About Your Diagnosis

Leukoplakia is a term used to describe white spots that occur on the inner lining of the mouth, lips, tongue, or vaginal area. Smoking is the most common cause of leukoplakia of the mouth. Sun exposure and chronic irritation are also associated with leukoplakia. Ill–fitting dental appliances can be a source of chronic irritation. If untreated, up to 20% can become cancer. Leukoplakia is not contagious. A doctor can sometimes diagnose leukoplakia upon examination of the involved area. A biopsy (removal of a sample of involved area) is required to determine the presence or absence of cancer or precancerous lesions. In most cases, leukoplakia can be cured with treatment, but recurrences are common and require retreatment.

Living With Your Diagnosis The most common sign of leukoplakia is a small white patch inside the mouth or on the tongue or lips. The patch is slightly raised and well defined. There can be multiple patches.

Treatment A biopsy is performed by first deadening the area with an anesthetic such as lidocaine. A sharp sterile knife or biopsy tool is used to remove a sample of the leukoplakia. This is sent to a special laboratory for microscopic analysis. Subsequent treatment depends on the location and the results of the biopsy. All patients should stop smoking. Small areas of leukoplakia will sometimes disappear after you stop smoking. Complete removal of a suspicious-looking area is sometimes performed instead of biopsy at the initial visit. Electrosurgery (using an electric needle) and cryosurgery (freezing) can be used to treat small areas of leukoplakia. Beta-carotene (a form of vitamin A) and isotretinoin (Accutane) are two medications taken by mouth that can cure some types of leukoplakia. These usually have to be taken daily for up to a few months. Isotretinoin can cause birth defects and should not be taken by pregnant women. Leukoplakia of the lip and outer vaginal area can sometimes be treated with application of 5-FU (Efudex) cream, applied two times per day for 2–3 weeks. This causes redness, soreness, and inflammation and actually destroys the involved area.

The DOs
• Report any suspicious-looking or unusual areas to your doctor, including anything on the skin, inside the mouth, on the tongue, or in the vaginal area.
• Follow your doctor’s advice until the leukoplakia is completely gone.

The DON’Ts
• If you smoke, stop immediately. Smoking is the major risk factor for leukoplakia of the mouth and tongue.
• If you chew or use any tobacco products, stop immediately.
• Remove any chronic irritation caused by teeth or dentures or sharp dental appliances.

When to Call Your Doctor
• If the leukoplakia does not go away after treatment.
• If any new white patches occur.
• If any fever or bleeding occur after treatment.