Why Do You Have a Yellow Tongue?

Medically reviewed by Edmund Khoo, DDS

There are several reasons why your tongue may be yellow. While the appearance may be distressing, the most common cause is thankfully fairly harmless. Yellow tongue is often caused by an accumulation of bacteria, debris, or yeast on the little bumps (papillae) that cover your tongue.

Besides bacterial or yeast buildup, other causes of yellow tongue may include gastritis, jaundice, or diabetes. Knowing the potential causes of your yellow tongue can help you get the diagnosis and treatment you may need.

What Causes Yellow Tongue?

Several conditions can cause your tongue to turn yellow. The shade of yellow can vary, with the yellow possibly being light in color. Besides a change in tongue color, you might experience other symptoms with each cause.

Hairy Tongue Syndrome

Hairy tongue syndrome is the most common cause of a yellow tongue. Hairy tongue syndrome is a condition characterized by bacterial overgrowth on the papillae, which are the little bumps that cover your tongue. Dead skin, debris, food, and yeast (thrush) may also accumulate on the tongue. The overgrowth of substances on the tongue's bumps can cause the tongue to look discolored.

The color your tongue turns depends on what substance is on the bumps. Besides yellow, hairy tongue syndrome can make the tongue appear black, brown, white, green, or pink.

The condition gets its name because, in many cases, you will notice the tongue has a hairy appearance.

Hairy tongue syndrome is thought to be triggered by poor oral hygiene, the intake of large amounts of coffee or tea, cigarette smoking, radiation treatment to the head and neck area, and prolonged antibiotic use. Besides antibiotics, the anticholinergic class of drugs used to treat many conditions, including cardiovascular disease and urinary incontinence, have been associated with hairy tongue syndrome.

Gastritis

A yellow tongue may be a sign of gastritis. Gastritis is the medical term for inflammation of your stomach lining. The inflammation can be caused by several factors, including infection with Helicobacter pylori bacteria and autoimmune issues.

Of all the causes of gastritis, H. pylori is most closely linked with a yellow tongue. People with gastritis associated with H. pylori infections in particular may have a tongue that looks like it has a yellowish, thick, greasy coating.

Other symptoms of gastritis include stomach pain, indigestion, bloating, nausea, and vomiting.

Diabetes

Some research has shown that there could be a connection between type 2 diabetes and the development of a yellow tongue. A 2018 study conducted in Japan showed higher rates of yellow tongue among people with diabetes—especially men and people who were older—compared to people without diabetes. A yellow tongue was also more common among people with prediabetes.

Other research has shown there to be a connection between a tongue that appears to have yellow fur and type 2 diabetes.

More research is needed into the connection and to see whether yellow tongue can be a predictor of diabetes.

COVID-19

A 2022 study found that COVID-19 often causes symptoms on the tongue, including causing the tongue to look like it has a yellow coating.

COVID-19 may also cause the tongue to look red or purple or as though it has a white or gray-black coating. The tongue may also look greasy and have a rough, cracker, spotty, inflamed appearance.

The researchers believe tongue changes caused by COVID-19 may be because of a hyper-inflammatory response to the infection.

Poor oral hygiene and medication side effects may also contribute to a yellow tongue if you have COVID-19.

Oral Psoriasis

Psoriasis is an autoimmune condition that causes skin cells to multiple too quickly. It most commonly affects the skin around the elbows, scalp, knees, fingernails, and toenails, causing scaly, irritated patches.

Less commonly, psoriasis affects the mouth. When this happens, it’s known as oral psoriasis. If you have oral psoriasis, you may notice yellow, white, or gray lesions on your tongue. You might also experience overall oral inflammation, discomfort, and pain.

Jaundice

A less common cause of a yellow tongue is jaundice. Jaundice is the yellowing of your skin and the whites of your eye. Sometimes jaundice affects the tissues in your oral cavity, as well as your tongue.

You can develop jaundice when there's an excessive amount of bilirubin that builds up in the bloodstream. This can happen if your liver is damaged and the organ cannot release bilirubin through bile. Instead, the excess bilirubin can make its way into your blood and cause the yellowing.

Besides yellowing of your tongue, eyes, and skin, jaundice may cause dark or brown-colored urine, pale or clay-colored stools, and itchy skin (pruritus).

Treatments for Yellow Tongue

The treatments for a yellow tongue depend on the cause. For example, if your yellow tongue is being caused by an underlying condition, like gastritis, diabetes, jaundice, COVID-19, or psoriasis, treating the root cause will usually clear up your yellow tongue. If you are taking a medication that is causing yellow tongue, weaning off the medication or switching to a different medication will generally fix the issue.

If your yellow tongue is related to hairy tongue syndrome, there are some simple oral hygiene measures you can take to reduce symptoms. These include brushing and flossing daily, using a toothbrush or a tongue scraper to remove the buildup on your tongue, and keeping up with regular dental appointments.

How To Prevent a Yellow Tongue

Yellow tongue can’t always be prevented, but managing the cause of your yellow tongue can decrease the chances of it recurring or occurring in the first place. Your healthcare provider can discuss what measures to take to manage your symptoms, based on what’s causing your yellow tongue.

Yellow tongue caused by hairy tongue syndrome can be prevented with oral hygiene practices, which includes cleaning the surface of your tongue each time you brush your teeth.

Lifestyle changes may also help prevent hairy tongue syndrome. These may include:

• Stopping smoking

• Drinking less coffee and tea

• Drinking less alcohol

• Treating dry mouth

• Eating soft foods
  

When To See a Healthcare Provider

Although most cases of yellow tongue aren’t serious, a yellow tongue is not considered typical. Consider seeing a healthcare provider if you notice your tongue has turned yellow or has become discolored in any other way. The provider can determine what may be causing your yellow tongue or if it could be a sign of a chronic condition that has not yet been diagnosed. In doing so, they can also determine whether the underlying cause needs treatment.

A Quick Review

A yellow tongue usually occurs as part of hairy tongue syndrome, which is when bacteria or other debris accumulate on the papillae of your tongue. But a yellow tongue can also develop as a result of medications like antibiotics as well as certain underlying medical conditions, such as gastritis, diabetes, jaundice, psoriasis, and COVID-19. If you notice that the appearance of your tongue has changed, consider seeing a healthcare provider to determine whether any treatment may be necessary.

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