who have HIV.

It almost always occurs on the side (or both sides) of the tongue and doesn't cause pain or any change in your sensation of taste. It usually resolves when the immune system improves.

Hairy leukoplakia is usually caused by the Epstein-Barr virus, although antiviral medicines rarely help. Unlike other types of leukoplakia, hairy leukoplakia doesn't carry a risk of mouth cancer.

However, it should be taken as an important warning sign that your immune system may be weakened. Visit your GP or specialist as soon as possible if you develop hairy leukoplakia.

Please note that hairy leukoplakia doesn't always mean you have HIV/AIDS.

Causes of leukoplakia

In a few cases of leukoplakia, the cause is unknown (idiopathic).

Leukoplakia is most often linked to irritation of the mucous membranes (soft tissues) inside the mouth caused by the use of substances such as tobacco and alcohol.


Tobacco use is thought to significantly increase your risk of developing leukoplakia. People who smoke are considered to be more at risk of getting leukoplakia than those who don't.

The risk is higher for people who use smokeless tobacco products, such as chewing tobacco or betel nut preparations, such as paan. Studies have shown that regular users of betel nuts are 25 times more likely to develop leukoplakia than non-users.


Heavy alcohol use is also thought to significantly increase your chances of developing leukoplakia. Heavy drinkers are eight times more likely to develop leukoplakia than non-drinkers.

Heavy drinking is drinking more than the recommended daily limit for alcohol consumption, which is 3-4 units of alcohol for men and 2-3 units for women.

Binge drinking may also increase your risk of developing leukoplakia or mouth cancer.

Other possible causes of white patches

Other possible causes of white patches in the mouth that can be differentiated from leukoplakia include:

  • frictional keratoses - this can be caused by misaligned teeth (malocclusion), ill-fitting dentures or long-term cheek biting
  • oral lichen planus - a non-infectious rash that can sometimes occur in the mouth
  • oral thrush (candidiasis) - a short-term fungal infection of the mouth
  • a vitamin A or B deficiency

Oral thrush is caused by a group of yeasts called Candida. Leukoplakia associated with a candida infection is known as candidal leukoplakia.

Infection with the human papilloma virus (HPV) has also been suggested as a possible risk factor for leukoplakia. This link is currently being investigated.

Treating leukoplakia

If you're diagnosed with leukoplakia it should be treated, particularly if it's thought there's a risk it might develop into mouth cancer.

Treatment should be considered if your biopsy results indicate particularly abnormal cells.

Your mouth should be regularly checked by a dentist or specialist to make sure the leukoplakia patch isn't changing or increasing in size and any new patches are identified early.

You should also visit your dentist for regular dental check-ups if your teeth or dentures are irritating your cheeks, tongue or gums.

Stopping smoking

If you smoke or use other tobacco products, the most effective form of treatment for leukoplakia is to stop. Not using tobacco can make a leukoplakia patch gradually disappear and may also significantly reduce the risk of developing mouth cancer.

If you smoke, it's strongly recommended you stop as soon as possible. Your GP can advise you about stopping, and prescribe medication to help you quit. NHS Smokefree also provides information, support and advice about giving up.

Read more about stopping smoking and treatments for stopping smoking.

Stopping or reducing alcohol

Giving up alcohol, or reducing your alcohol consumption, may reduce the size of a leukoplakia patch or lead to it disappearing completely. As with smoking, avoiding alcohol or limiting your intake will reduce your risk of developing oral cancer.

If you don't want to stop drinking alcohol altogether, you should ensure you don't drink any more than the recommended daily limits, which are:

  • 3-4 units a day for men
  • 2-3 units a day for women

A unit of alcohol is equal to about half a pint of normal-strength lager or a pub measure (25ml) of spirits. A small (125ml) glass of wine contains about 1.5 units of alcohol.

Visit your GP if you're finding it difficult to moderate your drinking. Counselling services and medication are available to help you reduce your alcohol intake.

You can monitor your level of drinking using the NHS Drinks Tracker which you can download for free if you have an iPhone, iPad or iPod touch.

Read more about drinking and alcoholalcohol units and treatment for alcohol misuse.

Surgical treatment

Surgically removing the leukoplakia patch may reduce the risk of mouth cancer developing by removing any abnormal cells.

The leukoplakia patch can be removed using a number of different techniques, including using a scalpel, laser or freezing (cryotherapy).

The procedure is usually carried out using a local anaesthetic, although a general anaesthetic may be required if the area is large.

After the leukoplakia patch has been removed, the underlying area of tissue should heal quickly. You'll usually need to have a follow-up appointment to check the affected area.

Medical treatment

There's currently limited evidence to suggest that medical treatment is effective in treating leukoplakia.

Medications such as retinoids or substances made from vitamin A have been proposed, but these treatments can have adverse side effects, and there's no consistent evidence that they're effective.

Treatments such as radiotherapy or chemotherapy are of no benefit.

Medical treatment may be used in cases where leukoplakia is associated with an infection by a fungus called Candida. In these cases, treatment with antifungal medicines may be used to get rid of the infection within the white patches. However, this is not a specific treatment for leukoplakia.